DEPARTMENT OF HEALTH & HUMAN SERVICES ADMINISTRATION FOR CHILDREN AND FAMILIES Mary E. Switzer Building 330 C ST, S.W. Washington, D.C. 20201 Case No: 18-F-0029 Civil Action 18-cv-0248 July 30, 2018 Ms. Katie O’Connor Legal Counsel Campaign for Accountability 611 Pennsylvania Avenue, SE, #337 Washington, D.C. 20003 Dear Ms. O’Connor: This is the first interim response of the Administration for Children and Families to Ms. Katie O’Connor’s October 27 2017, Freedom of Information Act (FOIA) request for records related to services for pregnant unaccompanied immigrant minors. Specifically, Ms. O’Connor sought the following items: 1. All records related to Office of Refugee Resettlement (“ORR”) policy regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. This request includes memoranda, directives, policy statements, policy interpretations, policy guidance, talking points, and other similar documents reflecting ORR policy. 2. All records related to ORR Director Scott Lloyd’s visits to ORR grantee shelters that house unaccompanied immigrant minors. This request includes calendar entries, travel and accommodation requests and approvals, itineraries, briefing memoranda, and meeting notes. 3. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and representatives of the Susan B. Anthony List, Concerned Women for America, the Heritage Foundation, the Center for Family and Human Rights (“C-Fam”), National Right to Life, Alliance Defending Freedom, Legal Works Apostolate, or the Knights of Columbus regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. This request includes communications to or from anyone using email addresses from the following domains: a. @sba-list.org b. @cwfa.org c. @heritage.org d. @c-fam.org e. @nrlc.org f. @adflegal.org Case No. 18-F-0029 Civil Action 18-cv-0248 Page 2 of 3 g. @legalworks.com h. @kofc.org 4. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and representatives of the White House regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. 5. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and members and staff of the U.S. Congress regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. Your request was sent to the Office of Refugee Resettlement (ORR) and the Office of the Chief Information Officer for a search for responsive records. Please find enclosed 360 pages of responsive records responsive in full to item #2 above. Some of the information on the enclosed pages has been withheld under the FOIA exemptions (b)(4), (b)(5), (b)(6), (b)(7)(A), (b)(7)(C), (b)(7)(D) and (b)(7)(F). Exemption (b)(4) of the FOIA protects trade secrets and commercial or financial information obtained from a person that is privileged or confidential, and is exemption is intended to protect the interests of both the government and submitters of information. In this case, the withheld information consists of business information such as hotel and rental car confirmation numbers. Disclosure of such numbers could allow their use for fraudulent purposes. The exemption (b)(5) protects inter-agency or intra-agency memorandums or letters which would not be available by law to a party other than an agency in litigation with the agency. The exemption protects agency deliberations, both internal and with agency contractors and consultants, attorneyclient privileged records and attorney work product. In this case, the withheld information includes predecisional discussions within the agency and between agency staff and contractors about management of ORR programs and/or individual children and sensitive communications between agency staff seeking legal advice and counsel on policy and other matters. The FOIA exemption (b)(6) permits the withholding of records which, if released, would constitute a clearly unwarranted invasion of personal privacy. In this case, the withheld information consists of the names, identity and/or other private information of private individuals and/or the identities of federal employees in sensitive positions and the work cell phones of federal employees. The withheld information also includes the locations of shelters housing vulnerable unaccompanied children and refugee centers. Public disclosure of this information would constitute an invasion of privacy of those individuals whose identifying information was disclosed. In particular, disclosing the locations of shelters subject the children to unwanted publicity and harassment. In withholding the information, the individual’s privacy interest was balanced against any public interest in disclosure. In each instance where information was withheld, it was determined that the individual’s privacy interests outweighed any public interest in disclosure of the withheld information. Disclosure of the withheld information AMERICAN PVERSIGHT Case No. 18-F-0029 Civil Action 18-cv-0248 Page 3 of 3 would invade the privacy of the subject individuals but would reveal nothing about the operations or activities of the government. Similarly, Exemption 7(C) provides protection for law enforcement information the disclosure of which could reasonably be expected to constitute an unwarranted invasion of personal privacy. In this case, the disclosure of information such as the locations or identities of unaccompanied children could subject vulnerable individuals to harassment and public hostility. The association of individual names in a law enforcement context could produce unwarranted publicity and embarrassment. Exemption 7(A), authorizes the withholding of records or information compiled for law enforcement purposes that could reasonably be expected to interfere with enforcement proceedings. In this case, the withheld information concerns a pending and/or prospective law enforcement investigation. Exemption 7(D) provides protection for records or information compiled for law enforcement purposes which could reasonably be expected to disclose the identity of a confidential source. In this case, the withheld information consists of reports to the investigators performing an investigation. If disclosed, the information could expose a source or sources of information who was/were held confidential when providing information for an investigation into the use of government funds. The FOIA Exemption 7(F) protects law enforcement information that could reasonably be expected to endanger the life or physical safety of any individual. In this case, the withheld information consists of the information about specific refugee centers providing services to individuals who have fled to the United States for safety. Disclosure of this information could subject these individuals and the workers who assist them to hostile or threatening behavior or could help the forces they fled to locate them. Sincerely yours, Kimberly N. Epstein FOIA Officer Administration for Children and Families \•1t~,, \J PVERSIGHT 000001 January 09, 2017 January 15, 2017 - January2017 SuMo TuWe Th Fr Sa 1 2 3 4 5 6 7 8 9 10 1112 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Monday, January 09 Tuesday, January 10 Wednesday, January 11 Thursday, January 12 - - February2017 SuMo TuWe Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 -~- - Friday, January 13 - Lloyd, Scott (ACF) pVERSIGHT 1 12/21/2017 4:45 PM EXT-18-248-A-000001 000002 January 2017 SuMo TuWe Th Fr Sa 1234567 8 9 10 1112 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January 16, 2017 January 22, 2017 Monday, January 16 Tuesday, January 17 Wednesday, January 18 Thursday, January 19 -+----- - - -- February 2017 SuMo TuWe Th Fr Sa S 12 19 26 6 13 20 27 1 2 3 4 7 8 9 10 11 14 15 16 17 18 21 22 23 24 25 28 - Friday, January 20 .. I /' Uoyd, Scott (ACF) pVERSIGHT 2 12/21/2017 4:45 PM EXT-18-248-A-000002 000003 January 23, 2017 January 29, 2017 M onday, January 23 - January 2017 SuMo TuWe Th Fr 1 2 3 4 5 6 8 9 10 1112 13 15 16 17 18 19 20 22 23 24 25 26 27 29 30 31 February2017 Sa 7 14 21 28 SuMo TuWe Th 1 2 5 6 7 8 9 12 13 14 15 16 19 20 21 22 23 26 27 28 Fr Sa 3 4 10 11 17 18 24 25 Tuesday, January 24 ~ 10:00am - 10:45am ORR Leadership Weekly ~ Numbef b)(4) Kenneth (ACF) v participant AccessCode (b)(4) 202/ - Tota, Wednesday, January 25 Thu rsday, January 26 Friday, January 27 I Lloyd, Scott (ACF) pVERSIGHT 3 12/21/2017 4:4S PM EXT-18-248-A-000003 000004 January 30, 2017 February 05, 2017 Monday, January 30 January 2017 February 2017 SuMo TuWe Th Fr Sa SuMo TuWe Th Fr Sa 1 2 3 4 5 6 8 9 10 1112 13 15 16 17 18 19 20 22 23 24 25 26 27 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 7 14 21 28 Tuesday, January 31 ~ 10:00am - 10:45am ORR Leadership Weekly Meeting Number : !(b)(4) Kenneth (ACF) ,_'> Wednesday, February 01 r Participant Access Code:fb)(4) (5202/ t Tota, Thur sday, February 02 Friday, February 03 A Uoyd, Scott (ACF) pVERSIGHT 4 12/21/2017 4:45 PM EXT-18-248-A-000004 000005 February 06, 2017 February 12, 2017 Monday, February 06 - February 2017 March SuMo TuWe Th Fr Sa 5 6 12 13 19 20 26 27 1 2 3 4 7 8 9 10 11 14 15 16 17 18 21 22 23 24 25 28 2017 SuMo TuWe Th Fr Sa 1 2 5 6 7 8 9 12 13 14 15 16 19 20 21 22 23 26 27 28 29 30 3 4 10 11 17 18 24 25 31 Tuesday, February 07 Ir&! 10:00a~ - 10·45am Number : b)(4) Kenneth (ACF) .) rRR Leadership Weekly Meeting (5202/ Participant Access Code:l(b)(4) I-Tota, Wednesday, February 08 Thursday, February 09 -- Friday, February 10 Lloyd, Scott (ACF) pVERSIGHT 5 12/21/2017 4:45 PM EXT-18-248-A-000005 000006 February 13, 2017 February 19, 2017 Mond ay, February 13 - February 2017 March 2017 SuMo TuWe Th Fr Sa SuMo TuWe Th Fr Sa 5 12 19 26 6 13 20 27 1 2 3 7 8 9 10 14 15 16 17 21 22 23 24 28 4 11 18 25 5 12 19 26 6 13 20 27 7 14 21 28 1 8 15 22 29 2 9 16 23 30 3 10 17 24 31 4 11 18 25 Tuesday, February 14 ~ 10:00am - 10 :45am ORR Leadership W eekl y Mee ting (5202/ t) - Tota, Numbe r:kbl(4l ~ Participant Access Code:l(bl/4l Kenneth (ACF) ,.~ -Thursday, February 16 W ednesday, February 15 Friday, February 17 /' Lloyd, Scott (ACF) pVERSIGHT 6 12/2 1/2017 4:4S PM EXT-18-248-A-000006 000007 February 20, 2017 February 26, 2017 Monday, February 20 - February 2017 March 2017 SuMo TuWe Th Fr Sa SuMo TuWe Th Fr Sa 5 12 19 26 6 13 20 27 1 2 3 7 8 9 10 14 15 16 17 21 22 23 24 28 4 11 18 25 5 12 19 26 6 13 20 27 7 14 21 28 1 8 15 22 29 2 9 16 23 30 3 10 17 24 31 4 11 18 25 Tuesday, February 21 fZl10:00am • 10;45am Number f b)(4) Kenneth (ACF) a lRR Leadership Weekly Meeting (5202/ Participant Access Code: Vbl/4) b- Tota, ~ Wednesday, February 22 Thursday, February 23 Friday, February 24 Lloyd, Scott (ACF) pVERSIGHT 7 12/21/2017 4:45 PM EXT-18-248-A-000007 000008 February 27, 2017 March 05, 2017 February 2017 March 2017 SuMo TuWe Th Fr Sa SuMo TuWe Th Fr Sa 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 1 2 3 4 5 6 7 8 12 13 14 15 19 20 21 22 26 27 28 29 9 16 23 30 10 11 17 18 24 25 31 Tuesday, February 28 Monday, February 27 ~ 10:00am - 10:45am ORR Leadership Week ly Meeting (5202/ Number fb )(4) Kenneth (ACF) "' Participant Access CodeJ h)/4) 1- Tota, ■ 1:00pm - 2:00pm FW: ASPE Follow -up Meeting on Refugee Survey redesign (Deputy Secretary's Conference Room) - Shipley, Samuel (HHS/IOS) Wednesday, March 01 Thursday, March 02 ■ 11 :00am - 11:30am ACF Briefing for New Policy Team (Deputy ■ l :30pm • 3:00pm FW: ORR/ DPC Meeting (Switzer Building ORR Offices Room 5524 at 330 C Street SW) - Gregg, Laura (ACF) Secretary's Conf Rm 607G) - HHS Secretary (HHS/IOS) ■ 3:00pm - 3:30pm Meeting ACF/ ORR (2nd floor conference room) - Lloyd, Edward (ACF) ■ 3:30pm - 3:45pm Check- in w/Ma ggie and Scott (625D) - Clark, Timothy (HHS/IOS) Friday, March 03 ~-----~ ~ 1:00om - 2:00om FW:l(b)(6) Call l(b)(4) ■ 3:30fm rocedure - Conference ICalero, Wilfred (ACF) - 4:30plm ORR Debri ef (Call in number . f b)(4) Code: b)(4) - Gregg, Laura (ACF) /' Lloyd, Scott ( ACF) pVERSIGHT j;Access 8 12/21/2017 4:45 PM EXT-18-248-A-000008 000009 March 06, 2017 March 12, 2017 Monday, M arch 06 March 2017 April 2017 SuMo TuWe Th Fr Sa 5uMo TuWe Th Fr Sa 1 2 3 4 5 12 19 26 6 13 20 27 7 14 21 28 8 15 22 29 91011 16 17 18 23 24 25 30 31 1 2 3 4 5 6 7 8 9 10 1112 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Tuesday, M arch 07 ~ 10 :00am - 10 :45am ORR Leadership Weekly Meeting (5202/ I Participant AccessCode:l(b)(4) Numbe dh \/4\ Kenneth (ACF)v I-Tota, ■ 6:30pm - 7:00pm UAC Issues - HOLD (Lance'sOffice) - Leggitt, Lance (HHS/1OS) Wednesday, March 08 Thursday, March 09 ■ 4:00pm - 5:00pm ORR Budget Briefing ( 611E/ Call in information : l(b)(4) jParticipant Access Code: fb )(4) 1-Gregg, Laura (ACF) 0--------------------------+------ ----- --- --- Friday, March 10 ■ 2:00pm - 3:00pm Human Trafficking Meeting (Deputy Secretary's Office - Room 614-G) - Horn, Wade (HHS/IOS) (CTR) Lloyd, Scott (ACF) pVERSIGHT 9 12/21/2017 4 :45 PM EXT-18-248-A-000009 000010 March 13, 2017 March 19, 2017 March 2017 April 2017 SuMo TuWe Th Fr Sa 5uMo TuWe Th Fr Sa 1 2 3 4 5 12 19 26 6 13 20 27 7 14 21 28 8 15 22 29 91011 16 17 18 23 24 25 30 31 1 2345678 9 10 1112 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Monday, Mar ch 13 Tuesday, M arch 14 ■ 2:00pm - 2:30pm Secretary Price at ACF ~ 10 :00a~ - 10·45am Leadership Weekly Meeting (5202/ Numbe r b)(4) Participant Access CodeJh )/4) !- Tota, Kenneth (ACF) c.' rRR ■ 3:00pm - 4:00pm Call Maggie Wednesday, March 15 ■ 5:00pm - 6:00pm Human Trafficking Meeting (Deputy Secretary's Office - Room 614-G) - Horn, Wade (HHS/IOS) (CTR) Thur sday, March 16 ~ 2:00pm - 2:30pm Call to update onfb )(?)(C) I (Via WebEx--number to follow) - Wh ite, Jonathan (ACF) ~ 2:00pm - 2:30pm Invitation to WebEx meeting: != (b-)(-7)-(C _)___ fb J(?)(C) __, ,pdate (WebEx Online) - Jonathan White via Cisco WebEx Friday, March 17 ■ 11:30am - 1:00pm Senior Staff Potluck (6th Floor - Secretary's Suite) - Leggitt, Lance (HHS/IOS) /' Lloyd,Scott (ACF) pVERSIGHT 10 12/21/2017 4:45 PM EXT-18-248-A-000010 000011 March 20, 2017 March 26, 2017 March 2017 April 2017 SuMo TuWe Th Fr Sa SuMo TuWe Th Fr Sa 1 2 3 4 5 12 19 26 6 13 20 27 7 14 21 28 8 15 22 29 1 91011 16 17 18 23 24 25 30 31 Monday , March 20 Tuesday, M arch 21 ■ 10:00am - 11:00am PRM/ ORR Call (Call .in number ~b )(4) Participant Access Codj ___ Lloyd, ~1 Scott (ACF) pVERSIGHT 11 12/21/2017 4:45 PM EXT-18-248-A-000011 000012 March 27, 2017 April 02, 2017 M onday, Mar ch 27 ■ 8:15am - 9:15am l(b)(6) ■ 10:00am - 10:30am March 2017 April 2017 SuMo TuWe Th Fr Sa SuMo TuW e Th Fr Sa 1 2 3 4 5 6 7 8 12 13 14 15 19 20 21 22 26 27 28 29 9 16 23 30 10 11 17 18 24 25 31 1 2345678 9 10 1112 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Tuesday, March 28 I ~ 10:00am - 10:45am ORR Leadership Weekly Meeting (5202/ ORRDirect or Meet !Participant Access Code: l(b)(4) Numbekb)(4 ) Kenneth (ACF) ,.;, and Greet (5122/ 5202) - ORR Director (ACF) tTota, ■ 1:30pm - 3:30pm Ma ndatory Prohib ited Personnel Practice and ■ 1:00pm - 1:30pm Daily Briefing Binder Review (Scott's Office) - Whistleblower Training (Switzer Conference Room 5324) - Townsell, Valencia (ACF) Lloyd, Scott (ACF) ■ 1:30pm - 2:30pm Discuss Secure/Staff Secure Releases (Scotts ■ 3:30pm - 4:30pm Conference Call re USRAP Cost Studies (Rm 8085) Office) - Lloyd, Scott (ACF) f b)(6) I Wednesday, March 29 Thursday, March 30 ■ 9:00am - 9:30am Check in with Anna Marie (Scott's office) - Lloyd, ■ 9:00am - 10:00am Polley Briefing (Scott's Office) - Lloyd, Scott (ACF) Scott (ACF) I ■ 11:00am - 11:45am Budqet Briefing (Scott's Office ~(b)(4) Participant AccessCode:Kb)(4) I- Lloyd, Scott (ACF~) -.:,-----' ■ 10:00am - 11:00am ORR - OJJDP Call on Juvenile Justice expertise and Unaccompanied Alien Children Releases (Switzer 5202) - White, ■ 11:00am - 11:30am Division of Health for Unaccompanied ■ 1:00pm - 1:30pm Photo Appointment (Directo r's Office 5101) - Lloyd, Scott (ACF) Children Briefing (Scott's office) - Gregg, Laura (ACF) ■ 1:30pm - 1:45pm 15 min Speak to ORA Staff at ORA Peer ■ 1:30pm - 2:00pm Travel Plan Briefing (Scott's office) - Gregg, Laura Discussion (4401) - Lloyd, Scott (ACF) ■ 2:00pm - 2:4Spm Weekly Check in with Joann (Director's office) - (ACF) ■ 3:00pm - 3:45pm Admin Briefing (Scott's office) - Gregg, Laura (ACF) Gregg, Laura (ACF) ■ 3:15pm - 4:00pm Check-In w/ AnnaMarie (Director's Office) - Lloyd, ■ 4:00pm - 4:30pm Monitoring Process (Scott's Office) - Gregg, Laura Scott (ACF) ■ 4:00pm - 5:00pm Refugee Briefing (Scott's office) - Gregg, Laura (ACF) (ACF) ■ 6:30pm - 7:00pm Scott Lloyd __ Participant Access Codel(b)(4) I- Gregg , Laura (ACF) -I ■ 11:30am - 12 :00pm ORR "Pending " Item s Discussion (!OAS Conference Room J 4th Floor (4026A) AND Kb)(4) Kb)(4) !Wagner , Mr. Steven (ACF) IPasscode: ■ 12 :30pm • 1:00pm ATCR Prep (Scott's office) - Gregg, Laura (ACF) ■ 1:4Spm - 2:15pm World Refugee Day (Director's Office) - Lloyd, Scott (ACF) ■ 2:30pm • 3:00pm ORR Funding Discussion (4th Floor I Room 4523) - Wagner , Mr. Steven (ACF) D 3:30pm • 4:00pm Canceled: M eeting w/ ORR to Discuss E-M ail Search (Conf Rm 3322) - Baerga, Debbie (ACF) ■ 4 :00pm - 4:30pm Meet w/ Trina re: Personnel Confidential in Natur e (Scott 's Off ice) - Tota, Kenneth (ACF) Lloyd, Scott (ACF) pVERSIGHT 21 12/21/2017 4:45 PM EXT-18-248-A-000021 000022 June 05, 2017 June 11, 2017 June 2017 July 2017 SuMo TuWe Th Fr Sa SuMo TuWe Th Fr Sa 1 2 3 4 5 1112 18 19 25 26 6 7 8 9 10 13 14 151617 20 21 22 23 24 27 28 29 30 M onday. June 05 Tuesday. June 06 ■ 9:00am - 9:30am Meeting w/ORR to Discuss E- Mail Search (Conf ■ 8:00am - 10:00am Out of Offic e ■ 10:15am - 10:45am Speak to Refugee Family Child Care Numbe r: f b)(4) Kenneth (ACF) O ! 1- Tota, partic ipant Access CodeJ(b)(4) ■ 12:30pm - 1:00pm Meeting with Tim Clark, White House Liasion's (ACF) Office (!OAS Conference Room 4026A) - Dugan, M eghan R. (ACF) Ii 1:00pm - 1:45pm Social Services Discretionary Grant Plan ■ 1:00pm - 2:00pm Governors call (620E Humphrey Bldg) - Gregg, (Director's Office) - Lloyd, Scott (ACF) ■ 2:00pm - 2:30pm Meeting with Scott Lloyd (5108 Conference Room Laura (ACF) ■ 2:00pm - 3:00pm UAC NPRM Briefing (Director 's Office) - Lloyd, (Humphr ey Building)) - Phillips, Lindsey (OS/ASA/OSSI) (CTR) ~ 3:00pm - 4:30pm FY 2019 Reforms and Reinvestment proposals - Update with Handout (Switzer Conference Room 4323/4401) -fb )(6) ■ 3:15pm - 4:00pm Travel to WH ~(b)(6) ILloyd, Scott (ACF) kb)(6) 10 1112 13 14 15 17 18 19 20 21 22 24 25 26 27 28 29 31 ~ 10:00am - 10:45am ORR Leadership Week ly Meeting (5202/ M icroenterprise Grantees (TBD) - Tot a, Kenneth (ACF) ■ 12:30pm - 1:00pm Pre call re: quarterly call J(b)(4) 1- Lloyd, Scott 9 16 23 30 ■ 9:30am - 10:00am OD Check in (Scott 's office) - Lloyd, Scott (ACF) o Rm 3322) - Baerga, Debbie (ACF) !(b)(4) 1 2 3 4 5 6 7 8 I Scott (ACF) j, ■ 3:00pm - 3:30pm ORR FY19 Proposals (Switze r 4026) - Barlow, Amanda (ACF) - 4:45pm Follow up meeting (Scotts officP if~b)~<4~)___ Participant Access Code:kb)(4) !Lloyd, Scott (ACF) ■ 4:00pm - 5:00pm Meeting re: Refugee Questions (W H, EEOB 374 (S Wednesda y. June 07 Thursday. June 08 ■ 10:15am - 10:45am Personnel Meeting (Director's office) - Lloyd, ■ 10:10am - 10 :30am Meet w/ l(b)(6) ~e: UAC FOAs~ Lloyd, Scott (ACF) Scot t (ACF) ■ 11:15am - 12:00pm Week ly Check-in w/ Joann (Scott's Office/ !lh \14 \ jPartic ipant Access Code: !(b\/4\ ) - Lloyd, Scott (ACF) ■ 3:00pm - 4:00pm In -Person Briefing for House OGR Committee (TBD: O'Neil or Rayburn Building ) - Sohn, Elizabet h (ACF) ffice) - - Lloyd, Scott (ACF) 0" ■ 11:00am - 11:30am ORO/ORR Call w/Commissioner David Han sell f ~ (Conference Number : b)(4) (Scott Lloyd's Office) - Sohn, Elizabeth (ACF) ■ 12 :45pm - 1:15pm ECDC Meeting (Switzer Buildling - 330 C Street SW -- ■ 10:30am - 11:00am Weekly Check-in w/ Anna Marie (Scott's Office) I- Lloyd, Scott (ACF) v ■ 12:00pm - 12:30pm Pre-Briefing for OGR Meeting Wednesday ~1 ■ 3:45pm ■ 11:30am - 12:30pm l(b)(6) Tania (ACF) r >202) - Irizarry, ■ 1:00pm - 1:30pm FOIA training (716A) - Flick, Heather (OS/OGC) ~ 1:00pm - 2:00pm 2017 Acquisition s Brown Bag Series: Source Selection Planning and Evaluation (Central Office Room 3322, region ■ 2:30pm - 3:30pm Senate Judiciary Hearing Prep Session #1 of 2 (S ■ 3:30pm - 4:00pm Check in with Amanda (Scott's off ice// Call l(b)(6)1) D 4 :00pm - 4 :30pm Canceled: Check in Meeting (IOAS Conference Roo ~ 5:00pm - 5:30pm Call with Congresswoman Comstock (IOAS Confer Friday, June 09 ~ 10:00am - 11 :00am Senate Judiciary Hearing Prep Session #2 of 2 (Switzer 5122) - Sohn, Elizabeth (ACF) f' Lloyd, Scott (ACF) pVERSIGHT 22 12/2 1/2017 4: 45 PM EXT-18-248-A-000022 000023 June 12 , 2017 June 18, 2017 June 2017 July 2017 SuMo TuWe Th Fr Sa SuMo TuWe Th Fr Sa 1 2 3 1 2 3 4 5 6 7 8 4 S 1112 18 19 25 26 Monday , June 12 6 7 8 9 10 13 14 15 16 17 20 21 22 23 24 27 28 29 30 9 16 23 30 10 1112 13 14 15 17 18 19 20 21 22 24 25 26 27 28 29 31 Tuesday, June 13 • J O • GENEVA - TRAVEL I L□• GENEVA - TRAVEL • ■ 9:30am - 10:00am OD Check in (Scott's off ice) - Lloyd, Scott (ACF) O ~ 10:00am - 10:45am ORR Leadership Weekly Meeting (5202/ Numbe db )(4) 1- Tota , Kenneth (ACF) .:;, ■ 4:00pm - 5:45pm Great Lakes Core Group Invitation (CICG,Room 6) Wednesday, June 14 0 • Thursday, June 15 • GENEVA - TRAVEL 0 • ~ 3:00pm - 5:00pm FY19 Mandatory Reforms and Reinvestments (Switzer 4523/ 4603.) - Barlow, Amanda (ACF) Friday, June 16 D 12:00pm - 12 :30pm Cancelled: Scott/ Laura/ Jonathan check in (Call in number: Kb)(4) Gregg, Laura (ACF) ■ 12 :30pm - 1:00pm Check- in Scott/Jonathan/Laur*b Access Code l/b)(4) White, Jonathan (ACF) I- )( 4 ) ' 12:00am GENEVA - TRAVEL ~ 4:00pm - 4:30pm FW: Check in Meeting (IOAS Conference Room 4th Floor I Room 4026A) - Pilato, Anna (ACF)v I I I ~ 12 :30pm - 1:00pm Invitation to WebEx meeting : ScotVJonathan/Laura Check In (WebEx Online) - Jonathan White via Cisco WebEx ~ 3:45pm - 4:45pm Invitation to WebEx meeting: HHS Testimony Discussion with EOP (WebExOnline) - Jonathan White via Cisco WebEx Lloyd, Scott (ACF) pVERSIGHT 23 12/21/2017 4:45 PM EXT-18-248-A-000023 000024 June 19, 2017 June 25, 2017 0 I 6 7 8 9 10 13 14 15 16 17 20 21 22 23 24 27 28 29 30 1 2 3 4 5 6 7 8 9 16 23 30 10 111 2 13 14 15 17 18 19 20 21 22 24 2S 26 27 28 29 31 ■ 9:30am - 10:00am OD Check in (Scott's office) - Lloyd, Scott (ACF) o ~ 10:00am - 10:45am ORR Leadership Weekly Meeting (5202/ Numbe ~b)(4) Tota, I Kenneth (ACF) ,..' ■ 12:00pm - 1:15pm World Refugee Day (S324) - ORR Director (ACF) ■ 2:00pm - 2:30pm DHS Data Report (Call) - Lloyd, Scott (ACF) ■ l :35pm - 1:SSpm Testimony Review (Scott's office) - Gregg, Laura (ACF) I - 4:30pm Briefing Prep (Director's Officp ](bl/ 4) f Lloyd, Scott (ACF) l World Refugee Day - Lucas, Sarah (ACF) (CTR) ■ 8:00am - 11:00am World Refugee Day Breakfast w/ URS ■ l :OOpm - 1:30pm Meet-and-Greet w/ GDIT Leadership (Director Lloyd's Office Switzer 5101) - Lloyd , Scott (ACF) ■ 4 :00pm - 4:30pm Repatriation Briefing (5202) - Lloyd, Scott (ACF) Wednesday, June 21 Thursday, June 22 - 10:00am Travel r b)(6) ■ 10:00am - 4:00pm Judicia~ry ---=H=e-a...,. rin -g ---= (T== B,,. D.,... ) -- .,.., Ll-oy- d.., ""' S-co...,. t .,... t .,.., (A""' C'=" F),--~ I■ ■ l :30pm - 2:00pm Check-in (Scott's Office) - Lloyd, Scott (ACF) I- 9:00am - 5:00pm Baltimore ~ 12:00pm - 1:00pm FINAL REMINDER: ORR URM Lunch & Learn I ■ 2:00pm - 3:15pm UC Stakeholders Meeting (5202 or ~ b)(4) Kurkjy, Brian (ACF) (CTR) Access Code:fb )(4) - SuMo TuWe Th Fr Sa Tuesday, June 20 ■ 12:30pm - 12:45pm Check- in regardi ng afternoon repatr iation briefing (Director 's Office) - Lloyd, Scott (ACF) ■ 9:20am SuMo TuWe Th Fr Sa 4 5 1112 18 19 25 26 ■ 10:00am - 11:00am FW: Joint Prep Session - Senate Judiciary Hearing - MS-13 (Conferene Line: f b)(4) OLA Confe rence Calls (/ h \/ ,1\ July 2017 1 2 3 M onday, June 19 ■ 3:00pm June 2017 starting soon! (Switzer 5202/5122 & UPDATED WebEx meet ing information) - M ullooly, Anne (ACF) ~ 2:30pm - 3:30pm Mandatory June Politica ls Gathering (Room 800) - - Bird, Catherine (HHS/IOS) ~ 4 :00pm - 4:30pm FW: Check in Meeting (!OAS Conference Room 4t h Floor I Room 4026A) - Pilato, Anna (ACF) '-' I Friday, June 23 ■ 9:00am - 9:45am Weekly Check- in w/ Anna Marie (Scot t's Office/ Lloyd, Scott (ACF) ,;• j(b)(4) I- Ior ■ 11:00am - 11:30am Travel (!kb)(6) I fb)(6) ■ ll :45am - 12:15pm Meeting with Rep. Burgess (R-TX) (Rayburn 2336) - Sohn, Elizabeth (ACF) I ■ 12:45pm - 1:00pm Iraqi Deportations (Dial in ~b)(4) kbl/ 4) I- Lloyd , Scott (ACF) ■ 2:00pm - 2:15pm Call w/ Senator Graham 's Offic e RE: Refugee Resettlement (Call-ln# j(b)(4) ~lb-)(6~)--1 K f ■ 2:15pm - 2:30pm Call w/ f b)(6) (ACF) I - Lloyd, Scott ■ 2:30pm - 3:15pm Meeting w/ Maggie (Maggie 's office) - Lloyd , Scott ■ 3:30pm - 4:00pm Travel fh \/n\ ■ 4 :00pm /' - 4:30pm Meeting w/ ICE -fb)(6 ) Lloyd,Scott (ACF) pVERSIGHT !or 240 I 24 12/21/2017 4 :45 PM EXT-18-248-A-000024 000025 June 26, 2017 July 02 , 2017 - June 2017 July 2017 SuMo TuWe Th Fr Sa SuMo TuWe Th Fr Sa 1 4 5 6 7 8 1112 13 14 15 18 19 20 21 22 25 26 27 28 29 2 9 16 23 30 3 10 17 24 2 9 16 23 30 1 3 4 6 7 8 10 1112 13 14 15 17 18 19 20 21 22 24 25 26 27 28 29 31 s Monday , June 26 Tuesday, June 27 ■ 5:15pm - 5:30pm Travel ■ 9:30am - 10:00am OD Check in (Scott's off ice) - Lloyd, Scott (ACF) v ■ 5:30pm - 8:00pm CVT UN lntemationa l Day Event (1739 N Street, Ira!10:00am - 10:45am ORR Leadershie Weekll Meetin9 (S202/ Number : l(b)(4) Tota, Kenneth (ACF) .;, NWDC) I- ■ 12:20pm - 1:00pm Travel (Meeting w/ ICE) l(b)(6) lis ~ Lloyd, Scott (ACF) l """" ■ 9:00am · 5:00pm OUT OF OFFICE(BOSTON SITEVISITS ) • Lloyd, Scott (ACF) I ■ 11:00am · 12 :00pm ORR/MA Repatriation Briefing ( MEMA Headquarters 400 Worcester Road (Route 9 East) Farmingham MA Lloyd, Scott (ACF) 5: I· Uoy 0 • Trina• out · Gregg, Laura (ACF) D 12 :00am Scott • Boston - Lloyd, Scott (AC_F...l ________ 0 Laura- telework • Gregg, laura (ACF) • ■ 10:00am • 11:30am MG Grantee Meeting (Check in with Tom G.) • • 2:00pm Call w/ Heidi Stirrup (desk·kbl(4l Kb )( 6) Thursday, August 03 Wednesday, August 02 D • Trina - out · Gregg, laura (ACF) ■ 1:30pm !{Scott call kb)(4) pm OUT OF OFFICE I- Lucas, Sarah (ACF) (CTR) fZl4:00pm • 4:30pm FW: Check in Meeting (JOAS Conference Room 4th Floor I Room 4026A) • Pilato, Anna (ACF) ,_ ,, I Friday, August 04 - D • Trina - out - Gregg , Laura (ACF) • Scott · Boston · Lloyd, Scott (ACF) D 12:00a~ ~(b_J<_6l_____________ ~0 D Ken· Telework - Tota, Kenneth (ACF) 0 Laura- Telework • Gregg, Laura (ACF) • I • __.l • j ■ 9:00am • 5:00pm OUT OF OFFICE (BOSTON SITEVISITS) f\ Lloyd, Scott (ACF) pVERSIGHT 30 12/21/2017 4:45 PM EXT-18-248-A-000030 000031 August 07, 2017 August 13, 2017 Trina- out - Gregg , Laura (ACF) 0 • Sarah - l(b)(6) 1 2 3 4 5 I • -♦ ·rD '□ 3 4 1 2 5 6 7 8 9 10 1112 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 I 1 I .-; ■ 12 :30pm - 1:30pm Mandatory Hatch Act Training (Room 730B) Bird, Catherine (HHS/IOS) ■ 3:00pm - 4 :15pm ORR 6 Overview and Update (Scott's Office (Dia l-in Ins ide Invite)) - Tota , Kenneth (ACF) ■ 4:45pm - 5:30pm Press Strategy fo r Gang Prevention Initiat ive (IOAS Conference Room (4026A)) - Wagner , Steven (ACF) ~ 12:00am Trina - out - Gregg , Laura (ACF) ~ 10 :00am - 10 :45am ORR Leadership Weekly Meeting (5202/ Number: !/bl/4) !Tota , Kenneth (ACF) ..:• ~ 4:30pm - 4:45pm Scott and Elizabeth Check-In (Soctt's Office ) Kurkjy, Brian (ACF) (CTR) Wednesday , August 09 • • ~b)(6) ■ 9:30am - 10:00am OD Check in (Scott's office) - Lloyd , Scott (ACF) ..:> ■ 2:00pm - 3:00pm FW: HHS ASPE Briefing on Results of Refugee Fiscal Impact Analysis (OS ASPE 422F, Conf2 (HHS/ ASPE)) - Ghertner, Rob in (HHS/ASPE) -r~ 10 1112 17 18 19 24 25 26 31 Tuesday, August 08 ■ 1:00pm · 1:30pm ORR Staff Small Group s (Director's Office (Dial In !/bl/4) I· Lloyd , Scott (ACF) ..:· 0 September 2017 SuMo TuWe Th Fr Sa 6 7 8 9 13 14 15 16 20 21 22 23 27 28 29 30 Monday, August 07 D• August 2017 SuMo TuWe Th Fr Sa ■ 4:30pm - 5:15pm Meeting w/ Maggie (Maggie 's off ice) - Lloyd , Scott (ACF) v Thursday, August 10 • ]1,0 • 1(b)(6) I • ■ 11 :00am - 11:45am Weekly Check-in w/ Joann (Scott's Off ice / ■ 10:00am - 10 :45am Weekly Check-in w/ Anna Marie (Scott 's Office !(b)(4) Lloyd , Scott (ACF) .:-· (Dial- in Inside Invite )) - Lloyd , Scott (ACF) ..:> I D 12 :00pm ■ 12 :00pm - 12:30pm Shelter Option s for th e Unaccompanied Alien Children ( UAC) Program (John Bardis' Office, Humphrey Build ing, Suit e 309 - F) • Bardis, John (HHS/ASA) - Canceled: Senior Leadership Officials (Confe rence Room 4523/4603) - Go ldhaber, Ben (ACF) C• ~ 2:00pm - 2:45pm Meeting with Tama r Magarik and Aaron Emmel of the American Academy of Pediatrics (Scott's office) - Kurkjy , Brian (ACF) (CTR) ■ 2:00pm - 3:00pm FY18 UAC Budget Discussion (5202) - Lloyd, Scott (ACF) ■ 3:00pm - 3:30pm ORR Staff Small Groups (Director 's Office ) ..:> ■ 3:00pm - 3:30pm ORR Staff Small Groups (Director's Office (Dial In Lloyd , Scott (ACF) o i(b)(4) I· ■ 4 :00pm - 4:30pm Interview : I ¥b l/6) (HHS - 200 Independence Avenue , SW, 625D, Wash ington , DC 20201 ) - Clark, Ti mothy (HHS/IOS) D 4:00pm - 4 :30pm Cancelled: Check in M eeting (JOAS Conf erence Room j 4th Floor I Room 4026A ) - Pilato , Anna (ACF) ,... Friday, August 11 D • 12:ooani ..-' (b=)(= 6 l--"T",--------------,I ■ 11 :00am - 11:30am call ... (b_J(_6)__ Lloyd , Scott (ACF) pVERSIGHT _.I 1 31 12/21/2017 4:45 PM EXT-18-248-A-000031 000032 August 14, 2017 August 20, 2017 August 2017 Septembe r 2017 SuM o TuWe Th Fr Sa SuM o TuWe Th Fr Sa 1 2 1 2 3 4 5 6 7 8 9 13 14 15 16 20 21 22 23 27 28 29 30 10 1112 17 18 19 24 25 26 31 3456789 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Monday, August 14 Tuesday, August 15 ■ 1:00pm - 2:00pm Audit Resolution Delegation of Authority ■ 9:30am - 10:00am OD Check in (Scott's office) - Lloyd, Scott (ACF) ._, ■ 10:00am - 11:30am Senior Review Board (SRB) previously call (Switzer 3225A) - Samuel, Janice (ACF) ■ 3:00pm - 3:30pm ORR Staff Small Group s (Director's Office) ._, Information Technology Review Board (ITIRB) (Conf Rm 2201) Baerga, Debbie (ACF) ~ 10:00am - 10:45am ORR Leadership Weekly Meeting (5202/ I - Tota, Numbe db )(4) Kenneth (ACF) ._, ■ 11:00am - 12:00pm Executive Secretariat/ORR Meeting w/SWIFT Llaison(s) (3225A [Switzer)) - ACF Exec Sec (ACF) ■ l :OOpm - 1:45pm Refugee Budget Options (Scott's Office) - Tota, Kenneth (ACF) ■ 2:00pm - 2:45pm Mee t ing w/ Maggie (Maggie's office) - Lloyd, Scott (ACF) ,? Wednesday, August 16 Thursday, August 17 I ■ 10:00am - 11:00 am Trave l to WH fb l/ 6\ !(b)(6) !Lloyd, Scott (ACF) ■ 11:00am - 12:00pm Meeting with !(b)(6) Lloyd, Scott (ACF) I(Whit e House) ■ 8:45am - 9:30am MED Workshop - Opening Remarks (4523/4603) Dunning, Sarah (ACF) (CTR) ■ 10:00am - 10 :45am Weekly Check-in w/ Anna Marie (Scott's Office) - Lloyd, Scott (ACF) v - ■ 12:00pm - 1:30pm Senior Leadership Officials (Conference Room ■ 11:00am - 11 :30am Ken/ Scott check in (Scott's office) - Gregg, 4523/4603, Kb)(4) ■ 12:00pm - '=" 1=-2 :-=-30=-p -m ---= T,.... ra_v_el,...,f ... ,ro -m ---,,W'""H ,-,-- .,.. Ll.-,o-yd...,-~,co ...,. t .,,_ t (,..., A..,. ,c=1F) -----1 ■ ll:30am Laura (ACF) - 12:00p~ (b)(6) ■ 1:30pm - 2:00pm Options for Safer Voluntary Departures (Scott's (CTR) 11 12:00pm - 1:00pm Stakeholders Meeting on PREA Imp lementation Office) - Lloyd, Scott (ACF) ■ 3:00pm fb l(4) - 3:30pm ORR Staff Small Groups (Dial l(b)(4) I- Lloyd, Scott (ACF) o l I loyd, Scott ~C (Rm 4202/ Switzer Buildi ng (330 C St SW. Washington DC 20024)) - Sch ■ l :OOpm - 1:30pm Lunch ■ 4:00pm - 4:30pm State Call (Numbe d (bl(4) Access Codp·jth11,1\ 1<5202) - Lucas, Sarah (ACF) t Participant ■ l :30pm - 2:00pm Upcoming speaking engagements (Scott's Office) ■ 2:15pm - 2 :45pm Contingency Planning (5202) - Lloyd, Scott (ACF) (ACF) ■ 4:30pm - 5:00pm Meeting w/ Mike and Elizabeth (Mi ke's Office) - ■ 3:00pm - 3:45pm Meeting with ORR Director on f h\/,t\ I ~ 4:00pm - 4:30pm FW: Check in Meeting (!OAS Conference Room J 4t Lloyd, Scott (ACF) Friday, August 18 0 l Laura- telework - Gregg, Laura (ACF) ■ 8:15am - 9:15am Meet w Demetrios Kouzoukas ■ 11 :30am - 12:00pm Next Week 's Coverage (Scot t's Office) - Lloyd, Scott (ACF) ■ 12:00pm - 12:30pm Check-in w/ Laura (Laura wi ll Call ) - Lloyd, Scott (ACF) ■ 2:00pm - 2:30pm Refugee Costs Report Discussion (ACF I 4th Floo r I Steve Wagner's Office (4032A)) - Wagn er, Steven (ACF) ■ 3:00pm - 3:30pm PRM/ ORR call re: report (Scott's office/ Call in number: f bl(4) Laura (ACF) f\ Lloyd,Scott (ACF) pVERSIGHT 1- White, 32 12/21/2 017 4:45 PM EXT-18-248-A-000032 000033 August 21, 2017 August 27, 2017 September 2017 SuMo TuWe Th Fr Sa 1 2 3 4 5 1 2 3 4 5 6 7 8 9 6 7 8 9 13 14 15 16 20 21 22 23 27 28 29 30 Monday, August 21 0 August 2017 SuMo TuWe Th Fr Sa 10 1112 17 18 19 24 25 26 31 10 111 2 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Tuesday, August 22 12 :00am Scott - ANNUAL LEAVE· Lloyd, Scott (ACF) 0 • • Scott- ANNUAL LEAVE - Lloyd, Scott (ACF) • ■ 9:00am · 5:00pm OUT OF OFFICE ■ 9:00am · 5:00pm OUT OF OFFICE ■ 3:00pm - 3:30pm ORR Staff Small Groups (Director 's Office) v ■ 9:30am - 10:00am OD Check in (Scott's office) - Lloyd, Scott (ACF) .:· ~ 10 :00am - 10:45am ORR Leadership Weekly Meeting (5202/ Number :!(b)(4) ~ Tota, Kenneth (ACF) v Wednesday, August 23 0 • Thursday, August 24 Scott- ANNUAL LEAVE· Lloyd, Scott (ACF) • ] ■ 9:00am · 5:00pm OUT OF OFFICE ■ 11 :00am - 11 :45am Weekly Check-in w/ Joann (5202 J"' (b...,. )(,4 ..,. ) ------,1 ,.... Participant Access Code: !(b)(4) 0 • Scott- ANNUAL LEAVE- Lloyd, Scott (ACF) ■ 9:00am - S:OOpm OUT OF OFFICE ! Lloyd, Scott (ACF) .:• ■ 3:30pm - 4 :15pm Weekly Check-in w/ Anna Marie f - Lloyd, Scott (5225N fb )(4) (ACF) v Friday, August 25 0 • D 12:00am Scott - ANNUAL LEAVE - Lloyd, Scott (ACF) Laura Telework - White, Laura (ACF) < ■ 9:00am - 5:00pm OUT OF OFFICE 3·30gm · 4·30gm Meeting with Kelly Ryans (5202 or Call in: [(b)(4) Lloyd, Scott (ACF) pVERSIGHT I-Kurkjy, Brian (ACF)(CTR) 33 12/21/2017 4:45 PM EXT-18-248-A-000033 000034 August 28, 2017 September 03, 2017 September 2017 SuMo TuWe Th Fr Sa 1 2 1 2 3 4 5 6 7 8 9 13 14 15 16 20 21 22 23 27 28 29 30 10 1112 17 18 19 24 25 26 31 3456789 10 1112 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Tuesday, August 29 Monday, August 28 D 12:00am August 2017 SuM o TuWe Th Fr Sa Jonathan on leave 8/28/8/29 - Wh ite, Jonathan (ACF) • D• 12:00am Jonathan on leave 8/28/8/29 - Whi t e, Jonathan (ACF) ■ 9:30am - 10:00am OD Check in (Scott's office ) - Lloyd, Scot t (ACF) o ~ 10:00am - 10:45am ORR Leadership Weekly Meeting (5202/ 1-Tota , Numbe rl(b)/4) Kenneth (ACF) c• ~ 2:00pm - 3:30pm NEW LOCATION-- ROOSEVELTROOM : PCC on FY 18 Refugee Report (WHSR JFK Room) - Bash, Zina G. EOP/WHO --------- Thursday, August 31 Wed nesday, August 30 D 12 :00am HOLD Refugee Summit (Refugee Program s Bureau) (San Diego, CA) ■ 11 :15am - 12:00pm Weekly Check-in w/ Joann (Scott's Office/ ·1 I Lloyd, Scott (ACF) v ~h\(4 \ 0 • 12 :00am HOLD Refugee Summit (Refugee Programs Bureau) (San Diego , CA) 11 1:00pm - 2:00pm Emergency Repatriation (Wyndham San Diego Bayside/ j(b)(4) Lloyd, Scott (ACF) t ■ 12 :00pm - 12:30pm Senior Leadership Officials (Conference Room 4523/4603) - Goldhaber , Ben (ACF) O Friday, Septem ber 01 0 Jonathan on leave 9/1 - White , Jonathan (ACF) ■ 12:30pm - 1:30pm Travel to WH (w/ Security Screening Considered) - Lloyd, Scot t (ACF) ~ 1:30pm - 2:30pm UAC Working Group (WAVES UNK ADDED) (EEOB210/212 (Diplomat ic Reception Room)) - Zadrozny , John A. EOP/WHO f' Lloyd, Scott (ACF) pVERSIGHT 34 12/21/2 017 4 :45 PM EXT-18-248-A-000034 000035 September 04, 2017 September 10, 2017 September 2017 October 2017 SuMo TuWe Th Fr Sa SuMo TuWe Th Fr Sa 1 2 1 2 3 4 5 6 7 3456789 10 1112 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 8 9 10 1112 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Mo nday, Sept ember 04 Tuesday, Septe mber 0 5 0 ■ 9:30am • 10:00am OD Check in (Scott's office) • Lloyd, Scott (ACF) .;i HOUDAY OBSERVED (Labor Day) (OFFICECLOSED) • Lucas, Sarah (ACF) (CTR) t::i.a 10:00am • 10 :45am ORR Leadership Weekl y M eeting (5202/ ~ 9:00am · S:OOpm LABOR DAY (OFFICECLOSED)· Lucas, Sarah (ACF) (CTR) Number :Vh\14\ Kenneth (ACF) ,_, I Tota, ■ 12:00pm • 1:00pm Lunch/ Break l ■ 4:00pm • 5:00pm Desk Time 1------------------W ednesday, Septembe r 06 --------~ Thursday, Septemb er 07 ■ 10:00am • 11:00am Urban In stitute F.al Briefioa · Qooortooities for Formal Evaluation (Switzer 5524 + ~b)(4) Martinez, Sofi (OS/ASPE) I ■ 8:00am • 12:00pm Computer Refresh (Please Drop off Your Computer Between These Hours) ■ 9:15am - 9:45am Additonal UAC Capacity (5202/ f b)(4) t::i.a 10:30am • 11:00am Group Repatri ation from Dominic an Republic ~(h\/4\ IRussell, Elizabeth and BahamasKb)(4) (ACF) ■ 10:00am • 10 :4Sam Wee kly Check-in · Lloyd, Scot t (ACF) <'"' ■ 11:00am · 11:45am Weekl y Check-in w/ Joann (Scott's Office / I· Lloyd, Scott (ACF) c• J b)(4) ~ Lloyd , Scott (ACF) I w/ Anna Mari e (Scott's Office) ■ 11:00am · 12 :00pm Briefing on Repatriat.ion TTX (Room 4323/4401) • Lloyd, Scott (ACF) 12:00pm • 5:00pm Out of Office 12:00pm • 1:00pm Lunch/ Break ■ 12 :30pm • 1:00pm URM check in on case (Scott's office) • White, Lau ■ 1:00pm • 2:00pm Urban Institut e Final Briefing : Strength ening Per 11 2:lSpm · 3:00pm SWK Audit (5122) • Lloyd, Scott (ACF) ■ 3:15pm - 3:45pm ORR Staff Small Groups (Director's Office/Dial-in) ■ 4:00pm • 4:30pm Check in Meeting (IOAS Conference Room I 4th Flo ■ 4:30pm • 5:00pm ORR/ DHS UAC Capacity Call (Call in number: 202 Friday, Septem ber 08 ■ 9:00 am · 9:30am M eeting w/ Paula (Paula's Office Humphrey 609F.3) · Lloyd, Scott (ACF) ■ 11 :00am • 11:45am Personnel meeting w/ Kim (Mary Switzer Building 330 C Street SW Washington , DC/ Room 3225B) - Lloyd, Scott ■ 12:00pm - 1:00pm OR.R Ql Spending Plans (!OAS Conference Room (4026A) ORKb)(4) Wagner, Steven (ACF) I- ■ 1:15pm - 1:45pm Mi ssouri State Update (Scott's Office) - Tota, Kenneth (ACF) ■ 2:00p m - 2:45pm Meetin g w/ 1rh11R1 !Re: UAC Legal Services and Direct Representation (5202 (Dial in l(b)(4) .'::-: -:-----:--.=====;- ■ 3:15pm - 4 :00pm Transportation to DHS M eeting !(b)(6) Kb)(4) Lloyd, Scott (ACF) I- i --,' t::i.a 3:30pm - 3:45pm Potential Repatriation (Call) - Barlow, Amanda (ACF) ■ 4:00pm - 5:00pm ORR/ DHS UAC Capacity follo w up in person me Lloyd, Scott (ACF) pVERSIGHT 35 12/21/2017 4:45 PM EXT-18-248-A-000035 000036 - September 11, 2017 September 17, 2017 4 5 6 7 1112 13 14 18 19 20 21 25 26 27 28 I , ~ OS Secretarys Operat ions Cent er (SOC/Alb)(4) I- ~ 10:15am ■ 9:00am - 10:00 am DOS Wa shington Liaison Group call ~/h \/ 4 \ - 11:00am Meeting wJ!(b)(6) lof LOS Humanitartian Services/Refug ee Resettlement (Conference Call- Ke I ■ 10:30am - 11:00am ORR Leadership Weeki)!'.Meeting (5524/ passcode: b)(4) ■ 1:00pm - 2:00pm HOLD - Division of Policy Training on Cultur e of I - ACF hswatchofficer <'' ■ 1:00pm - 1:30pm Opening Remarks at Webinar Hosted by o W elcoming Refugees (Webinar/Desk) ~ 3:30pm - 4:00pm Emergency Repatriation lnteragency Coordinatio ■ 4:00pm - 4:30pm Hill call (Phone call/ l(b)(4) j- Tota, Kenn Number : f b)(4) ■ 12:00pmf 1:00pj Emergency Repatriation Updat4b )(4) ■ 12:00pm - 12:30pm Hurricane Irma ACF Repat Travel Team Check■ 3:30pm - 4 :00pm ORR Staff Small Groups (Director's Office} I- ACF hswatchofficer ■ 9:30am - 10:00am OD Check in (Scott's office} - Lloyd, Scott (ACF) ,.' ■ 11 :40am - 12:00pm Meeting with OLAB (Amanda's office) • White, L - 1:00pm Emergency Repatriation Update d(b)(4) 1- Hooban, Tala (ACF} 10:00am - 10:30am Repatriation Internal Operators call PR (DO ACF hswatchoffi NOT FORWARDJ!(b)(4) ■ 5:30pm - 6:00pm Leave Garage I -- Thursday. Septem ber 14 Wednes day,Septem ber13 ■ l(b)(6j on leave 1(b)(6) ■ 9:15am - 9:50am SW Key follow up meeting (5122/ Number: I-Whi t e, Laura (ACF) - Lloyd, Scott (ACF) <'' ■ 11:00am - 11:30am URM Check- in (Scott's Office) - Lloyd, Scott (ACF} reform (Humph rey 615F.3) - Lloyd, Scott (ACF} w/ Joann (Scott's Office/ l ~ 1:30pm - 2:00pm Senior Leader Brief to Acting Secretary Wright ~ b)(4) OS Secretarys Operations Center ~ 10:00am - 10:45am ORR Leadership Weekly Meeting (5202/ ! Number : l(b)(4) Kenneth (ACF) •-' 3:00pm - 3:30pm ORR Staff Small Groups (Director 's Office) ..:> I-Tota, ~ 11:00am - 12:00pm UC/Refugee Coordination (JOASConference Room (4026A) OR 866 -687-9176 I Passcode: 4881945) - Wagner, St even (ACF) ,;, ■ 1:00pm - 1:30pm IT Hot spot Trouble Shoot (Director 's Office (5101)) - Lloyd, Scott (ACF) ■ 1:15pm - 1:45pm AEVP Case Staffing (Scott 's off ice) - Lloyd, Scott (ACF) ■ 3:00pm - 4:15pm ORR Staff Meeting (5324/ Call in number Number : kb\(4) I- ORR Director (ACF) ■ 4:30pm - 5:15pm Meeting w/ Maggie (M aggie 's office) - Lloyd, Scott (ACF) O Wed nesday, October 11 Thursday, October 12 ■ 11 :00am - 11:45am Data Match meeting (Scott 's Off ice/ l(b)(4) ■ 10:00am - 10:45am Weekly Check- in w/ Anna Marie (Scott's Office) - Lloyd, Scott (ACF) v !Lloyd, Scott (ACF) ,.,~ ■ 2:00pm - 2:30pm Personnel Meeting (Scott's office) - Lloyd, Scott (ACF) O ■ 11:00am - 11:45am Policy Meeeting re: preg (5202) - Lloyd, Scott (ACF) ■ 3:10pm - 3:30pm Travel to Hill ~ 12:40pm - 12 :50pm M eeting with ORR (Steve's Office) - Powers, M ary (ACF) ■ 3:30pm - 4:30pm Staff Level Briefing on Refugee Consultation for ■ 1:00pm - 1:45pm Weekly check in with Joann (Scott 's office) - Lloyd, SJC and HJC by State , DHS, HHS (2138 Rayburn HJC Members' confere nce room) - Clark, Barbara (HHS/ASL) Scott (ACF) ■ 2:00pm - 3:00pm U.S. Emergency Repatriation and Federal lnteragency Meeting (Mary E.Switzer Buildi ng, 330 C ST SW, Washing ■ 3:15pm - 3:45pm ORR Staff Small Groups (Director's Office) - Lloyd, Scott (ACF) 0 ■ 4:00pm - 4:30pm Pre Depature Check-in w/ Pedro (Scott's Office) - Lloyd, Scott (ACF) ■ 4:30pm - 5:00pm S- Level Briefing (Humphrey 523B) - Lloyd, Scott (A Friday, October 13 D Laura- telework - White, Laura (ACF) "" D Pedro - Teleworking - M oreno, M r. Pedro (ACF) ,..,.....,.,.,.. ' _______ ....., ■ 1:00pm - 1:30pm ORR Call (Call in numbe rl~ 1b~ __ _ _ ______ ID • L _.I 12 :00am Sarah - Leave (Professional Development) - Lucas, Sarah (ACF) (CTR) I q (b)(6) rc'.J Laura- telework ... - White , Laura (ACF) ,..--. Lloyd, Scott (ACF) pVERSIGHT 41 12/21/2017 4:45 PM EXT-18-248-A-000041 000042 October 23, 2017 October 29, 2017 Octobe r 2017 November 2017 SuMo TuWe Th Fr Sa SuMo TuWe Th Fr Sa 1 2 3 4 5 6 7 8 15 22 29 9101112 13 14 16 17 18 19 20 21 23 24 25 26 27 28 30 31 Monday, October 23 Tuesday, October 24 D kb)(6) 0 0 ■ 12:00pm - 1:00pm Meeting w/ Scott Lloyd - ORR Director (Governo r's Conference Room or Call-in : ~b)(4) ~ eeting ID: l(b)(4) l -!(b)(6) tGOV) 1 2 3 4 5 6 7 8 12 13 14 15 19 20 21 22 26 27 28 29 9 10 11 16 17 18 23 24 25 30 ~ 12:00am HOLD: Homestead Trip - Kurkjy, Brian (ACF) (CTR) Scott - Telework ■ 9:30am - 10:00am OD Check in (Scott's office) - Lloyd, Scott (ACF) v ■ 10:lSam - 10:45am ORR Leadership Weekly Meeting (5202/ ~ Tota, Numbe rfh\/4\ Kenneth (ACF) ,,, li'i1l 10:30am · 11:00am Call (CALL-IN INFORMATION ADDED) (Call-In: kb)(4) EOP/WH O ! ) · !/b\/ 6\ ■ 11:00am - 12 :00pm UC/ Refugee Coordination (!OAS Conference Room (4026A)) - Wagner , Steven (ACF) v Wed nesday, October 25 0 • Thursday, October 26 12:00am HOLD: Homestead Trip - Kurkjy, Brian (ACF) (CTR) I ■ 8:15am • 8:45am Meet at HHH ASL office @ 8:15 ■ 9:00am • 11:00am Hearing Prep ■ 9:00am - 12:00pm House Judiciary Meeting (TBD) - Lloyd, Scott (ACF) ■ 11 :00am • 11:4Sam Weekly Check-in w/ Joann (Scott's Office / t Lloyd, Scott (ACF) 0 !(b)(4) ■ 1:00pm • 2:00pm Refugee strategy session (5122/ Call in: ■ 2:30pm · 3:00pm Personnel Paperwork (HHH Bldg, 8th Floor, Suit e 801, Room 13) • Lloyd, Scott (ACF) li'i1! 3:30pm - 4:00pm JOAS Appeals meeting (5225A) - White , Laura (ACF) D Laura- telework - White, Laura (ACF) .:o 0 Pedro. Teleworking • Moreno, Mr. Pedro (ACF) ~ 4:00pm • 4:30pm Check in Meeting (!OAS Conferenc e Room I 4th Floor I Room 4026A) - Pilato, Anna (ACF) .;, l Friday, October 27 11 I Lloyd, Scott (ACF) v 4'bl/ 4l ■ 1:00pm - 3:00pm Hearing Prep (Humphrey 416 G) - Wh ite , Laura (ACF) ■ 11 :15am • 11:45am Call w/ Laura and Anna Mari e (Call in: !(b)(4) poyd, Scott (ACF) I ■ 1:00pm - 2:00pm Prep Call for Governors Call (Call in l(b)(4) Participant Access Code: f b)(4) f ota, Kenneth (ACF) ■ 3:30pm • 4:00pm ACF SES FY2017 Performance Closeout Discussionwith Scott Lloyd (Steve Wag ner's Off ice (4032A)) Wagner, Steven (ACF) ■ 4:00pm • 4:30pm Predecisional/deliberative discussionre: ACF (4026A Switzer) - Stirrup, Heidi (HHS/IOS) /' Lloyd, Scott (ACF) pVERSIGHT 42 12/2 1/2017 4:45 PM EXT-18-248-A-000042 000043 October 30, 2017 November 05, 2017 M onday, October 30 D 12:00a r,i(b)( 6 ) Oct ober 2017 November 2017 SuMo TuWe Th Fr Sa SuMo TuWe Th Fr Sa 1234567 8 9101112 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 Tuesday, October 31 IWh ite, laura {ACF) 0 • l{b)(6) • ■ 10:30am - 11:00am W eekly Check-in w/ Kim {Scott 's Off ice) - Lloyd, •' jWh ite, Laura (ACF) ■ 8:30am - 9:00am fd Scott {ACF) v ■ 9:30am - 10:00am OD Check in (Scott's office) - Lloyd, Scott (ACF) .:> ■ 11:30am - 12:00pm UAC FOAs (Scott's Office) - Lloyd, Scott {ACF) ■ 9:30am - 10:00am ORR Leadership Weekly Meeting (5202/ Number : ■ 12 :00pm - 1:00pm Lunch/Desk Time/ Break ■ 10:00am - 10:30am UAC Meeting (5202) - Lloyd, Scot t (ACF) ■ 1:00pm - 3:00pm PRM/ORR/ DHS Governo r Call (5122) - Tota, Kenneth {ACF) ■ 10:30am - 11:00am Travel tlh \/111 /hi/RI ■ 11:00am - 12:00pm After-action on recent UAC / HHS case (EEOB3 ■ 3:00pm - 3:30pm ORR Staff Small Groups (Director's Office ) - Lloyd , Scott {ACF) v ■ 12:00pm - 12:30pm Travel ■ 3:30pm - 4:00pm Meeting re:kb)(6) 5101) - Lloyd, Scott (ACF) ■ 1:00pm ■ 1:00pm - 2:00pm Safe Families Meeting (Switzer 5424() - Pilato, Ann !Case (Scott's Office Switzer ~ 2:00pm - 3:00pm EEi Manager 's and Supervisor's Briefing- Session ~ 5:lSpm - S:45pm ORR Follow Up with Paula (Counse lors Conference Room (HHS) 611E or CALL IN *b ){6) ~ 2:00pm - 3:00pm EEi MANAGERS AND SUPERVISORSSESSION 1 (S ! More Items ... Thursday, Novembe r 02 Wednesday, November 01 [ii ! Wed nesday. November 15 Thursday. November 16 D r□ 12:00am Scott• training Laura- telework • Wh ite, Laura (ACF) D 12:00am ■ 9:50am • 10:20am Phone interview (Scott's office) • Training - White , Laura (ACF) • ■ 9 :00am - 10:00am Budget Staff Check-in (5424() ~ 11:00am- 12:00pmWeekly Check-in w/ Joann (Scott's Office/ ~b)(4) Lloyd, Scott (ACF) .:.• ■ 11:15am • 11:45am PMF Jnformaitonal Interview w~ (b)(6) (Director's Off ice (Switzer 5101)) - Lloyd, Scott (ACF) ■ 1:50pm · 3:30pm SRC Training Initiative I Launch Webinar (Switzer 3322) - Mitchell, Genna (ACF) (CTR) ■ 12:30pm • 1:00pm Complete Staff Workload Tracker I· ■ 4 :00pm - 4:30pm Capacity Meeting/ Meeting Server Main Number:~b )(4) Lloyd, Scott (ACF) I l1l'.a 1:30pm • 3:00pm ACF Senior Review Board (SRB) (Cont Rm 3401) • 1(5202) - Blake, Sebrina (ACF) ■ 2:00pm · 2:30pm PLACEHOLDER:ORA Meeting wit h Scott (5524) - ■ 4:30pm • 5:30pm Weekly Check-in w/ Pedro Moreno (Scott's Office) Rubenstein, Carl (ACF) - Lloyd, Scott (ACF) .:> ■ 2 :30pm · 3:00pm Call with ICE/ CBP/USCIS/ORR (Call-In: IICE.Scheduler l(b)(4) I from World Education Services (WES) (Mary E. Switzer Building !Room 42021 330 C. St. SW DC l1l'.a 4 :00pm • 4:45pm Meeting w/ kh1m1 l1l'.a 4 :00pm • 4 :30pm Check in Meeting (!OAS Conference Room I 4th Flo Friday, November 17 [D• ID• 0 Srott-ttalnlng I • 12 :00am Training · White, Laura (ACF) . Laura• telework - White, Laura (ACF) iJ ■ 10:00am • 11:00am Personnel Meeting (Scott's Offic e! Dial- in 1- g)( 4) Lloyd, Scott (ACF) v il :OOam• 11:45am Weekly Check-in w/ Anna Marie (Scott's Office Call-in: Kb)(4) ~ Lloyd, Scott (ACF),_--. I ■ 12:00pm • 1:00pm ORR Leadership and Lt. Gov. Luis Rivera-Marin Meeting (Switzer Buidling-Room 5122 I Dial-in f b)(4) Kb)(4) f Lloyd, Scott (ACF) I ■ 2:15pm • 3:00pm Meeting w/ Maggie (Magg ie's office) - Lloyd, Scott (ACF) ,_. Uoyd, Scott (ACF) pVERSIGHT 45 12/21/2017 4:45 PM EXT-18-248-A-000045 000046 November 20, 2017 November 26, 2017 November 2017 Decem ber 2017 SuMo TuWe Th Fr Sa SuM o TuWe Th Fr Sa 1 2 3 4 1 2 3 4 5 6 7 8 9 5 6 7 8 12 13 14 15 19 20 21 22 26 27 28 29 91011 16 17 18 23 24 25 30 10 1112 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 M onday, November 20 Tuesday, November 21 0 ■ 9:30am - 10:00am OD Check in (Scott's office) - Lloyd, Scott (ACF) o On leave - Womack, Kimberley (ACF) ■ 10 :15am - 10 :45am ORR Leadership W eekly Meeting (5202/ ■ 10:30am - 11:30am Repatriation Discussionwith OEM and ACF (O'Neil Building ClClS) Number : llh\/4\ Kenneth (ACF) '--' - Hame l, Joseph (OS/ASPR/1O)(CTR) ■ 12 :00pm - 1:00pm Surprise (IOAS Conference Room 4026A Switze r) - Kellogg, Cori (ACF) ■ 1:00pm - 5:00pm l~ (b - )-(6- )---~I I-Tota, ■ 11 :00am - 11:45am UC/Refugee Coordination (IOAS Conference Room (4026A)) - Wagne r, Steven (ACF) ,> OUT OF OFFICE ■ 12 :00pm - 12:15pm Meet re: Ex Assistant contract position (Scott's office) - Lloyd, Scott (ACF) ■ 1:30pm - 2:00pm MTW Scott Lloyd (405F.4 Humphrey) - Destro, Brenda (HHS/ASPE) ■ 2:00pm - 2:45pm Meeting w/ Maggie (Magg ie's office) - Lloyd, Scott (ACF) '--' ■ 3:00pm - 5:00pm Emergency Repatriaton Briefing w/ Department (Humphrey Bulidng ------- ---- --- I 5th Floor! SCIF Room 523.B) - Lloyd, Scott (ACF) - Wednesday, November 22 Thursday, November 23 ■ 12 :00pm - 12:30pm ORR Meeting with HHS/ OCR (5101) - Lloyd, .Q J(b)(6) D Scott (ACF) ■ 12 :30pm - 1:00pm Prep for Secy Briefing 1 l(ACF) Thanksgiving ■ 10:00am - 10:45am Weekly Check-in w/ Anna Marie (Scot t's Office) - Lloyd, Scott (ACF) ,> ■ 1:00pm - 1:30pm FW: EDH Brief on the UAC Program Referrals & ■ 1:00pm - 2:00pm Refugee strategy session (3401/ Call in: Capacity (610- F) - Secretary Scheduler (OS/IOS) t bl(4) t Lloyd, Scott (ACF) 0 Friday, November 24 D !rhv ~, D Laura- telework - Wh ite , Laura (ACF) ,> Dj(b)(6) /' Lloyd, Scott (ACF) pVERSIGHT ' I 46 12/2 1/2017 4:45 PM EXT-18-248-A-000046 000047 November 27, 2017 December 03, 2017 November 2017 December 2017 SuMo TuWe Th Fr Sa SuMo TuWe Th Fr Sa 1 5 6 7 8 12 13 14 15 19 20 21 22 26 27 28 29 2 9 16 23 30 3 10 17 24 4 11 18 25 Monday, November 27 Tuesday, November 28 ■ 9:30am • 10 :00am Scheduling Check-in (Scott 's Office) • Lloyd, Scott II ~ 10:30am · 12 :00pm WAVES link for UAC PCC • Tuesday, November ■ 11:00am - 11:30am Prep Call for HSGAC briefing l(b)(6) Vh11A, s I w/ Pedro Moreno (Scott's Office) • Lloyd, Scott (ACF) v Participant: 1 2 4 6 7 8 9 1112 13 14 15 16 18 19 20 21 22 23 25 26 27 28 29 30 9:30am - 10:00am OD Check in /Scott's officel • Llovd, Scott (ACF) v ■ 10:00am • 10:30am Trave~(b)(6) lor ib l(4l (ACF) v ■ 10:lSam - 11:00am Weekly Check-in 3 10 17 24 31 I I· White , Laura (ACF) 28, 10:30- 12:00 (EEOB 350) (EEOB350) - Bash, Zina G. EOP/WHO ■ 12:00pm · 12:30pm Travel ■ 12:30pm - 1:00pm Travel ■ 1:00pm • 2:00pm NPRM ■ 1:00pm - 2:00pm Senate HSGAC Minority Styaff Briefing (344 ■ 3:15pm - 4:00pm UC/Refugee Coordination (IOAS Conference Dirksen) · Clark, Barbara (HHS/ASL) Room (4026A)kh\/4\ Steven (ACF) ,., ... ■ 2:00pm - 2:30pm Travel ■ 4:30pm - 5:00pm Steve Wagner/ Scott Lloyd Call (Call in Number: Lloyd, Scott (ACF) l(b)(4) ■ 3:00pm - 3:30pm Urgent Call for UAC Shelter Leadership (Call in I- ILloyd, Scott (ACF) number : [b )(4) I-Wagner, ■ 4:00pm - 4 :30pm Changes to Repatriation Program and Discussion (Scott's Office) - Lloyd, Scott (ACF) Thursday, November 30 Wednesday, November 29 9 ~b)(6) 0 li\CF) ■ 11 :00am - 11:45am Weekly Check-in 1 I Sarahfb )( 6 ) ILloyd, Scott (ACF) v ~ 12:00pm • 1:00pm Senior Leadership Officials (Conference Room - 3:30pm FW: UC Stakeholders (5324 or fb )(4) Wh ite, Jonathan (ACF) Access Codel/b\/4\ I- ■ 2:00pm - 3:00pm DRA HQ I Monthly - Lloyd, Scott (ACF) v ■ 1:00pm - 2:00pm Refugee strategy session (S202/ Call in: Lloyd, Scott (ACF) v llh\/ 4\ I· 4 523/4603) - Gold haber, Ben (ACF) v ■ 2:00pm 9:30am - 10:00am Personnel Meeting (Scott's office) • Lloyd, Scott (ACF) ..,, ■ 10:30am - 11:15am Weekly Check-in w/ Anna Marie (Scott's Office) w/ Joann (Scott's Office/ [b )(4) II I ■ 2:15pm - 2:45pm Mary/ Scott/ Laura Check in (Scott 's office) - White, Laura (ACF) ■ 3:00pm • 4:00pm Follow-up: Repatriation Discussion with OEM Meeting (Switzer 4603) • and ACF (Mary E. Switzer I Room 3322) - Lloyd, Scott (ACF) Mitchell, Genna (ACF) (CTR) ~ 4:00pm - 4:30pm Check in Meeting (JOASConference Room I 4th ■ 3:30pm - 5:00pm Repatriation MOU Floor I Room 4026A) - Pilato, Anna (ACF) ,_--. -Friday, December 01 D Laura- telework - White , Laura (ACF) v ■ 9:30am - 10:00am Touch Base w/ Ken (Scott's Office) - Lloyd, Scott (ACF) ■ 10:00am · 11:15am RCUSA Meeting with ORR (Switzer Buildi nq- 330 C Street SW, Room 5122/ Meetina Server Main Number: ~b)(4) Participant Access Cod¥b)(4) Lloyd, Scott (ACF) I- I ■ 11:15am - 11:45am Travel ■ 12:00pm - 12:30pm Meetina on Unaccompanied Alien Children (Stephen Miller's Office ,~b)(6) M iller, Stephen EOP/WHO ~ 1:00pm - 3:00pm UCG Deputies Meeting (HHS Switzer Building, 330 l C Street SW, Roo m 5324) - l(b)(6) D 1:00pm - 2:00pm Canceled: HHS - DoS Bilateral on Repatriation (600 19th St NW, 10th Floor, Room 10.00 (Large Conference Room), Washington, DC 20036) { b)(6) I Uoyd, Scott (ACF) pVERSIGHT 47 12/21/2017 4:45 PM EXT-18-248-A-000047 000048 December 04, 2017 December 10, 2017 January 2018 SuMo TuWe Th Fr Sa 1 2 3 4 5 6 7 8 9 10 1112 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 7 14 21 28 123456 8 9 10 11 12 13 15 16 17 18 19 20 22 23 24 25 26 27 29 30 31 Tuesday, Decemb er 05 Monday, December 04 D 12:00am December 2017 SuMo TuWe Th Fr Sa Ken - Travel (Denver & Boise) - Tota, Kenneth (ACF) D • Ken - Travel D ~b -day • ■ 9:30am - 10:00am Scheduling Check-in (Scott's Office) - Lloyd, Scott (Denver & Boise) - Tota, Kenneth (ACF) • ] ■ 9:30am - 10:00am OD Check in (Scott's office) - Lloyd, Scott (ACF) "' (ACF) ,;, ■ 10:00am - 10:30am Repatriation meeting w/ Elizabeth re: ~ 10:00am - 10:45am ORR Leadership Weekly Meeting (5202/ Number : l(b)( 4 ) !Tota, Kenn Emergency Repatriation TIX and Draft Summary of Conclusions (Scott's Office) - Lloyd, Scott (ACF) ■ 12:00pm - l :OOpm!(b)/6) for Laura Gregg White (Switzer Room 5202) - Johnson, Harmony (ACF) ■ 10 :30am - 11:00am Weekly Check-in w/ Kim (Scott's Office) - Lloyd, Scott (ACF) "' Ioasscode ■ 1:05pm - 1:35pm Murray Mtg Prep {fh \/d, ■ 1:00pm - 2:00pm OHS Collaboration Follow-up (ACF/Mary E l(b)(4) Switzer Building I 330 C Street, SW I 5th Floor I Room 5122 ) - Lloyd, Scott (ACF) I- Logan, Scott (ACF) ■ 2:00pm - 2:45pm Meeting w/ Maggie (Maggie 's office) - Lloyd, Scott (ACF) ._. ■ 3:00pm - 3:30pm Check-in with Scott Lloyd on Clearance Ite ms (Steve Wagner's Office (4032A)) - Wagner , Steven (ACF) ■ 3:30pm - 4:15pm FY2018 Spend Plans Meeeting D 4 :15pm .. Thursday, December 07 Wednesday, December 06 D • Ken - Travel (Denver & Boise) - Tota, Kenneth (ACF) D I ORR (JOASConfe - 5:00pm Canceled: UC/Refugee Coordination (!OAS Confer 0 • 12 :00am Ken - Travel (Denver & Boise) - Tota, Kenneth (ACF) ■ 9:30am - 10:00amfh\/S\ Pedro - Offsite (available by e- mail and phone) - Moreno , Mr. Pedro (ACF) l(b)(4) (Scott's Office or Call in: I-White , Jonathan (ACF) : 9·QQaro- l Q·QQam I eoal Sj.rvices Follow Up (5122 or Call in: ~ )(4) _- Kurkjy, Brian (ACF) (CTR) ■ 10:00am - 10:45am Weekly Check-in w/ Anna Marie (Scott's Office) W 11:00am - 11:45am Weekly Check-i n w/ Joann (Scott's Office/ l(b )(4) Lloyd, Scott (ACF) "' ~ 11:00am - 11 :15am ORR issues discussion (will call Scott on cell pho ~ 12:00pm - 12:30pm Senior Leadership Official s (Conference Room ■ 12:00pm - 1:00pm Meeting w/ ORR Director and ASPA (Scott Lloyd - Lloyd, Scott (ACF) ,;, f 4523/4603 o r!/bl/ 4l ■ 11:30am - 12 :00pm Document's Conversation (Scott Lloyds Office I- Goldhaber, I ■ 1:00pm - 1:30pm OPP Monthly Briefing (teleconference; Room: 552 ■ 12i3Qpm - 1·15pm PHS/0\R MOA Discussion (Scott's Off ice or Call in: _(b)(4) _ ) - White , Jonathan (ACF) ■ 1:30pm - 2:00pm UPDATED: ORR HQ Holiday Party (5202) - Lucas, pr ■ 2:00pm - 2:30pm Travel fh \/R\ ■ 2:00pm - 2:30pm Personnel Meeting (Scott's office) - Lloyd, Scott (A ■ 2:30pm - 3:30pm Brief Senate HELP on ORR and Medical Care (Har ■ 3:00pm - 3:30pm *ORR Staff Small Groups (Director's Office) - Uoy ■ 3:30pm - 4:00pm Travel ■ 4:00pm - 5:00pm PREA Stakeholders Meeting (Room 5202, Switzer ■ 4:45pm - 5:1 5pm 10 minutes ■ 5:00pm - 5:30pm Meeting w/Scott (Anne's Office) - Pilato, Anna (AC w/ Elizabeth (Scott's Office) - Lloyd, Sc Friday, December 08 D Laura- telework - White, Laura (ACF) ,J ■ 9:30am - 12 :30P"1(b)(5) 1- Lloyd, Scott (ACF) l ■ 1:15pm - 1:30pm Call w/ Elizabeth Weekly Check-in (Reschedule) (Call) - Lloyd, Scott (ACF) ■ 1:30pm - 2:00pm Meet w/ Amanda (Scott's Office) - Lloyd, Scott (ACF) ■ 2:00pm - 2:30pm Meeting w/ !/bl/6) Background Investigation (Scott's Office) I ■ 3:00pm - 3:30pm PMAP (Scott's Office) - Lloyd, Scott (ACF) ■ 3:30pm - 4:30pm Weekly Check- in w/ Pedro Moreno (Scott 's Office) - Lloyd, Scott (ACF) ,;, /\ Lloyd, Scott (ACF) pVERSIGHT 48 12/21/2017 4:45 PM EXT-18-248-A-000048 000049 December 11, 2017 December 17, 2017 January 2018 SuMo TuWe Th Fr Sa 1 2 3 4 5 6 7 8 9 10 1112 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 M onday , Decem ber 11 1 2 3 4 5 6 7 8 9 10 1112 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Tuesday, December 12 D 12:00am Site Visit to Homestead UC Shelter (Homestead, FL ) White, Jonathan (ACF) • ■ 9:30am - 10 :00am Scheduling Check- in (Scott's Office) - Lloyd, Scott (ACF) O ■ 10:30am - 11:00am Weekl y Check-in w/ Kim (Scott's Office) - Lloyd, Scott (ACF) .:• I ■ 11 :lS am - 11 :45am DHS/ ORR Call (Call in Number fb )(4) Participant Access Cod!lh11.11 ~ Wh ite, Laura (ACF) D• 12:00am Site Visit to Homestead UC Shelter (Homestead , FL ) White, Jonathan (ACF) ]J ■ 10:00am - 10 :4Sam ORR Leadership Weekly Meeting (5202/ I·Tota, Number. fb )(4) Kenneth (ACF) .Y D 11:00am - 12:00pm Canceled: UC/ Refugee Coordination (JOAS Conference Room (4026A) OR Whl/4) ~ Wagner, Steven (ACF) ,} ~ 1:00pm - 2:30pm ASPE-IRP Leaming Exchange on Early Childhood ■ 11:30am - 12:15pm Meeting w/ Maggie (Maggie's office) - Lloyd, Brain Science (HHS Humphrey Building , 200 Independence Ave SW, Room 425A) - Hutchison , Lindsey (OS/ASPE) Scott (ACF) .;, ■ 12:30pm - 1:00pm EOIR & HHS Call re: UAC Docket (Dial- in 202- 77 ■ 1:15pm - 1:45pm Fee Meeting (Conference Call:!(b)(4) December 2017 SuMo TuWe Th Fr Sa !Partici ■ 2:00pm - 2:30pm Response draft : Request for data match submissi ■ 2:30pm - 2:45pm 15 min Meeting w/ Elizabeth (Scott 's Office) - Lio ■ 3:00pm - 5:00pm Christmas Open House (Room 800 (Humphrey buil W ednesday, December 13 Thursday, December 14 ~ 11 :45am - 12 :00pm Political Meeting with Secretary Hargan (JOAS ■ 10:00am - 10:45am Weekl y Check- in w/ Anna Ma rie (5202) - Lloyd, Scott (ACF) O Conference Room) - Dugan, Meghan R. (ACF) ~ 12:00pm - 1:30pm Senior Leadership Officials (Conference Room 4523/4603, VTC and audio info below) - Goldhaber, Ben (ACF) O ■ 3:00pm - 5:00pm USCRI Holiday Party (Arlington VA) ■ 2:00pm - 2:30pm Personnel Meeting (Scott's office) - Lloyd, Scott (ACF) 0 ----- Friday, December 15 D Laura- telework - Wh ite, Laura (ACF) o ■ 4 :30pm - 5:30pm HOLD - Deposition Prep (Conference call w/ DOJ) Lloyd. Scott(ACF) [b)(5) I I Uoyd, Scott (ACF) pVERSIGHT 49 12/21/2017 4:45 PM EXT-18-248-A-000049 000050 - December 18, 2017 December 24, 2017 Monday , December 18 0 7 14 21 28 1 2 3 4 5 6 8 9 10 1112 13 15 1617 18 19 20 22 23 24 25 26 27 29 30 31 ■ 11:15am - 11:45am ORR Pre- Briefing Meeting w/ AAS Steve Wagner (IOAS Conference Room) - Lloyd, Scott (ACF) Scheduler (05/105) ~ ■ 12:45pm - 1:30pm Transportation l<_>______ Alamo Car Rental Confirmation: l..... Phone 9:30pm _, Check into Hotel Anchorage Marriott Downtown 820 W. 7th Ave Anchorage AK 99501 Phone:907-279-8000 5 Confirmation: f..... b_><_> _ __, Thursday, December 14 9:30am Repatriation Meeting Location: Robert Atwood Building Address: 550 West 7th Avenue , Suite 1700 17th Floor 5 lb)( ) l(b)(6) @alaska.gov POC: ~b)(6) Participants: Valerie Davidson, Commissioner, Heal and Social services; John Henry Heckendom, Speacial Assistant to the Governor and Chief of Staff; Mike O'Hare , Division Director, Homeland Security and Emergency Management; Bob Doehl, Deputy Commissioner, Department of Military and Veterans Affairs 12:00pm Lunch 1:00pm Refugee Site Visit Meet with Liza Krauszer(Program Director) , Erika Baumann (Employment and Education Coordinator), and Luba Belavtseva (Reception and Placement Coordinator) for RAIS program overview 1:30pm Refugee Site Visit Meet with college student, Garden , Restaurant , and On the Job Training Participants Friday, December 15 8:02am Flight Departs ANC for SEA 12:34pm Flight Arrives in SEA 3:55pm Flight Departs SEA for IAD Flight: Alaska Airl ines 112 and 956, leaving ANC@ 8:02am, Arriving IAD @ 11:47pm EXT-18-248-A-000055 000056 000057 Homestead/Anchorage Trip December 11-13, 2017 Monday, December 11 Flight: American Flight 1005, leaving DCA @ 7:00pm , Arrive MIA @ 9:50pm 7:00pm Depart DCA for MIA 8:00pm Check in to Hotel Hampton Suites Miami S Homestead 2855 N.E. 9th Street Homestead FL 33033 Phone:305-257-7000 (b_)(6 _) -~ Confirmation: 1~ Tuesday, December 12 8:30am Depart for Homestead 9:00am Site Visit: Homestead Address: ~b)(6) IHomestead, I FL~ 1(202) t b)(6) Participants: Asst Sec Steve Wagner, Asst Sec John Bardis, Maggie Wynne, Jonathan White, Gregg Gnipp, Jill Volovar P0Cs: l(b)(6) Wednesday, December 13 Flight: Delta Flight 940 , leaving MIA for ANC at 8:45am , Arrive ANC 8:45am Flight Departs MIA for ANC @ 8:45am 10:42am Arrive in Atlanta 12:39pm Depart for Minneapolis 2:24pm Arrive in Minneapolis 5:30pm Depart for Anchorage 8:54pm Arrive in Anchorage 8:54pm Pick up Car Rental EXT-18-248-A-000057 000058 000059 Lucas, Sarah (ACF) (CTR) Afrom: W!ient: Coleman, Ms. Marquittia (ACF) Monday, December 11, 2017 12:46 PM Lucas, Sarah (ACF) (CTR);White, Laura (ACF) TRAVEL (Update re Rental Car) Concur Itinerary 12/11/2017: MULTI-SEGMENT TRIP TO CONDUCT SITEVISITS IN HOMESTEAD, FL MIAMI AND ACHORAGE ALASKA (LNMWDM) DCA-M IA.ics; MIA-ANC.ics; ANC - IAD.ics; Hampton Inn & Suites.vcf; Marriott Downtown Anchorage .vcf To: Subject: Attachments: Hello Sarah and Laura: Please see below Scott's updated travel reservation to include a rental car in Alaska. Thanks, Marquittia From: Concur Travel [mailto:TravelWizard@concursolutions.com] Sent: Monday, December 11, 2017 12:43 PM To: Lloyd, Scott (ACF); Coleman, Ms. Marquittia (ACF) Subject: Concur Itinerary 12/11/2017: MULTI-SEGMENT TRIP TO CONDUCT SITE VISITS IN HOMESTEAD, FL MIAMI AND ACHORAGEALASKA (LNMWDM) ti Trip Overview Trip Name: Multi-Segment Trip to Conduct Site Visits in Homestead, FL Miami and Achorage Alaska Start Date: December 11, 2017 End Date: December 15, 2017 Created: November 29, 2017, Marquittia Coleman (Modified : December 11, 2017) Description: To conduct · · · estead, Fl and Anchorage Alaska Agency Record Locator: (b)(4) Ticket Number(s): (b)/6) Passengers: Edwa""r""""'co'--,,.o~oy -.--' Total Estimated Cost : $1,889.31 USO Agency Name: Omega - HHS Reservations • • . I . 0 • • • Flight Washington, DC (DCA) to Miami, FL (MIA) American Airlines 1005 /\Mlf ~b)(6) I Departure: 07:00 PM Confirmation: Seat:26F (Confirmed) Ronald Reagan National Arpt (DCA ) Status : Confirmed ~---~ Arrival: 09:50 PM Miami Intl (MIA ) ll Al\ pVERSIGHT 1 EXT-18-248-A-000059 000060 000061 Additional Details Distance : 921 miles - Emissions: 396.0 lbs CO2 Cabin : Economy (G) Remarks • NO HOTEL BOOKED FOR MIAMI FL PREFERRED SEAT NOT AVAILABLE. CHECKS CONTINUE UNTIL DEPARTURE DATE NO FREQUENT FLYER NUMBER IN YOUR PROFILE FOR CARRIER BOOKED Hampton Inn & Suites 2855 N.E. 9th St Homestead, Florida, 33033 us 305-257-7000 Checking In: Mon Dec 11 5l__ Confirmation: ,~l (b_l<_ Room 1, Days 2, Guests 1 Status:Confirmed ~ Checking Out: Wed Dec 13 Additional Information Daily Rate: $120.60 USD Total Rate: $241 .20 USD Room Details Room Description : RoomDescriptionCodeAOBB3Y Remarks HX40182ARR11DEC CXL:CXL BY 1159P DAY PRIOR ARVL • 0 ednesda , December 13, 2017 Flight Miami, FL (MIA) to Atlanta, GA (ATL) Delta 940 Departure: 08:45 AM Seat:33E (Confirmed) Miami Intl (MIA) Confirmation: l(bl(5l Status: Confirmed ,....___ ___. Arrival: 10:42 AM Hartsfield Intl Arp! (ATL) Additional Details Distance : 596 miles Emissions : 256 .3 lbs CO2 Cabin: Economy (L) Remarks • - /\Mlf NO FREQUENT FLYER NUMBER IN YOUR PROFILE FOR CARRIER BOOKED 1r;57 min layover at Hartsfield Intl Arpt (A TL) ll Al\ pVERSIGHT 2 EXT-18-248-A-000061 000062 000063 Flight Atlanta, GA (ATL) to Minneapolis/St. Paul, MN (MSP) • Delta 1715 Departure: 12:39 PM Confirmation: ~~ b_Jc5_l __ Seat:32E (Confirmed) Hartsfield Intl Arpt (ATL) Status : Confirmed Arrival: 02:24 PM Minneapolis St Paul Intl (MSP) Additional Details Distance : 906 mites Emissions: 389.6 lbs CO2 Cabin : Economy (L) • ,r, 6 min layover at Minneapolis St Paul Intl (MSP) Flight Minneapolis/St. Paul, MN (MSP) to Anchorage, AK (ANC) Delta 1088 - Departure: 05:30 PM Confirmation: Seat:43F (Confirmed) Minneapolis St Paul Intl (MSP) Status: Confirmed _J (b_l(_6l__ Arrival: 08:54 PM Anchorage Intl Arpt (ANC) Additional Details Distance : 2510 miles Emissions : 978.9 lbs CO2 Cabin: Economy (L) Alamo Car Rental at: Anchorage US (ANC) Pick-up at: Anchorage US (ANC) Pick Up: 08:54 PM Wed Dec 13 Confirmation: Pick-up at:Anchorage US (ANC) Number of Cars:1 Status:Confinned -------Rate Code :MGD r b)(G) Return: 08:02 AM Fri Dec 15 Returning to :Anchorage US (ANC) Additional Details Rate: $12.00 USO daily rate, unlimited miles Total Rate: $57.90 USO Corporate Discount: -~b_)(_6)____ ~ Rental Details Intermediate I Car I Automatic transmission / Air conditioning /\Mlf ll Al\ pVERSIGHT 3 EXT-18-248-A-000063 000064 000065 Marriott Downtown Anchorage - 820W 7th Ave Anchorage, Alaska, 99501 us 907-279-8000 • Checking In: Wed Dec 13 Confirmation: l(b)(6) Room 1, Days 2, Guests 1 Status :Confirmed ._ ___ ___, 6 Frequent Guest Number :.... b_>< _ >____ f Checking Out: Fri Dec 15 ____, Additional Information Daily Rate : $249 .95 USO Total Rate: $499 .90 USO Room Details Room Description : RoomDescriptionCodeCORA00 Remarks MC25864ARR13DEC CXL:PERMITTED • 0 UP TO 02 DAYS BEFORE ARRIVAL Frida , December 15, 2017 Flight Anchorage, AK (ANC) to Seattle, WA (SEA) Alaska Airlines 112 Departure: 08:02 AM Confirmation f.._b_)<_6>___ Seat :22E (Confirmed) Anchorage Intl Arp! (ANC) Status : Confirmed ___. Arrival: 12:34 PM Seattle Tacoma Intl Arpt (SEA) Additional Details Distance: 1444 miles Emissions : 563.2 lbs CO2 Cabin: Economy (Y) Remarks • NO FREQUENT FL YER NUMBER IN YOUR PROFILE FOR CARRIER BOOKED ,r, 21 min layover at Seattle Tacoma Intl Arpt (SEA) Flight Seattle, WA (SEA) to Washington, DC (IAD) Alaska Airlines 956 5 ~f b_>< _>__ Departu re: 03:55 PM Confirmation: Seat:28E (Confirmed) Seattle Tacoma Intl Arpt (SEA) Status : Confirmed ~ Arrival: 11 :47 PM Washington Dulles Intl (IAD ) /\Mlf ll Al\ pVERSIGHT 4 EXT-18-248-A-000065 000066 000067 Additional Details Distance : 2299 miles -• Emissions : 896.6 lbs CO 2 Cabin : Economy (Y) Total Estimated Cost Air Ticket Number:o.::k b""')/ "'" 6') ___ Taxes and fees: Air Total Price: Hotel: Car: Total Estimated Cost: On- line Check- in _,I$976.37 USO $113.94 USO $1,090.31 USO $741.10 USO $57.90 USO $1,889.31 USO Alaska Airlines Check-in You can check- in on-line up to 24 hours before your flight. You may print your boarding pass at your home or office to avoid ticket counters and kiosks and go right to security . Click the Check - in button to find out more . Confinnation: LWJTHW Remarks CHECK-IN TIME ARE 90 MINUTES PRIOR TO DEPARTURE FOR DOMESTIC FLIGHTS OR 120 MINUTES FOR INTERNATIONAL ** * * -- **** *--***** DELTA AND AMERICAN AIRLINES (INCLUDING US AIRWAYS) NO LONGER HAVE TICKETING AND BAGGAGE AGREEMENTBEGINNING SEPT. 15 . -BAGGAGE TRANSFERS ALSO WONT BE ACCEPTED BETWEEN THE CARRIERS . 6A * ** *-- ***** -- **** * OMEGATRAVEL . COM FEDERAL SERVICES - HOTEL/CAR/AIR /RA I L 855 . 326 . 5411 7 A- 10P EST 85 5-326-5411 EMERGENCY CHECK CARRIER WEB SITE FOR CHANGE/CANCEL AND BAGGAGE POLICIES /\Mlf ll Al\ pVERSIGHT s EXT-18-248-A-000067 000068 000069 Homestead Site Visit Date: Tuesday, December 12, 2017 Location: Former Job Corps Center in Homestead, Florida Site Address: 12350 SW 285th, Homestead, FL 33033 k 6 Point of Contact:,_ 1b)_( _) __ _.,L.._ l(b)(6) ______ ___. Arrival Instructions: Please plan on arriving to the facility by 9:00am on December 12. After showing a government issued photo ID, the security guards will escort attendees to the meeting room for the briefing. The schedule for the day is below. Agenda for Visit: 9:15AM: Briefing on Homestead's use for influx sheltering 10:00 AM-12:00 PM: Tour of site 12:00 Lunch 1:00-2:00 PM Debrief and follow up discussion ~--- ..--, Attendees: Maggie Wynne, Counselor for Human Service Policy John Bardis, Assistant Secretary for Administration Steve Wagner, Acting Assistant Secretary for Children and Families Scott Lloyd, Director, Office of Refugee Resettlement Jonathan White, Deputy Director, Office of Refugee Resettlement Ji11Volovar, Federa l Field Specialist, Office of Refugee Resettlement Gregg Gnipp, Senior Emergency Management Specialist, Office of Refugee Resettlement EXT-18-248-A-000069 000070 000071 • CHiiifREN ~FAMILIES - Office of Refugee Resettlement www.ac f.hhs.gov/prog rams/orr I 330 TO: ACF and HHS Leadership FROM: Scott Lloyd, ORR Director DATE: December 11, 2017 SUBJECT: Read Ahead for Homestead Visit C Street . SW ., Washington. DC 20201 BACKGROUND The Office of Refugee Resettlement (ORR) is responsible for receiving all unaccompanied alien children (UAC) referred by the Department of Homeland Security (DHS) within 72 hours of apprehension, and providing each UAC received with custody and care consistent with the law. To fulfill this requirement , ORR maintains a national shelter network of grant ee residential care facilities. - Referral numbers are historically volatile and unpredictable. Child migration is influenced by complex and overlapping push and pull factors such as poverty, violence, family unity, abuse, crime, natural disasters , and hunger. (b)(5) historic hi b)(5) e census o UAC in ORR care reached a 12 000 UAC in December 2 1 )(5) (b)(5) h\(t;\ Sa result, by Apri l, the number ofUAC in ORR care had plummeted to approximately 2,400, and remained at 2,300-2,400 until mid-June. To make responsible use of ORR's appropriation, the program reduced its permanent shelter bed capacity by 3,053 beds. However, today the picture is very different. The census today is 7,045 UAC in care, more than double the number ofUAC in care since August and up nearly 1,500 UAC from just 30 days ago. At present , the elevated level of referra ls outpaces discharges. Over the past seven days, an average of 44 more UAC have entered ORR care dail throu h referra l from DHS than have exited throu h dischar e. (b)(5) b)(5) u /\Mlf In estimating the need for she lter space, HHS uses a Bed Capacity Model developed by staff of the HHS Assistant Secretary for Planni ng and Evaluation (ASPE). This econometric model estimates beds required , given assumptions regarding the average number of referrals in each month and the time in care. The Bed Capacity Model does not in any way predict the number of UAC that are likely to enter the US. On November 20th, ORR reached the 85% maximum ll Al\ pVERSIGHT EXT-18-248-A-000071 000072 000073 - capacity target and has remained at or above that target since that date. ORR is currently at 88% of current shelter capacity , and there are 925 open beds (of7,970 beds total). b)(5) 11 he (b)(5) week of May 11-17, average daily referrals were 35 UAC/day. That number has climbed to 135 UAC/day for the current seven-day period. (b )(5) n November b)(5) CAPACITY TARGET (85%) - b)(5) IAt me ~Uo/o occupancy thresho ld, larger numbers ofUAC begin exceeding the 72 hour mark. At approximately 95% occupancy , major backups into Border Stations begin. (b)(5) 85% occupancy is also the minimum occupancy level for use of Temporary Influx Shelter capacity. Under the terms of the Flores Settlement Agreement, temporary influx shelter capacity in licensure-exempt sites is permitted in "emergencies" which is generally considered to be at or above the 85% occupancy thresho ld. Operationally, "influx" is defined as UAC in care attaining or exceeding the 85% threshold. CONTINGENCY PLANS b)(5) 0 .b~ ~S5/~'J!/f Children and Families I Office of Refuge e Resettlement I www.acf.hhs.gov/programs/orr EXT-18-248-A-000073 000074 000075 - b)(5) • b)(5) (b)(S) .b~~§f~'jff Children and Families I Office of Refugee Resettlement I www.acf.hhs.gov/programs/orr EXT-18-248-A-000075 000076 000077 APPENDIX A: HOMESTEAD (b)(5) - - .b~~J~ ;i'.j'f ChHdren and Fammes I Office of Refugee Resettlement I www .acf .hhs.gov/programs/orr EXT-18-248-A-000077 000078 000079 - b)(5) •.b~~ if ~;Rt Children and Families I Office of Refugee Resettlement I www .acf .hhs.gov/programslor r EXT-18-248-A-000079 000080 000081 Office of Refugee Reset tlement U.S. Repatriation Program State of Alaska Tentative Agenda (b)(S) -• /\Mlf ll Al\ pVERSIGHT EXT-18-248-A-000081 000082 000083 ~ections to be completed by~ - j(M , ., and DRS are highlighted as indicated .I Refugees in the following categories receive service priority: • New arrivals in their first year in the U.S. • Those receiving cash assistance • Unemployed refugee s not receiving cash assistance • Employed refugees in need of services to retain employment or to attain economic independ ence Refugee Social Services dollar s are provided to Catholic Social Services to provide employment and employability services in the Anchorage area. The services are provided through classes administered by CSS. CSS prioritizes refugees receiving RCA, however over the past two years the agency has been provided certain ESL and job-training classes to refugees receiving TANF. CSS is working out a current plan to serve TANF eligible refugees with additional pass through funding from the grantee in the state that provides TANF . • Services to Older Refugees Set-Aside: o Alaska does not receive SOR funding. • Cuban/ Haitian Set-Aside: o Alaska does not receive C/H funding. • - School Impact Set-Aside: o Catholic Social Services receives School Impact money to assist in supporting arriving refugee families with school-age children. The Newcomer Center in Anchorage receives funding to support refugee children in Anchorage. The Anchorage Schoo l district continues to be one of the most diverse in the country, especially given the population size of Alaska. 3. Targeted Assistance Grant (TAG) Formula Alaska does not receive Targeted Assistance Grant money due to the limited number of refugees arriving in the state. County Name Refugees C-H Entrants Asylees SIVs Total Total Allocation Amount N/A V. Discretionary Grants State Administered Discretionary Grants in Alaska. /\Mlf 1. Targeted Assistance Discretionary 3 1 IC/\I\ pVERSIGHT EXT-18-248-A-000083 000084 ~ections to be completed by PiU] . , pilij,and DRSare highlighted as indicated.I 2. Health Promotion Catholic Social Service s, Inc. in Anchorage is awarded $75,000 in Refugee Health Promotion (RHP) funds. The majority of RHP funds are utilized to support partial Catholic Social Services staff positions , including, a Refugee Health Care Coordinator (RHCC), case managers , the SRC, a Discretionary Grants Coordinator , an Education and Employment Coordinator , an Education and Employment Speciali st, and other administrative position s within the agency. The RHCC provides medical case management for refugee s who need health and mental health services. Case managers work with the RHCC to coordinate healthcare services. Healthcare education classes are provided by the RHCC , and the Education and Employm ent Coordinator and Specialist. RHP funds also support interpretation and transportation for health-related services. Discretionary Grants Administered by Resettlement Agency or Other Service Providers 1. Survivors of Torture Program Alaska does not operate a Survivors of Torture Program. 2. Refugee Agricultural Partnership Program Grantees are funded in the Refugee Agricultural Partnership Program (RAPP) to develop strategies that incorporate agriculture and food system s to improve the livelihood s and economic self-sufficiency of refugee families , with particular emphasis on newly arrived refugees. The strategies employed by the agencies are aimed towards developing a sustainable and/or supplemental income, improve access to healthy foods and better nutrition, and enhance integration into communities by refugee familie s. The organi zations are required to provided I) Access to land for agricultural purposes , 2) Training and Technical Assistance , and 3) Farming Production. GRANTEE CITY STATE Catholic Social Services, Inc. Anchorage AK PROJEC T START 9/30/ 16 PROJECT END AMOUNT 9/29/ 19 $90,000 CONTACT J(b)(6) (b)(6) I l@cssalaska .org Catholic Social Services, Inc. 4 /\MERll /\I\ pVERSIGHT EXT-18-248-A-000084 000085 ~ections to be completed by · - M•,ii@ij, and DRSare highlighted as indicated.I The grantee is in the first year of a three-year project period. While progress for the grant has not been reported yet, the grantee proposed to accompli sh the following during its project period: 1. To increase newly arrived refugees' access to healthy foods, enhanced food security, and better nutrition through a hands-on training garden, monthly food security work shops and ongoing technical agriculture assistance. 2. To support the development of new Alaskan refugee farm entrepreneurs by providing participant s agribusiness classes, hand s-on trainin g on how to manage a for-profit garden , a farmers market stand and ongoing technical assistance. 3. To promote refugee wellbeing, and the succ essful integration of refugees into their new communit y through agriculture and customer service based Vocational English classes, and monthly cooking and nutrition classes. VI. Employment Outcomes For a state with a larg e amount of seasonal employment, Alaska has relatively good outcomes for employment. The outcome rate for FY 2016 was 42%, but 87% of those gaining employment met the 90 day retention rate. Alaska does not currently have a Match Grant program. - VII. Maior Issues/Concerns (b)(5) b)(5) b)(5) b)(5) AMlf ICAI\ pVERSIGHT 5 EXT-18-248-A-000085 000086 ~ections to be completed by blU) . , prtij, and DRSare highlighted as indicated.I b)(5) VIII. Program Highlights/Best Practices Though a small program, Catholic Social Service s continues to orovide stron!! serv i""<'tn newly arrivin g refugees in Alaska.\ (b)(5) b)(5) Appendix A- ORR Funding Overview for FY 2016 Alaska ORR Fundin2 Alaska- FY 2016 Cash & Medical Assistance (CMA) 1 $91,386 Social Services (SS) 1 $128,612 Targeted Assistance Formula (TA-F) 1 $ Wilson Fish (WF) 2 $7 18,916 Refugee School Impact (RSI) 3 $ 175,736 Targeted Assistance Discretionary (TA-D) 3 $ Services to Older Refugee s (SOR) 3 $97,200 Cuban/Haitian (C/H) 3 $ Refugee Health Promotion (RHP) 3 $83 ,055 Matching Grant (MG) 4 $ Preferred Communitie s (PC) 5 $ Individual Development Account s (IDA) 6 $ 6 /\Mlf ll /\I\ pVERSIGHT EXT-18-248-A-000086 000087 ~ections to be completed by -- - ., and DRSare highlighted as indicated .I Micro-enterprise Development (MED) 6 Family Child Care Microenterprise Development (RFCCMED) 6 $ Ethnic Community Self-Help (ECS-H) 6 Refugee Agricultural Partnership (RAPP) 6 $ $ Survivors of Torture (SOT) 6 Total $ $ $1,197,705 Footnotes: This table represents a snapshot of ORR funding available to date for FY 2015. Amounts may vary as new funding opportunities are awarded and as continuation applications are processed. In addition, amounts may also vary as grantees sub-award funds throughout their network. 1 CMA amounts listed here are for FY 2015 awards to date. SS and T A-F Grant amounts listed here are for FY 20 I 5 allocations listed in the FY 2015 Final Notices . 2 WF figures are FY 2014/ 15 awards for use in FY 20 I 5. 3 Funding figures for the State Discretionary grants: RSI, T AG-D , SOR, RHP , and C/1-1are FY 2014/15 awards for use in FY 2015. 4 FY 2015 MG funds are awarded to the national Resettlement Agencies , which allocate these funds to their local affiliates. MG funds are awarded on a per capita basis, so the funds available within the state are listed here. 5 FY 20 15 PC funds are awarded to the national Resettlement Agencies , which allocate these funds to their local affiliate s on a programmatic rather than a per capita ba sis, so the PC funds available within the state may not be shown on this chart. 6 Funding figure s for the IDA, MED , SOT, ECS-H, and RAPP shown in this table are FY 2014/15 awards for use in FY 2015. The se grants are not managed by the state and may be awarded to different organizations within a state. /\Mlf 7 ICAI\ pVERSIGHT EXT-18-248-A-000087 000088 000089 - Alaska 2016 State :! Profile FFY: Regional Offices to complete for profile FFYby 5/1 of the current FFYyear - ORR Regional Representative : ORREligible Populations Top 5 Countries Jordan Becker Refugee Asylee 146 11 Previous FFYNumbers ProfileFFYYear Numbers 128 Other 0 2 40 25 15 7 13 20 ORRPopulationsTotal 0 Total FFY Expenditures Refuge Cash Assistance (include WF CMA as applicable) $21,525 Refugee Medical Screening (include WF CMA as applicable) $0 Unaccompanied Refugee Minors $0 CMA Total ORRAuthorizedFFYAward $91,386 RefugeeSocialServicesFFYAllocation $128,612 $0 TargetedAssistanceFormulaFFYAllocation Medicaid Expanded State? ORR Discretionary Grants $0 2016 /\Mlf Temporary Assistance for Needy Families (TANF) Wilson/Fish or Public/Private Partnershio $0 $0 $0 $923 $514 $0 FFYOUTCOMES(GPRA-AOGP) EmployabilityServices(0-60 monthseligible) 236 Caseload 98 42% 45 Cash Terminations Termination 52% Rate 87% $10.06 Average Wage FFYOUTCOMES(MG) Amount $0 $175,736 MatchingGrant N/A N/A Reaching120 Days 120-day Self-Sufficient (SS) Services to Older Refugees $0 Outcome Rate #VALUE! Cuban/Haitian $0 AverageWage $0.00 Grant $83,055 Health Promotion • Refugee CashAssistance Retentions (90-day) V Targeted Assistance Refugee School Impact Family of3 Outcome Rate $718,916 Wilson/Fish Single Entered Employments 2017 Current FFVCMA Budget Estimate Total Monitoring (year last conducted} CashAssistanceLevels $0 Refugee Medical Assistance (include WF CMA as applicable) State Plan (year last approved) 26% 16% 10% 8% 6% 10 155 Cashand Medical Assistance(CMA) Program - (b)(6) C/H 159 ORR Population s Total "of ORR Popul. Number Individual Development Account Preferred Communities {funded through Volags) $0 $0 Refugee Agricultural Project $0 Micro -Enterprise Development Home BasedChildcare $0 Ethnic Community $0 Survivors of Torture $0 Matching Grant $0 Total ORR Discretionary Funding Total ORR Funding ll /\I\ pVERSIGHT SSon 180-day #VALUE! Outcome Rate NO Micro Enterprise Development Self-Help N/A N/A Reaching 180 days State Refugee Coordinator Phone l(b)(6) l(OJlOJ I l;iccsalaska.org State Refugee Health Coordinator l fo )(6) Phone $977,707 $1,197,705 I l(b)(6) Kb)(6) l(b)(6) ~ccsalaska.org EXT-18-248-A-000089 I 000090 000000 California Monday, August 28, 2017 - Friday, September 1, 2017 000092 000093 Table of Contents - a Flight & Hotel II. Southwesk Key San Diego D Alliance for African Assistance & Catholic Charities ~ IRC San Diego Crittenton Services Backgrounder - II URM Backgrounder Crittenton Shelter & Long-Term Foster Care II II Repatriation ORR 1 J NCardinal /\~~~ I pVERSIGHT • State Profile EXT-18-248-A-000093 000094 000095 SD/ Los Angeles - Monday 10:00am-12:00pm UAC Site Visit Site Name: SWK San Die o El Cajon CA ~)~~)f phone 619-832-2350 Site Address: (b)(5);(b)(7)(C) Site POC:"-' (b-'-'-) (6"-'---~-=--=--=--=--=.-,,work619 (6> k@ccdsd.org ), phone (619~b)(6) IExt. l(b)(6) I Meeting participants: • Dr. Robert Moser, Executive Director • Nadine Toppozada , Director of Refugee Services • l(b)(6) !Staff Physician, Refugee Health Assessment Program - Assistant Clinical Professor , Department of Family Medicine and Public Health, University of California , San Diego. l Health Navigator • !(b)(6) 6 Wilson Fish/Match Grant Case Manager • l I, Wilson Fish/Match Grant Case Manager • l,I SitePOC b)(6) l(a),rescue.org) Phone: (619) '-------' Meeting Participants: • (b)(6) (b)(6) • ,1.-.------,-----J • fo )(6) • b)(6> • (b)(6) • (b)(6) • l(b)(6) • Kb)(6) Regional Director Deputy Director , Programs Early Employment Manager VESL Supervisor ESL Instructor IVESL Instructor IYouth and Career Development Manager IAsset Building Manager Wednesday 10:30 - llam _) /\Mlf ll Al\ pVERSIGHT Meet and Greet with State Coordinators Meeting Location: Wyndham San Diego Bayside , Embarcadero Room 1355 North Harbor Drive , San Diego , CA 92101 See attached list of meeting participants EXT-18-248-A-000097 000098 000099 SD/ Los Angeles • 11-12pm State Refugee Coordinator Meeting Meeting Location: Wyndham San Diego Bayside/ Captain 5 meeting room 1355 North Harbor Drive San Diego, California 92101 Meeting Participants: • ~b)(6) SRC • _(b)(6) SRHC • Marcela Ruiz, Chief, California Department of Social Services, Immigration and Refugee Branch • Dan Torres, Director, Immigrant Integration, Office of the Governor I 12pm-5pm I State Conference Meeting Location: Wyndham San Diego Bayside, 1355 North Harbor Drive San Diego, California 92101 Thursday 10:00am-11 :00am Repatriation Meeting Meeting Location: Wyndham San Diego Bayside, 1355 North Harbor Drive San Diego, California 9210 , Porthole room Invitees: California Department of Social Services (CDSS) Will Lightbourne, Director Pat Leary, Chief Deputy Director Karen Dickerson, Deputy Director LeAnn Raffanti , Bureau Chief Marv Ann Johnson , Program Manager I fb )(6) l(b )( 6 ) California Governor's Office of Emergency Services (Cal OES) San Bernardino County Office of Emergency Services I I Kristini Moffitt, Program Manager Lynne Olson, Sr. Emergency Services Coordinator Cindy Serrano, Assistant Emergency Services Manager Mike Antonucci, Emergency Services Manager /\Mlf ll Al\ pVERSIGHT EXT-18-248-A-000099 000100 00 000101 SD/ Los Angeles • 2:30-3:15pm URM Site Visit Site Name: Crittenton Services for Children and Families ORR Grants: UAC Pro am/ URM ro ram Site Address: b)(6);(b)(?)(C);(b)(?)(F) Fullerton , CA l(b)( 6);(bI Site POC: (b)(6) .________. @critte ntonsocal.org, cell (909) ._l (b_H6_) _ ___.. work 714-680-9000 Meeting Participant s : e (b)( 6) IVP Residentia l Services • b)(6) !Program Director, Shelter • b)(6) I VP Foste r Care and Adoption Services • l(b)(6) ICEO • l(b)(6) !Senior Vice President Program Director Foster Care • l(b)(6) I 3:15 -4:00pm UAC/ URM Site Visit Site Name: Crittenton Services for Chi ldren and Families ORR Grants: ~A~~p~+i#.,~.!.ll,,JLLLJ..l.llLj:, Site Address: (b)(5);(b)(?)(C);(b)(?)(F) A ~~\~tt},( crittentonsocal.org , cell (909) rb)(6) '--------' Site POC: (b)(6) work 714-680-9000 ants: • • • • _____ ,.__------.-~ (b)(6) l(b )(6) • l(b)(6) • l(b)(6) /\Mlf ll Al\ pVERSIGHT VP Resident ial Services Program Director, Shelter VP Foster Care and Adoption Services ICEO l Senior Vice President Program Director Foster Care _. I EXT-18-248-A-000101 000102 02 000103 - 110\0MEGA ~ KORLDTA4KL Omega Travel.com Federal Services Hotel/Car/Air/Rail 855.326.5411 7A-10P EST 855-326-5411 FmArgency Your Connectionto the World fb )(4) I Thursday , 24AUG 2017 09 :09 AM EDT ..,...,...,..,.,....------, 5 Passengers : EDWARD SCOTT LLOYD '.b _l<_ l___ ____. 4 Agency Record Locator: fbl( ) I l.... »ViewTrip » TSA PreCheck »FAA Airport Info »Federal Travel Online Please do not reply to this email. This is an unattended email box Omega World Travel must be notified within 24 hours regarding corrections. Thank you. Sunday, 27AUG 2017 United Airlines Flight Number: 2029 From : (IAD) Washington Dulles DC, USA Depart : 02:50 PM To: (SAN) San Diego CA, USA Arrive : 05:08 PM Stops : Nonstop Duration: 5 hour(s) 18 minute(s) Seats : 31A Status : CONF IRMED Equipment: Boeing 737-900 Jet MEAL: FOOD TO PURCHASE Class: S-Coach/Economy Miles : 2258 / 3613 KM ARRIVES SAN TERMINAL 2 Frequent Flyer Number: (b)(6) ..,...,...,..,.,....---'-------,!:- -,-,,,., ---, United Airlines Confirmation number is "-b..:..:)('""'6) _ ____. Check in on-line to obtain boarding pass : United Click here for Baggage policies and fees : United HOTEL Sunday, 27AUG 2017 Springhill Stes Bayfr Marriott (SPR INGHILL SUITES) 900 Bayfront Court San Diego CA 92101 US Number of Rooms : 1 Confirmation Numberf.... b_)(4 _l__ Phone : 1 619-8310224 Fax : 1 619-3919780 ~ Rate : USO 179.00 Room GUARANTEED TO VISA Check Out: Thursday , 31AUG 2017 Reserved For: LLOYD EDWARD SCOTT Hote l membership: l(b)(6) - Room Type : REG '------------' XVB7152ARR27AUG CXL:PERMITTED UP TO 03 DAYS BEFORE ARRIVAL XVB7152ARR27AUG CXL:PERMITTED UP TO 03 DAYS BEFORE ARRIVAL Guaranteed to :!(b)(4) /\Mlf ll Al\ pVERSIGHT I Page 1 of 3 EXT-18-248-A-000103 000104 04 000105 Approximate total: 751.34USD Credit card required at check-in - HOTEL Thursday , 31AUG 2017 LOS A ngeles Airport Marriott (MARRIOTI) 5855 W Century Blvd Los Angeles CA 90045 US ---- Number of Rooms : 1 Confirm ation Numberf b)(4) Phon e: 1 310-6415700 Fax: 1 310-3375358 Rate: USO 158.00 Room GUARANTEED TO V ISA Check Out: Friday , 1SEP 2017 Hotel membership: f,_b_)(_6)__ Reserved For: LLOYD EDWARD SCOTT ...., Room Type : GOV MC1104ARR31AUG CXL:PERMITTED UP TO 02 DAYS BEFORE ARRIVAL Guaranteed to fb\/6\ I Approximate total: 182.94USD Credit card required at check-in AIR - Friday, 1SEP 2017 United Airlines Flight Number: 360 From: (LAX)Los Angeles CA, USA Depart : 07:05 AM To: (IAD) Washington Dulles DC, USA Arrive: 03:09 PM Stops : Nonstop Duration: 5 hour(s) 4 minute(s) Seats: 25D Status: CONFIRMED Equipment: Boeing 737-800 Jet MEAL: FOOD TO PURCHASE Class : S-Coach/Economy Miles: 2295 / 3672 KM DEPARTS LAX TERMINAL 7 Frequent Flyer Number:l~ (b-)(-6)--~ 6)__ United Airlines Confirmation number is '-'-l (b_)("-'Check in on-line to obtain boarding pass : United Click here fo r Baggage policies and fees : United TOUR Saturda y, 30DEC 2017 THANK YOU FOR BOOKING WITH OMEGA WORLD TRAVEL CHECK- IN TIME ARE 90 MINUTES PRIOR TO DEPARTURE FOR DOMESTIC FLIGHTS OR 120 MINUTES FOR INTERNATIONAL CHECK CARRIER WEB SITE FOR CHANGE/CANCEL AND BAGGAGE POLICIES OMEGATRAVEL.COM FEDERAL SERVICES-HOTEUCAR/A IR/RAIL 855.326.5411 7A- 10P EST 855-326-5411 EMERGENCY A TRANSACT ION FEE OF $8.26 HAS BEEN CHARGED TO YOUR CARD THE TRANSACT ION FEE NUMBER IS ~(bl(4l A TRANSACTION FEE OF$ 34.30 HAS BEEN CHARGED TO YOUR CARD THE TRANSACT ION FEE NUMBER IS -~b)(4) TICKET NUMBER - , bl(4l INVOICE NUMBER bl!4l AIRFARE CHARGE - $ 0.00 TOTAL CHARGES INCL TRANS FEE - $34.3 ! ! ! I Ticket/Invoice Information: - Ticket for: EDWARDSCOTT LLOYD Date issued: 08/24/2017 Invoice nbr: l(b)(4) Ticket Nbr: b)(4) Electronic : Yes Amount: 407.40 USO Exchange for: Issued : 23AUG17 Charged to: (b)(6) '---------J Service Fee: \MLt EDWARD LLOYD I../\1\i pVERSIGHT Page 2 of 3 EXT-18-248-A-000105 000106 06 000107 Date issued : 08/24/2017 Document Nbr1.... (b_)(_4)___ ___. - Amount: 34.30 USO Total Tickets: 407.40 Total Fees: 34.30 Total Amount: 441.70 Changes to airline reservations may result in an increase in fare and/or carrier penalties. Please verify the validity of picture ID, passport and/or any visa requirements if traveling abroad Faeebook lnstagram llnkedln Twitter YouTube - /\Mlf ll Al\ pVERSIGHT Page 3 of 3 EXT-18-248-A-000107 000108 08 000109 - Facility Contact list Facility Name: Southwest Key San Diego Facility contact information: Add res~b )(6);(b)(?)(C );(b)(?)( F) lcA~\~!\~!d Phone 619-832-2350 Email (if any) Admin istration (faci lity and corporate) Name Daniela Rios Ana Babudar Title Program Director Assistant Program Director Phone Email Kb)( 6 l@swkey.org b)(6) ~@swkey.org (b )(6) Case Management - Name l(b)(6) I Titl e Lead Case Manager (b)(6) Title Lead Clinician l(b)(6) Phone I l(b)(6) Email l@swkey.o rg Clinical Services Name J): Since 1985, under contract from the County of San Diego, Catholic Charities has implemented this federally-funded program, which has touched nearly 58,000 refugees . The only non-profit, non-governmental provider of this service in the country, CCDSD works with the County Department of Public Health and the University of California at San Diego, Department of Preventive Medicine to provide a comprehensive health screening within the first 30 days of arrival to San Diego County. CCDSD health navigators conduct intake, orientation, initial review of symptoms, health education, referral and follow-up, while UCSD medical staff performs the phlebotomy, nursing and clinical functions. The primary purpose of the program is to identify health and mental health needs, to protect the public health and to connect refugees to health care home. The health exam includes immunizations for children, a review of medical history and test results, a physical examination and referrals to healthcare providers in the community . The Wilson/Fish Project: Prior to 1990, the Welfare System was the resettlement milieu for most refugees across the country , including San Diego. Enabled by the passage in 1984 of the Wilson/Fish Amendment to the Refugee Act, the national Volags solicited and then selected San Diego to pursue being a private-sector alternative to that system. In 1990, CCDSD became the first such alternative, and as the longest operating Wilson/Fish (WF) Project in the country, wc have consistently and clearly demonstrated higher outcome levels in terms of employment and earnings , earlier and longer selfsufficiency , and lower costs and dependency rates than exists within the public sector system. Since 1999, the San Diego Wilson/Fish Project includes all of the voluntary resettlement agencies, and we currently serve all time-eligible (i.e., < 8 months) Refugee Cash Assistance refugees and asylees in San Diego County., The WF Project directly distributes RCA and provides Employment, Accu lturation, and Case Management services. Employmentservicesenable selfreliance and economic self-sufficiency. The Employment team focuses on providing services in the area of job search , job skills, job development, vocational skills training and building relationships with employers in the community. The team coaches clients one-on-one to assess clients for employability , skills and experience, assign appropriate employment activities, and develop a job search plan with client participation . They work in close coordination with the case management and acculturation teams. They help clients refine their resumes, prepare for job interviews, assist clients with oriental.ion to the work environment, and identify job fairs and employment interview opportunities. The team also teaches a series of Job Readiness Workshops to foster necessary skills for the application and interview processes, and to enable newcomers to be successful in the U.S. job market. They act as liaisons between the employer and the job seeker; matching the right candidate and their experience to the employer 's needs, and following up on any issues that arise. The placement success rate by RCA expiration for FY16 was 83.51%. Acculturation services enable successful community integration and assist in removing barriers to self-sufficiency that result from a lack of familiarity with the American culture. Communicative and socio-cultural competencies arc the foundation for the success of acculturation and integration. The program uses an experiential, intercultural learning model that pays anent.ion to the value systems and cultural traditions clients bring with them as well as those that make up the fabric of American society. The Acculturation curriculum covers San Diego Culture, Mapping Resources and Engaging with the Community, Financial Competency , Basic Laws and Regulations, Educational Opportunities , among other topics. Catholic Charities ' acculturation program has been recognized nationally as an innovative initiative fostering clients ' resiliency and sense of belonging. Case management services enable needs and problems to be identified and addressed as quickly as possible and enhance the achievement of objectives through the regular monitoring of a refugee's progress and performance by the use of assessment tools and individualized Self-Sufficiency Plans (SSP). The assessment tools reflect our statrs training on trauma-informed, person -centered services. Case Managers assess clients through personal interviews and assist them to build their future by removing barriers to employment or social integration. They provide case management to clients from date of arrival through 12 months, or up to 60 months if needed. ~ Gu:holic lJ Charities f b~)~ ~ (6~) _______ ~1San Diego, California !/h\l R I• Tel. (619) 287-9454 • Fax (619) 287-6328 Member Agency of United Way • Member Agency of Catholic Charities USA Diocese of San D iego I\ pVERSIGHT EXT-18-248-A-000117 000118 18 000119 - Catholic Charities Address: j_~~ Email:Ll Tristyn lngallinera, V.P of Residential Service s Office: 714~(b)(6) Cell: 714fb)(6) 1Email: ~f b~)(6 -) --l I r~-cr_i tt _e_n_to_n_s_oc_a_l._ or....,,.g @crittentonsocl.org FosterCare: fbl(B) ~ MFTI, V.P Foster Care and Adoption Office: 714-fb)(B) Cell: 909f b)(6) Email:,..,....l (b)..,.,,. (6) .----.~ crittentonsocal.org I I Primary Points of Contact, ORR/Division of Unaccompanied Children's Services Richard Zapata , Federal Field Specialist (Shelter) Tel: (202) 380-6894; Email: Richard.zapata @acf.hhs.gov Alex Sanche z, Federal Field Specialist (Foster Care) Tel: (202) 494-0394; Email: Alex.Sanchez @acf.hhs.gov Ivonne Velazquez, Supervisor, Federal Field Specialist /\Mlf ll Al\ pVERSIGHT 1 EXT-18-248-A-000127 000128 000129 • Tel: (202) 281-9535; Email: lvonne.velazquez@acf.hhs.gov Reina Byrd, Project Officer Tel: (202) 401-5677; Email: Reina.byrd@acf.hhs.gov SHELTERLOCATION: CorporateOffice: l(b)(6);(b)(7)(C);(b)(7)(F) I Fullerton, CA fb]~?l ;(b Main Number: 714-680-9077 Valley View Cam us: b)(6);(b)(7)(C);(b)(7)(F) Fullerton, CA ~~!\~:<~ U FOSTERCARELOCATION: - • Overview UCP Shelter: Crittenton Services for Children and Families, Unaccompanied Children's Program provides temporary shelter care and other related services to children in Office of Refugee and Resettlement (ORR) custody. The clients served range from age 8 through his/her 18th birthday (younger children may be served but require a waiver from Community Care Licensing). Additionally, Crittenton is equipped to take pregnant and parenting teenage mothers and youth with medical, emotional, and/or behavioral issues. Given its long term experience working with youth with complex needs, Crittenton accepts placements that would be considered "therapeutic group home" and "therapeutic staff secure". The Southern California location provides access to resources to accommodate youth from many cultures. All shelter staff are bi-lingual (English/Spanish) and other languages and cultural competencies are easily provided as needed. Countries served since 2006 include: China, India, Eritrea, Somalia, Iraq, Columbia, Equador, Peru, New Zealand, and Canada. Services provided include shelter/group home; case management; medical services; education/academic and cultural enrichment; recreational activities; counseling and mental health; chemical dependency as indicated; pregnancy prevention and counseling; parenting as indicated. Over the course of the past year, the shelter program has seen significant changes in the client's length of stay. Due to this, the agency has made adjustments to case management, clinical and medical department schedules so as to accommodate the rapid rate of intake and discharge. These changes have increased Crittenton's ability to assess each client in a timely manner, provide appropriate referrals, and find necessary community resources for each client. Further, this has /\Mlf ll Al\ pVERSIGHT 2 EXT-18-248-A-000129 000130 30 000131 also allowed the program to meet ORR contract requirements in relation to discharge timelines. All programs and services are trauma-informed and are nationally accredited. Crittenton Long-Tenn Foster Care: Crittenton primarily provides long term foster care placements; however, we also provide transitional foster care as needed. Crittenton Foster Family Agency (FFA) has 73 certified foster homes and two foster homes pending final certification , located throughout 5 counties: Los Angeles, Orange, San Bernardino, Riverside, and San Diego. Crittenton FF A has an office in two locations: Fullerton (Orange County) and Moreno Valley (Riverside County). An additional office in San Diego County is in the process of becoming licensed. Crittenton FFA is licensed to serve children from birth up to 21 years-of-age; however per-contract, DCS-funded youth can remain in the program only until the age of 18. Crittenton Services LTFC program has been 99 % successful of establishing Legal Residency to the DCS children we have served in 2015-2016 and plan to continue with equal success in the future. Crittenton F.C. has established and maintained a positive working relationship with Immigrant Defenders, which works diligently in coordination with the Social Worker, to meet the child's legal needs. Additionally, since the inception of our program, we have established positive working relationships with the local courts that have a clear understanding of our program (s). The management team, along with the Masters Level Social Workers have developed community collaboration with many agencies to meet the needs of the children in our care, i.e. Mental Health, psychiatry, medical, dental, as well as advocating and educating teachers, and administration at the local High Schools, Junior High's and English Language Development facilities in the community. Despite many of the DCS youth in our program enter care with very limited academic history; many of the youth have demonstrated educational success with the continued advocacy of the Foster Care staff as well as the foster parent. - Crittenton LTFC, employs three Master Level clinicians to offer Mental Health services to the child/minor in the home, assisting with transition, depressions, adjustment, and offers family sessions to assist the minor in all areas of mental health while in the foster home. The clinical department also offers weekly Drug and Alcohol education classes for the youth in our care. A significant advantage that Cri ttenton' s LTFC program has is the ability to collaborate between the Crittenton UAC Shelter which is a DCS funded shelter. The ability to discuss referrals, share the same FFS, GDIT, and ICE agent seamlessly streamlines the continuity of care of the minor, facilitates communication, and maintains a best practice approach. Additionally, the Crittenton LTFC program offers an Unaccompanied Refugee Minor Program and once the DCS youth is designated as a URM to the State of California, the youth is able to remain in the same foster home until all services are exhausted, maintaining consistent relationships, and social, emotional, and academic stability. Additionally, the support and collaboration of the shared Case Management/Family Reunification services of the Crittenton UCP shelter, and the continued development and training of the LTFC Social Worker to maintain family exploration, has resulted in many youth being reunified with • /\Mlf 1 ICAI\ pVERSIGHT 3 EXT-18-248-A-000131 000132 32 000133 - family across the nation. Crittenton does not anticipate any difficulty maintaining this standard of care. All Crittenton Services LTFC program staff was trained by Kevin Campbell in Family Finding and Engagement (sponsored by Crittenton Services), which has facilitated successful Sponsor reunification for the youth . - /\MlfllCAI\ pVERSIGHT 4 EXT-18-248-A-000133 000134 34 000135 - Office of Refugee Resettlement U.S. Repatriation Program Tentative agenda August 31, 2017 Meeting Agenda 1. Introduction 2. Memorandum of Understanding between ACFand ASPR a. Brief overview (b)(S) b. MOU and state impact 3. b)(S) Emergency Repatriation a. Update and Ontario lnt enational Airport b. Federal assistance and CA SERPrevision c. Los Angeles International Airpo rt and potential planning d. Potential CA SERPexercise 4. Non-Emergency Repatriat ion a. - Open dialogue of potential issues/concerns S. Other b)(S) I b)(S) ·O /\Mlf ll Al\ pVERSIGHT EXT-18-248-A-000135 000136 36 000137 • 2. Support during SERP development : ASPRwill help identify and connect the state with the appropriate DOD POCwho will be assistance during SERPplanning . Ill. EMERGENCY REPATRIATION a. Ask the State to provide an update about ONT airport b. Advise: We would like to continue working with you and to use CA SERPas model plan to other states. • Ask: whether CA is interested in authorizing the Federal government to use its SERPas a Model plan once approved by ORR. • Ask:deadline to submit SERP. It is my understanding that you have a deadline to submit your SERP. We w ant to work with you in extending this deadline . th Would October 30 work? Do you need any assistance with your SERP development? c. Ask: HHSwould like to know whether the state is able to include LAX as part of their SERP. If so, how can HHS support you? d. Advise: It is my understanding that late last year you had a discussion with Elizabeth • about potentially exercising your CA SERP. We want to support you, but have no money . Please let us know how we can help you . • We would like, if possible, to expand this exercise to invite other states and federal partners to be observers. This can be used as a great training and networking opportunity. IV. NON-EMERGENCY REPATRIATION a. V. Open dialogue of potential issues/concerns , recommendations OTHER 3 /\Mlf 1 ICAI\ pVERSIGHT EXT-18-248-A-000137 000138 38 000139 - U.S. Repatriation Program Meeting with california (8-31-17) Draft Talking Points Acronyms ASPR:Assistant Secretary for Preparedness and Response OTA:Department of Transitional Assistance EMG:Emergency Management Group (ASPR) MEMA:Emergency Management Agency (state) NERP: National Emergency Repatriation Plan POC:Point of Contact RECs:Regional Emergency Coordinators (ASPR) SERP:State Emergency Repatriation Plan SOC:Secretary Operations Center EOC:State Emergency Operation Center ISS-USA:International Social Services (grantee) (b)(5) • • /\Mlf 1 ll Al\ pVERSIGHT EXT-18-248-A-000139 000140 EXT-1 000141 W5) EXT-1 41 000142 EXT-1 000143 • ORR-1 California Office of Refugee Health Estimat es for Refugee Medical Assistance, Refugee Health Assessments, & Administration Costs Justification FY 2018 Refugee Medical Assistance (RMA) a. RMA Recipient Costs: 1. Rationale for estimating the number of RMA Recipients: According to the U.S. Department of State's fiscal year 2018 Reception and Placement Program Resettlement Agency's (RA) proposals , the following is the proposed arrivals for California: Individual s with U.S. Ties Individuals without U.S. Ties Special Immigrant Visa Holders (SIVs) Total Proposed for FY 2018 (Individuals) IRC - Glendale 500 0 50 550 USCCB - Glendale 100 0 80 180 USCRI - Glendale 375 75 260 710 CWS - Los Angeles 190 0 40 230 EMM - Los Angeles 75 IO 25 110 HIAS - Los Angeles 105 0 5 110 LIRS - Los Angeles 30 20 20 70 HIAS - Los Gatos 105 0 60 165 WR-Modesto 130 55 140 325 WR-North Highlands 500 0 600 1,100 IRC - Oakland 160 20 200 380 Affiliate • /\Mlf Page 1 of 11 California Office of Refugee Health ORR-1 Cost Justification August2017 1 ICAI\ pVERSIGHT EXT-18-248-A-000143 000144 EXT-1 000145 • USCCB - Oakland 55 0 90 145 USCRI - Oakland 55 0 45 100 CWS - Sacramento 70 0 900 970 JRC - Sacramento 390 10 900 1,300 ✓ - USCCB - Sacramento 42 0 48 90 USCRl - Sacramento 75 25 300 400 USCCB - San Bernardino 5 0 30 35 ECDC - San Diego 270 l l0 145 525 HIAS - San Diego 185 165 50 400 IRC - San Diego 415 500 85 1,000 USCCB - San Diego 195 190 76 461 IRC - San Jose 50 60 40 150 USCCB - San Jose 14 0 36 50 IRC - Turlock 130 220 100 450 HIAS - Walnut Creek 15 25 110 150 4,236 1,485 4,435 10, 156 STAT E TOTAL However , based on previous historical data the RA proposed arrivals are always increased by 20% (n=2031) for a total of 12,187 new refugees in FY 2018. In addition, the Office of Refugee Resettlement provided the following FY 2018 arrival estimates: 15,000 entrants, 7,000 SIVs, 25,000 asylees, and 1,000 trafficking victims . Thus, wit h the latter ORR estimates and based on California's FY 2017 data, we estimate that California will receive 2000 asylees, 500 secondary refugees, 100 VOTs, 1000 walk-in SIVs and 100 Cuban/Haitian entrants this year. ·• /\MlfllCAI\ pVERSIGHT Page 2 of 11 California Office of Refugee Health ORR-1 Cost Justification August 2017 EXT-18-248-A-000145 000146 EXT-1 000147 - 2. Arrival Estimates: Based on data from PRM, RAs , and our program , California's arrival estimates for FY 2018 are as follows: • • • • • • Refugees Asylees Secondary Refugees VOTs Walk-in SIVs Cuban & Haitian Entrants Totals : 12,187 2,000 500 100 1000 100 15,887 3. Monthly ave rage cos t per RMA recipient: - California provides RMA benefits which are the same as for regular Medi-Cal beneficiaries . The cost estimated and presented in this document include costs fo r fee-for-service medical providers (1st month of arrival) , managed care plans , dental services , mental health services , and developmental health services . The monthly average cost per unit is $370. This monthly average cost per unit is based on the actual monthly expenditures for RMA claims during the last three years , divided by the average number of beneficiaries during the same period . This is the RMA estimated cost per unit we will use to calculate the annualized total estimates for FY 2018 . 4. Monthl y ave rage of RMA recip ients entering th e program : Table 1 below shows the number of RMA recipients currently enrolled whose RMA eligibility will cross from FY 2017 , and new expected arrivals in FY 2018 : Table 1 - RMA Recipie nt Monthly Loads and Costs - MONTH CARRY OVER FROM FY 2017 Octobe r 100 /\MlfllCAI\ pVERSIGHT ESTIMATED TOTAL FY 2018 MONTHLY ESTIMATED MONTHLY NEW RECIPIENTS AVERAGE IN FY 2018 100 200 ESTIMATED COST PER UNIT $ 370 ESTIM ATED MONTHLYCOST $74,000 Page 3 of 11 Ca liforn ia Office of Refugee Hea lth ORR- 1 Cost Justification August 2017 EXT-18-248-A-000147 000148 EXT-1 000149 - Novembe r December January February March April May June July Aug ust Septembe r 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 200 200 200 200 200 200 100 100 100 100 100 $ 370 $ 370 $370 $ 370 $ 370 $370 $ 370 $ 370 $ 370 $ 370 $ 370 Grand *Total 700 1,200 1,900 $370 $74,000 $74 ,000 $74,000 $74,000 $74 ,000 $74,000 $37,000 $37,000 $37,000 $37,000 $37,000 $703 ,000 * For the purpose of completing the FY 2018 ORR-1 Cash and Medical Assistance Program Estimates form , Section 2-a (RMA Recipient Cost) , we divided the estimated monthly user total in table above by 12 months which equals 159 recipients per month . b. RMA Administ ration Cost: - Personne l Serv ices 0.15 FTE's Salaries and Wages Yearly Salary $ 11,000 These positions are for Medi-Cal Eligibility Division to oversee eligibility requirements for refugee medical assistance ; preparing and distributing All County Welfare Directors letters related to RMA eligibility , requirements, and procedures ; respond to county inquiries pertaining to eligibility requirements ; conduct annual RMA case monitoring; implement enhances to MEDS ; monitor adherence to RMA regulations; provide training to local eligibility staff ; preparing correspondence pertaining to program eligibility requirements , etc. Fringe Benefits (49.2%) California requires a 49.2% fringe benefit rate based on total salaries and wages : $11,000 x 49.2% = $5,500 $ 5,500 Total Salaries and Fringe Benefit $ 16,500 These positions are required for the overall management and oversight of the Refugee Medical Assistance program . /\Mlf Operating Expe nses General Expense (supplies , copying, etc .) Communication (state standard costs) Facilities Operations (state standard costs) $ $ $ 2,000 1,000 4,000 Page 4 of 11 California Office of Refugee Health ORR-1 Cost Justificat ion August2017 ll Al\ pVERSIGHT EXT-18-248-A-000149 000150 50 000151 - Consolidated Data Center/Enhancement to MEDS Total Op eratin g Expenses $ $ 20 ,500 27,500 TOTAL ESTIMATED DHCS ADMINISTRATION COST S $ 44 ,000 c. Medical Screening & County Administration Cost: 1. Breakdo wn of cost for each medical sc reening provided : California provides culturally and linguistically-appropriate comprehensive health assessments to newly arrived refugees , asylees , special immigrant visa holders, federally-certified victims of severe forms of trafficking , and other eligible entrants . The Refugee Health Assessment Program (RHAP) focuses not only on screening of and prevention of communicable diseases, but also on identification and diagnosis of chronic diseases and other important medical and mental health conditions . The assessment also includes assessment of immunization status for children and adults and referral to health providers for further medical evaluation, treatment , and follow -up of chronic and other important medical and mental health conditions . • Because of the large geographical area and the large volume of medical screenings conducted in California, contractual award agreements are required with nine impacted local health departments (Alameda, Contra Costa , Los Angeles , Orange, Sacramento , San Diego , San Francisco , Santa Clara and Stanislaus) to provide services to new arrivals. Annual local subvention awards are allocated to these impacted counties based on anticipated number of arrivals , staffing needs for intake, nursing , medical provider and other factors , such as cost-of-living differentials . Thus, the award to each county is negotiated. However , cost per medical screening unit calculated below is considered as an estimate . Furthermore , in California the Medi-Cal rates are extremely low for medical providers , thus, RMA funds are needed to fund local public health departments to ensure that Refugees have adequate health services. However , Medi-Cal does reimburse for the necessary labs and immunizations if they are performed within the first 30 days of the Medi-Cal application and then no RMA funds are needed for those services . We calculated the estimated average cost per health assessment based on the following factors : a. Age brackets provided by ORR . • /\Mlf lll 'Al\ pVERSIGHT Page 5 of 11 California Office of Refugee Health ORR- 1 Cost Just ification August 2017 EXT-18-248-A-000151 000152 52 000153 - b. Three-year arrival average broken down by adults/children (34% of all arrivals are children under 18 years of age; 66% of all arrivals are 18 years of age and older). c. Estimated costs for medical exams per refugee for adults/children provided by ORR. 2. Cost per health assessment : Based on the criteria listed above, the following costs were calculated per health assessment which is completed in two visits: a. Children (less than18 years of age): $240 .41/assessment b. Adults (18 years of age or greater): $27 4.02/assessment For detailed calculations of per assessment costs see Attachment A. 3. County Health Assessment Administrative FY 2018 cost: - Responsible for coordinating the program planning and oversight activities at the local refugee health assessment programs to ensure the compliance with California State established guidelines during the delivery of post-arrival health assessments The total administrative cost (including operational costs) to fund nine local refugee health county programs (Alameda, Contra Costa , Los Angeles, Orange , Sacramento, San Francisco , Santa Clara, San Diego & Stanislaus) is $1,143,855 . 4. Projected FY 2018 caseload and antic ipated carry over from FY 2017: Currently , the average length of time between refugee arrival/adjudication date and scheduling of the first appointment to start the medical screening is approximately 10-20 days. The process period between the start and completion of the health assessment is approximately 15-25 days -- it takes at least two clinic visits for the completion of the medical screening and referrals . Therefore, the average time from refugee arrival/adjudication date to completion of health assessment is 30-50 days. We anticipate approximately 1000 refugees to carry over from FY 2017 . These screenings should be completed by October 31, 2017 . • /\Mlf Page 6 of 11 California Office of Refugee Health ORR- 1 Cost Justification August 2017 1 ICAI\ pVERSIGHT EXT-18-248-A-000153 000154 54 000155 - Table 2 below shows the monthly health assessment workloads for FY 2018 , based on arrival projections by PRM, California RAs, and our program : Table 2 - Health Assessment Monthly Workload Refugees & SIVs( 12,187 + 12) 1,016 = 1,000 + 12) 83 Secondary Refugees (500+ 12) 42 Victims of Trafficking (100 + 12) 9 Cuban/ Hait ian Entrants (100 + 12) 9 Walk-in SIVs (1,000+ 12) 83 Carry over from 2017 (1,000+ 12) 83 Total Estimated Monthly Load for 2018 *Tota l fo r FY 2018 (1,325 x 12) 1,325 (15,900) Asylees* (2,000 x 50% *The estimated month ly load for asylees is based on an average of actual number of asylees served during the last three years and projections from California immigration partners . This year we expect to serve approximately 1,000 new asylees in California . The reasons why more asylees don't seek our services may be because they already have jobs with medica l insurance and do not require our screening services, or they may not be aware that they are entitled to medical screening services , which has been the case in several instances . 5. Cost per health assessment (Attachment A): a. Children (less than18 years of age): $240/assessment b. Adults (18 years of age or greater): $274/assessment These costs per assessment will be used in our estimates below . Table 3 below shows the estimated monthly average of health assessments and costs for children less than 18 years of age (34% of total estimated arrivals) . Approximately 340 Children will arrive in late September 2017 and will be carried over into FY 2018: /\MlfllCAI\ pVERSIGHT Page 7 of 11 California Office of Refugee Health ORR-1 Cost Justification August 2017 EXT-18-248-A-000155 000156 56 000157 • Table 3 - Children (0-17 years of age) (34% of total refugees) · Month October November December January February March April May June July August September Total Children Carry Over from 2017 340 340 Estimated Monthly Recipients in 2018 Estimat ed Unit Cost 456 450 $240 $240 $191,040 $108,000 450 450 $240 $240 $108,000 $108,000 450 $240 $108,000 450 $240 $108,000 450 450 $240 $108,000 450 450 $240 $240 $240 $108,000 $108,000 $108,000 450 $240 $108,000 450 $240 $108,000 5,406 $240 $1,379,040 Estimated Monthly Cost Table 4 below shows the estimated monthly average of health assessments and costs for adults - 18 years of age or greater (66% of total estimated arrivals) . Approximately 660 adults will arrive in late September 2017 and will be carried over into FY 2018 . Table 4 - Adults (~18 years of age) (66% of total refugees) Month October November December January February /\Mlf Carry Ove r from 2017 660 Estimated Monthly Recipients in 2018 Estimated Unit Cost Estimated Monthly Cost 880 874 874 $274 $274 $421,960 $239,476 $274 $239,476 874 874 $274 $274 $239,476 $239,476 Page 8 of 11 California Office of Refugee Health ORR-1 Cost Justification August 2017 IC'AI\ pVERSIGHT EXT-18-248-A-000157 000158 58 000159 - March 874 $274 April May 874 874 $274 $274 June Jul y August 874 $274 874 874 $274 $274 $239,476 $239,476 $239,476 Septembe r 874 $274 $239,476 10,494 $274 $3,056,196 Total Adults Table 5-Total - Child Totals Adu lt Totals Total Grand Total 660 $239,476 $239,476 $239,476 Estimated Health Assessment Costs for FY 2018 Estimated Total Recipients Inc ludin g carry over from 2017 Cost per assessme nt 5,746 11,154 16,900 16,900 $240 $274 N/A $262 Total 2018 Estimated Cost for Health Assessments Total $1,379,040 $3,056,196 $4,435,236 N/A N/A N/A $4,435,236.00 * For the purpose of completing the FY 2018 ORR-1 Cash and Medical Assistance Program Estimates form, Section 2-c (Medical Screening), we used the following figures : • We derived the monthly workload by dividing the total 15,900 annual estimated recipients by 12 months= 1325.3=1325 average workload . • Total estimated amount of $4,173,858 divided by total number estimated recipients 15,900 = $262 per assessment cost. • To adjust for cost of living increases the health assessment has been rounded to $300 per assessment. d. Total California Office of Refugee Health Administr ation Cost: Personne l Services Yea rly Salary Resea rch Scientist Supervisor I 100% FTE $ 111,853 (Filled) - Chief of the Office of Refugee Health . Establishes, implements , and oversees policy for the delivery of quality refugee health services in California. /\Mlf Research Scientist Ill 100% FTE $ 100,104 Page 9 of 11 California Office of Refugee Health ORR-1 Cost Justification August2017 1 ll 'Al\ pVERSIGHT EXT-18-248-A-000159 000160 000161 - (Filled) - Provides leadership in assessing the state 's refugee health epidemiology workforce and infrastructure , and guiding statewide efforts to enhance local refugee health epidemiology capacity . In addition , is responsible for ensuring health assessment data quality; designing and responding to ad hoc data requests from local, state , and federal agencies serving refugees. Research Scientist II 100% FTE $ 91 ,016 (Filled) - Responsible for coordinating the program mental health planning , training and oversight activities related to the local refugee health assessment programs to ensure the compliance with established guidelines as well as linkage to mental health providers after the health assessments . Health Program Specialist I 100% FTE $ 79,725 (Filled) - Provides leadership to all refugee stakeholders . Thus , is responsible for providing the link between State sponsored services such as Medi-Cal and refugees to address the needs of the community. In essence, the work of Health Program Specialist I centers on informing the refugees about various issues that affect them as we ll as getting their input on these . Health Program Specialist I 100% FTE $ 79,725 (Filled) -Provides administrative work to support operation of the program , including the areas of development and implementation of program policy and procedures , prepare budget change proposals and legislative analysis. In addition , is responsible in monitoring and supporting funded health assessment programs. Associate Accounting Analyst 100% FTE $ 76 ,235 (Filled) - Responsible for providing fiscal management. Develops funding proposals and grant applications; monitoring grant application expenditures to ensure they comply with grant requirements ; submitting monthly , quarterly , and annual revenue , expenditure , and other cost reports ; and reviewing and reconciling the program's financial records. - UC Davis Master of Public Health Student (Intern) $ Total Salaries $ 538,658 Fringe Benefits (50.990%) California requires a 50.990% fringe benefit rate based on total salaries and wages : $538 ,658 x 50.990% = $274 ,662 $ 274 ,662 Total Salaries and Fringe Benefits $ 813,320 -0- Indirect Cost (¥bH4) M,) $ ~..... b)_(4_) _ __. CDPH requires an indirect cost charge for all state positions that are federally funded. The current indirect cost rate for personnel services negotiated between the California pVERSIGHT Page 10 of 11 California Office of Refugee Health ORR- 1 Cost Justification August 2017 EXT-18-248-A-000161 000162 000163 - Department of Public Health and the federal government is lrbl<4l applicable to salaries and benefits . (Attachment B) Pio.This Total Salaries, Fringe Benefits, and Indirect Cost $ rate is 990,623 These positions are required for the overall management and oversight of the Refugee Medical Assistance Screening program. Other Required Direct Costs The following direct costs are required by CDPH for each federally-funded state employee housed in a State-owned/leased facility : Communication $1 ,300 x 7 positions Facilities Operations $10 ,500 x 7 positions Total Other Required Direct Costs - $ i $ Operating Expenses Trainings w/ local health assessment providers and stakeholders General Supplies Printing/Reproduction of protocols , and other health materials IT Maintenance and Support Travel (for site visits and to attend out-of-state conferences and meetings) In-State 2 staff x 10 trips x airfare at $450 each = $9 ,000 2 staff x 10 trips x 2 days per diem at $46 each = $1, 840 2 staff x 10 trips x 2 nights lodging at $125 each = $5,000 12 trips x 1 day rental car at $65 each = $780 Total In-State= $16, 620 $ $ $ $ $ 9,100 73,500 82,600 40 ,000 15,000 15,000 148,201 16,620 Total Operating Expenses $ TOTAL EST/MA TED CDPH ADMINSTRA TION COST $ 1,308,044 pVERSIGHT 234,821 Page 11 of 11 Californi a Office of Refugee Health ORR-1 Cost Justification August 2017 EXT-18-248-A-000163 000164 000165 ORR-1 CMA Program Estimates Program Name: Refugee Cash and Medical Assistan ce Grantee Name: California (Medical) Report Name : ORR-I CMA Program Estimates Report Period : I 0/01/2017 to 09/30/2018 Report Status: Submission Accepted by CO Department of Health and Human Services Administration for Children and Families 0MB No. 0970-0030 AppfOYalexp.es : 10131/2014 Refugee Resettlement Program Estimates: CMA ORR-1 CASH AND MEDICALASSISTANCE PROGRAM ESTIMATES Instructions : Click on balded headings for instructions . Information Gn ntee Na me: Califomia Federal Fiscal Year: 2018 Estimates Cash and Mediul Auista nce Program Components (Column A) . f-1rimated Average ' Monthly Unit Cost (Column B) Estimated AVtl'ale Monthly Recipients / Estima ted Total Fiscal Year upenditurts u.... (Column D) (CollUllllC) I. Refugee Cash Assistance (RCA) . a) RCA Recipit-nl Co1b - $0 0 $0 b) RCA Administration so .. c) Subtotal : $0 l . Refugee Medical Assistance {RMA) a) RMA Recipient Costs b) ~tA . Adminu lrarion $370 159 . ' c) Medical Scrttnin C $705,960 $300 d) Medical Scrunlng Administration $44,000 - 1,325 $4,770,000 $1 , 143,855 e) S11btotal $6,663 ,815 3, Unaccom panied Refugee Mino~ (URM) •>St-rvkn ror URMJ so . 0 $0 b) URM l'rofram Admin.utration $0 c) Subtotal ◄. so Admini1tratlon • Pr"lr•m Coordination and Pla11nlll1: $1,308.044 5. Total AdmlniJtralioo $2,◄95,899 6. Total Estimate $7,971 ,859 Certification - . . Ce rtificati on: I certify to th e bc,t or my kn owledge and belief that this report is co rrect and co mpl ete for performance Na m e and Title of Approving Official Telepho ne Number : Susan Osfeld E-mail Addres s: susan .osfeld@cdph .ca.gov Signatur e of Approving Official Date Re port Submitted: 08/11 /2 017 ~. ", pVERSIGHT Page I EXT-18-248-A-000165 000166 000167 Federal Fiscal Yea r (FFY) 2018 ORR-1 Justificatio n for California August15,2 017 1. REFUGEE CASH ASSISTANCE (RCA) a) RCA Recipient Costs: Caseload : Based on most recent historic RCA caseload data from October 2016 through April 2017 , the California Department of Social Services (COSS) determined the average monthly caseload for RCA to be 2,069 . However , the COSS believes this number is too low to project a viable funding amount for FFY 2018 . The COSS evaluated RCA caseload data trends for the last 12 months average to the end of FFY 2018 , and an increase in the average monthly caseload is 3,058. Moreover , proposed Resettlement Agency (RA) capacity levels are projected at a higher amount than the projected refugee arrivals to California this year (10,156 versus 7,167). As a result of the data and RA proposed capacity levels , the COSS is projecting an average monthly caseload for FFY 2018 to be 2,498 RCA recipients . - - In the last two years, California has moved to the top state for placement of the combined populations of refugee arrivals , asylees being granted asylum , victims of trafficking , and Special Immigrant Visas (SIV) holders , and is expected to be impacted in FFY 2018 . While the refugee arrivals caseload may be impacted by the Pres idential Order by not restricting tied cases , the number of asylees , trafficking victims , and SIVs are expected to continue , thus potentially increasing arrival numbers. California has received approximately 10 percent of the nation 's refugee arrivals and the majority of SIV arrivals as Sacramento County continues to remain the epicenter for SIV arrivals. There has been an increasing upward trend in the last two years of SIV arrivals receiving services in California , as verified by the federal Office of Refugee Resettlement (ORR) . For FFY 2017 , California has already processed 5,550 SIVs compared to a total of 4,010 for FFY 2016 and 2,009 for FFY 2015 . The trend has been increasing steadily since 2013 without a downward fluctuation . Cash Grant: Historical expenditure data from May 2016 through April 2017 was used to determine the RCA cash grant. The average monthly grant cost for RCA per recipient during this time period was $334 .96. However , on October 1, 2016 , California issued a 1.43 percent increase to the grant amount for the California Work Opportunity and Responsibility to Kids (CalWORKs) program, which also applied to RCA grant amounts . To adjust for this unusual fluctuation , the months of October and November 2017 were not included to determine the adjusted estimated average monthly grant cost for RCA per recipient of $340.87. Therefore , the average monthly grant cost for RCA p~r recipient for FFY 2018 is estimated to be $340.87 (rounded to $341.00). ($341.00 X 2,498 X 12 = $10,221,816) . /\MlfllCAI\ pVERSIGHT 1 of 8 EXT-18-248-A-000167 000168 000169 Federal Fiscal Year (FFY) 2018 ORR-1 Justification for California August 15, 2017 The proposed cost is higher than the previous year because the cost per case expenditures have increased. Total RCA Recipient Costs= $10,221 ,816 b) RCA Administration: The county RCA administration cost of $3,269 ,782 is based on most recent historic actual expenditure data (April 2016 through March 2017). Expenditures are reported by the counties for caseworker and allocable support costs in accordance with the COSS' federally approved Cost Allocation Plan for County Welfare Departments. These costs include RCA eligibility determinations , grant maintenance activit ies, and conducting cause determinations and conciliations for RCA clients . Expenditures also include costs for Electronic Data Processing and direct costs. For FFY 2018 , the average month ly administrative costs per RCA recipient is estimated to be $109.08 ($109 .08 X 2,498 X 12 = $3,269,782). Total RCA Administration= $3,269,782 c) RCA Subtotal= $13,491,598 - 2. REFUGEE MEDICAL ASSISTANCE (RMA) RMA Recipients: Costs associated with Medical Assistance will be reported by the California Department of Public Health under separate cover. Medical Screenings : Costs associated with Medical Screenings will be reported by the California Department of Public Health under separate cover. 3. UNACCOMPANIED REFUGEE MINOR {URM) PROGRAM URM C OSt Esf 1mates andE xpend"tI ures ORR-1 Line 3(a) URM Services ORR-1 Line 3(b) URMAdmin . ORR-1 Line 3(c) URM Subtotal .. t rati o n - D"1rect Serv,ces and Ad mm1s SRC's Office (CDSS-RPB) Contracted URM Provider#1 (South-CFCS) Contracted URM Provider #2 (North-CCSCC) Contracted URM Provider #3 (North-I CA) $0 $9 ,947,538 $8,290,405 $1,995,629 $20,233,572 $471,185 $552,178 $743,130 $105,862 $1 872,355 $471,185 $10,499,716 $9,033,535 $2,101,491 $22,105,927 Totals for ORR-1 Column D 2 of 8 /\MlfllCAI\ pVERSIGHT EXT-18-248-A-000169 000170 000171 - Federal Fisca l Year (FFY) 2018 ORR-1 Justification for California Augu st 15, 2017 a) Serv ices for URM: URM Proposed Budget: For FFY 2018 , the estimated amount fo r services for the URM program in California is $20 ,233 ,572 . In FFY 2017 (as of May 2017) there have been 55 placements and 40 exits . As of May 2017 , there are 232 minors being se rved in California 's URM program. Overall , the program caseload has grown steadily and is projected to increase for FFY 2018 . The program is , and Ill) w ith the providers administered through state contracts (Attachments I, 11 Catholic Charities of Santa Clara County (CCSCC) , an affiliate of U.S . Conference of Catholic Bishops , and Crittenton Family and Children Services (CFCS) and International Christian Adoptions (ICA) who are affiliates of Lutheran Immigration and Refugee Services . It is important to note that the contracts for the URM programs in California are based on a State Fiscal Year (SFY) (July through June) . The current contracts are in effect for three years , with the contracts starting on July 1, 2017 and ending June 30, 2020 . The amounts provided in this justific ation have been prorated to coincide with FFY 2018 . In an effort to avoid over estimated contra cts, the RPB used prior expenditure data to calculate more accurate projections. Additionall y, the URM proposed budget for FFY 2018 includes funds to expand services for CCSCC and CFCS . These expansions are not yet included in the contract amounts . It is anticipated that the contract amendments will be completed by October 1, 2017 . Expansion services by each of these providers are explained below : • • CCSCC will open a sub-office in the East Bay area . Forty percent of Catholic Charities ' caseload are placed with resource families that live in the East Bay (Alameda and Contra Costa Counties) . This sub-office will allow for future program growth as it is laying the foundation for continuing program growth in that geographic area . The ORR and the COSS , have discussed the need for more URM placements in California , specifically regarding placements for URMs who need short term residential therapeutic centers (STRTCs ) due to behavior issues , mental health needs, or specialized placements for hard to place URM youth . CFCS owns two eight bed, fully furnished , and licensed Group Homes that could start serving male URMs that require a higher level of care than a traditional foster home can provide in the ORR 's URM network . Based on historical placement data, the COSS projects an upward trend in minors being served for FFY 2018 , with an estimated average monthly caseload of 313 minors (Attachment IV) . Based on the projected trend , it is estimated there will be approximately 366 minors being served at the end of FFY 2018 (September 2018) . The estimated average monthly cost of care for the youth is $5,387 ($5 ,387 X 313 X 12 = $20,233 ,572) . 3 of 8 /\MlfllCA~ pVERSIGHT EXT-18-248-A-000171 000172 000173 - Fede ral Fiscal Year (FFY) 2018 ORR-1 Justification for California August 15, 2017 • URM Foster Care Services : The California URM program provides a wide range of benefits and services which mirror the foster care provisions in the California Title IV-E plan. This includes traditional foster care , therapeutic group homes , and emancipation services until age 24. Emancipation services are for youths between the ages of 18 - 24 who are compliant with their Independent Living Plans and include independent living training, employment training, educational grants , and supported housing. The URM program places youths into the most appropriate and least restrictive setting possible . Youths are primarily placed into certified foster family homes supervised by licensed Foster Family Agencies . In certain situations when necessary , the program will place children into certified therapeutic homes or licensed group homes/residential treatment centers (levels 1 - 14) until the youth is ready to return to a foster family setting. In California , the foster care system was overhauled to change the certification process , licensing categories , and the running of group homes which is referred to as the Continuum of Care Reform (CCR). It also draws together a series of existing and new reforms in California 's Child Welfare. The implementation of CCR will occur between now and 2021. The impact of CCR on the URM program will affect URM youth residing in group homes . CCR is eliminating group homes in California and replacing group homes with STRTCs . STRTCs will provide intensive treatment interventions for youth requiring highly intensive 24-hour supervision and treatment but are designed to quickly transition youth to a permanent foster home placement. Current foster care costs have increased from the previous year primarily due to the anticipated caseload and the rates for care set by the state have increased. On January 1, 2017 , a new rate structure for foster care and group homes due to the implementation of the CCR changed from an agebased structure to a level of care-based structure . The CCR is a major reform of the mainstream foster care system that the URM program is paralleling. The current foster care rates are shown in Attachment V (All County Letter (ACL) No . 17-75) . Due to the timing of implementation, rates for Foster Family Agencies , based on a youth's age , are still in effect and these are the rates we have been using (see page four of the ACL for information on Phase I FFA Rate Components) . - Starting December 1, 2017 , all URMs will be reassessed based on their level of care and the new rate structure for CCR or Phase 11 , will become effective (see page five of the ACL fo r information on Phase II FFA Rate Components) . The highest level of care rate , which most of the URM youth will receive is $117 more than the current highest rate that our youth receive based on their age. We have planned for this rate increase in all three of the URM budgets /\MlfllCAI\ pVERSIGHT 4 of 8 EXT-18-248-A-000173 000174 000175 Federal Fiscal Year (FFY) 2018 ORR-1 Justification for California August 15, 2017 - so we should not need to do amendments to cover the costs for the rate changes that will take place in December 2017 when CCR becomes active. The ACL lists the new rate for the short-term residential therapeutic program (STRTP) that is replacing most of the group homes in California. Two of our providers (ICA and CCSCC) will be using the new STRTP rate starting on December 1, 2017. We have already budgeted for this higher rate in the contracts. Crittenton will still be using the old group home rate as they have been given an exception to continue use of a group home for their URMs. The FFY 2018 URM budget projects Foster Care Services costs to include the following: Item Cost Licensed Foster Care $4,172,952 Foster Care Support Services/Independent Living $1,646 ,800 - Residential Treatment Centers/Group Homes/Drug Treatment TOTAL $5,594,937 $11,414,689 • URM Legal Fees: Legal expenses are projected to be $173,879 for FFY 2018. The URM program pays for the legal costs, including attorney fees, to establish private guardianship of the youths placed in the state . It also pays for annual guardianship reports that must be filed with the local courts for each foster child in care, as required by California's Foster Care program. Per ORR State Letter #09-24 , refugee entrants are required by federal law to file with the USCIS Form 1-485 "Application to Register Permanent Residence or Adjust Status" after one year in the U.S. and adjust to legal permanent resident status . The URM program budgets for miscellaneous legal fees in anticipation of certain instances when legal counsel will be necessary to adjust a youth 's immigration status to legal permanent resident. The URM program does not pay the filing fees for adjustment of status or citizenship . • - URM Medical Costs: URM foster children in California receive full-scope Medi-Cal, which is the state's version of federal Medicaid. State-funded full scope Medi-Cal, at no cost to the URM program, is also extended to URMs with approved Special Immigration Juvenile Status, and those who have been granted a U Visa . When entering the URM program, youths are always enrolled in Medi-Cal, which pays for medically necessary health care services /\MlfllCAI\ pVERSIGHT 5 of 8 EXT-18-248-A-000175 000176 000177 Federal Fiscal Yea r (FFY) 2018 ORR•1 Justification for Ca lifornia August 15, 2017 - that include: physician visits , prescription drugs, hospitalization , x-ray and laboratory, nursing home care, some dental care , some ambulance services, prosthetic and orthopedic devices, eyeglasses , hearing aids and some medical equipment, and hospice care. However , occasionally youths may need medical , dental , or therapeutic medical treatments that are not reimbursed by Medi-Cal. This may occur because no appropriate Medi-Cal resource is available . For example, many youths who arrive are highly traumatized and in need of immediate mental health services in their native languages . It can take six to eight weeks to schedule an appointment with a Medi-Cal provider, and it may not be with a therapist with the appropriate language or experience. In such cases , the URM program may initially pay for counseling in order to stabilize the youth while awaiting Medi-Cal services. The Department of Health Care Services (DHCS) and the COSS issued a joint letter (All County Letter 16-03) in January 2016 for the purpose of clarifying Medi-Cal eligibility for youth in the URM Program . URM youth and former URM youth in California are eligible to receive full scope Medi-Cal regardless of their immigration status up to age 26. - The FFY 2018 URM budget projects medical costs to include the following : Item Mental Health/Medical Services Unreimbursed by Medi-Cal Cost $176,483 TOTAL $176,483 • URM Personnel Costs : The Northern California URM programs are operated by the CCSCC and ICA , and the Southern California URM program is operated by the CFCS. The projected personnel costs for FFY 2018 will be $5,645,176 and include staff salaries and benefits based on actual time worked in the URM program . Costs have increased by $732 ,824 ($320 ,003 for Northern California CCSCC, $594,685 for Northern California ICA, and decreased by $181 ,864 for Southern California CFCS) from last year , due to increased staffing to accommodate the anticipated caseload increase , cost of living increases, and the addition of the new Northern California provider (ICA) . CFCS 's personnel costs have decreased from last year's budget due to a decrease of five staff positions in the projected contract. /\Mlf 6 of 8 ICAI\ pVERSIGHT EXT-18-248-A-000177 000178 000179 Federal Fiscal Year (FFY) 2018 ORR-1 Justification for California August 15, 2017 Location Northern California (CCSCC) Northern California (ICA) Southern California (CFCS) TOTAL • FFY 2017 Person nel Cost FFY 2018 Projected Personnel Cost Cost Difference $2,590,027 $2,910,030 + $320 ,003 $170 ,539 $765,224 + $594 ,685 $2,151 ,786 $1,969,922 - $181,864 $4,912,352 $5,645,176 + $732,824 URM Other Costs : The URM contracts in California include $2,823,3 45 for other expenses that cover supplies, space , communications , equipment , advertising/outreach , travel, training , background checks , miscellaneous, and costs for the supported housing program . Total Services for URM = $20,233, 572 - b) URM Program Ad ministration: URM state administration includes a cost of $471,185 for state staff to administer the URM programs in California . Please see the attached line-item budget (Attachment -VI) that provides detail on salaries , benefits , operating expenses , and indirect costs for state staff. URM provider administration includes a cost of $l' I ·• ~ "" """; ~e~~~ 1 arad1se Rock Club C!! Harvard Bridge 60s t 0 . Untvers1t JS C!! (!) (7),. ,, , ~" "'' or 1ie~<-- ..¥"__ 0 Kenmore SquareO 6 ;,; ,f ® BACK "(i) w~:/ ¥ ~ Fenway Parl< (!) --oo· • •• • w H •-Klldehst ~ '~ SUIIJn er.a - Somit -2 i)<> mo; r, 11; P;p te lic oi lheCor'lO l! o ,n11 t.1<1tia1ze;,-c,111s ;:tt,in:".4 ~, ·r.a.q :. , . S n :!~m Swan Arm li!p u:t" (.;1•11.t ./ .l~ Whatistheir immigrations status? 11iCl'~nn r, gront,d osrlumin 2015 .... ,, -~ a; ::, (1,.-r re.'!I First \'l;it 7'l¼. 68% Asyt ,. 1% 10½ 8% 2% R■!uate Permon1nt R11idem 5.7% 7% U.S . Citi m 1.5% 11% I Un,bwmeni!d lr.illliJrcf S IJI A.sylurn Seek er 'E ... -" .. 1i {I: cc C 3 .... ., f ~ ~ ~ E ;., .:c :I ..,.. C :a 'f; l.! cf • Ill ::i ■ A, fr•: , Vr, I •. }! i C ID E :, Temporary PrclettedStoliis 0.11 % V-iso D011va tiw Asyltt 1% 9.6r,;, D% 05% 0% 1% ),tt~·J< t /\Mlf 1 ll Al\ pVERSIGHT EXT-18-248-A-000235 000236 000237 Travel Phone List Boston Traveler s Michael Vineyard Scott Lloyd Elizabeth Russell Ce ll:Db)(6) Ce ll: Ce ll: Regiona l Rep Contact Lisa Raffone lli Ce ll:.._f b-)(6-) ___ _, HH S HO Co ntacts For Mike: Erica Chapman Erica.chapman@hhs.gov Desk: 202-26 0-7190 Ce ll: f b)(6) I For Scott and Elizabeth: Laura Gregg Laura.Gregg@acf.hhs.gov Desk: 202-401-4849 Cell: l(b)(6) I Sarah Lucas Sarah.Lucas@acf.hhs.gov Desk : 202-2 05-8764 Ce ll: NA (Personal Phone has work email) Marquittia Co leman marquittia.coleman@acf.hhs.gov De sk: 202-401-9382 Travel Flight (Omega) Omega Travel.corn 855-326-54 l l Ground Tran sportation To be coordinated onsite Important Addresses Hote l: Courtyard Cambrid ge Marriott 777 Memorial Driv e Cam bridge MA 02139 Phone : 61 7-492- 7777 EXT-18-248-A-000237 000238 000239 ~ections to be completed by • 111. jjM, itffl,and DRSare highlighted as indicated.I Massachusetts ORR Refugee Program Briefmg I. Refugee Program Background The Massachusetts Office for Refugees and Immigrants (MORI) is the agency responsible for administering the Wilson Fish (WF) refugee resettlement program in the Commonwealth of Massachusetts. In place since 1995, MORI subcontracts with USCCB, USCRI, LIRS, ECDC, EMM, and HIAS Resettlement Agency partners to implement the WF program in four primary areas of the state: the greater Boston metropolitan area (including the North Shore); Lowell and the Merrimack Valley; Worcester County , and Hampden County (Springfield, West Springfield , and Westfield). MORI is a stand-alone agency located within the Executive Office for Health and Human Services; the Executive Director assumes the role of State Refugee Coordinator and is appointed by the Governor. MORI provides a comprehensive set of benefits and services to refugees resettling in Massachusetts through the WF program, which include RCA; core and intensive refugee case management; integrated pre and post-employment job services and English language training; literacy training; vocational skills training; Vocational English Language Training (VELT); re/certification training; post resettleme nt community services; refugee citizenship services; translation and interpreter services; social adjustment services; and youth adjustment services. State Refugee Coordinator: Mary Truong, Executive Director, Massachusetts Office for Refugees and Immigrants (MORI), MA Executive Office for Health and Human Services (EOHHS) State Refugee Health Coordinator: Jennifer Cochran, Director, Refugee and Immigrant Health Program, MA Department of Public Health (DPH) Consultations MORI holds mandatory quarterly "Welcoming Network" consultations , held quarterly, which cover the four geographical regions of the Commonwealth: Eastern MA (Suffolk & Essex Counties); Merrimack Valley; Worcester County; and Hampden County. Additional regional consultations occur as needed, along with periodic program-based meetings (regional and/or statew ide) to provide opportunities for information sharing and strategizing to resolve issues. Additionally , MORI works with local partners in the resettlement communities (e.g., Mayors ' offices, school systems, local Boards of Health , public safety entities , public assistance offices) to prepare them for the arrival of new refugee 'populations. II. Total ORR Funding for Refugee Services and Programs $18,623,221 in ORR funding went to the state in FY2016 to serve refugees and eligible populations. Of this total, nearly all funds were issued to the state-administered Wilson/Fish program; less than ten percent went directly to community based organizations and providers . For a complete list of ORR funding, see Appendix A. - III. FY2016 Arrivals -Top Locations AMlf I Al\ pVERSIGHT 1 EXT-18-248-A-000239 000240 ~ections to be completed by ... , Rl4, and DRSare highlighted as indicated.I The top five countries of origin of refugees in MA were the Democratic Republic of Congo, Haiti, and Iraq, each with 15% of the arriving population; Somalia (12%), and Bhutan (10%). Resettlement occurs in four urban areas: greater Boston, including the North Shore (approximately 20% of arrivals); Lowell (approximately 13% of arrivals); Metrowest/Worcester, with approximately 30% of arrivals, and Western MA (Springfield, Westfield, West Springfield), with about 37% of arrivals. IV. State Administered Formula Programs 1. The Cash and Medical Assistance (CMA) Program reimburses states for 100 percent of services provided to refugees and other eligible persons, as well as associated administrative costs for the following: • Refugee Cash Assistance (RCA) • Refugee Medical Assistance (RMA) • Unaccompanied Refugee Minors Program (URM) ORR clients determined ineligible for Temporary Assistance for Needy Families (TANF) and Medicaid may be eligible for RCA and RMA for up to eight months from the date of arrival in the U.S., date of final grant of asylum for asylees, or date of certification for trafficking victims. a) Refugee Cash Assistance and T ANF MORI provides monthly cash assistance to RCA-eligible clients based on MA TANF payment standards, in accordance with Department of Transitional Assistance {DTA) regulations. The state agency also receives funding from the Department of Transitional Assistance {DTA) for job placement and job upgrades for refugees who receive Temporary Assistance for Needy Families (TANF). RCA payment rates mirror the state's T ANF rates: Case Size 1 2 3 Rate Case Size 4 $428 $531 5 6 $633 Rate $731 $832 $936 RCA eligibility determination, enrollment , case maintenance, and recipient file documentation are duties performed under the Refugee Case Management (RCM) contract; RCA Case Managers at the Resettlement Agencies are responsible for determining eligibility for RCA at the initial point of application, and on a monthly basis throughout the RCA eligibility period. They also determine eligibility for the Early Employment Retention Bonus (EERB) for employment 1) gained within 4 months from their date of time eligibility (within 6 months for Cuban and Haitian Entrants) and 2) maintained for a 90-day period. In May 2014, MORI issued a policy directive establishing a clear set of protocols to encourage Resettlement Agencies to distribute RCA checks to recipients from their offices rather than continue the practice of directly mailing checks to recipients. This check delivery method became mandatory for all new RCA recipients in FFYI 5. 2 /\MERll 'Al\ pVERSIGHT EXT-18-248-A-000240 000241 ~ections to be completed by. - ,- ■•- and DRSare highlightedas indicated.I b) Refugee Medical Assistance (RMA) and Refugee Medical Screening (RMS) The Office for Refugees and Immigrants (ORI) has an Interdepartmental Service Agreement with the Office ofMassHealth, Executive Office of Health and Human Services for the provision ofRMA. Local resettlement agencies have the responsibility for determining initial RMA eligibility for clients they resettle who are ineligible for Medicaid. The RMA income standard is 200% of the Federal Poverty Level (FPL). Massachusetts has expanded Medicaid coverage to low-income adults without dependent children. RMA enrollees should mostly consist of refugees whose income falls between 133% and 200% FPL or former Medicaid clients who lost coverage due to employment but are still within the eight month eligibility period. The Department of Public Health (DPH) oversees the medical screening program through an Interdepartmental Service Agreement with ORI. DPH contracts with community health centers or hospital-based clinics for the provision of medical services. RMA funds most direct medical screening costs and some costs associated with coordinating screenings. DPH tracks medical screening data in MAVEN c) Unaccompanied Refugee Minors (URMs) - Background The Unaccompanied Refugee Minors (URM) program was developed in the late 1970s to address the needs of children who entered the U.S. as refugee s without a parent or guardian to care for them. Over the years Congress has passed additional legislation authorizing URM eligibility to other categories of unaccompanied children such as asylees, Cuban/Haitian Entrants , trafficking victims, certain Special Immigrant Juveniles , and U-visa recipients. Eligible children are placed into the URM program and receive the same range of child welfare benefits and services available to other children in the State, including those identified in the State 's plans under Title IV-Band IV-E of the Social Security Act. Grantee/ Administration Massachusett s Office of Refugee s and Immigrants (MORI) is the state agency responsible for administering the URM program. MORI has an Interdepartmental Service Agreement (ISA) with the Massachusett s Department of Children and Families (DCF) for the provision of URM services. MORI, DCF, and URM program staff have shown strong coordination and communication in administering services. URM services have been provided by Massachusetts since 1980. • Legal Responsibility Massachusetts is a public custody state. DCF obtains legal custody for the children in their care through a court hearing for those children under 18, and through a Voluntary Placement Agreement (VPA) up to 72 hours before the child's ls1h birthday. As such, all URMs in Massachusetts receive Medicaid benefits (Mass Health) to cover their medical , dental , and mental health care and are eligible for independent living services, education and training vouchers (ETVs) , and discharge support from DCF. AMlf K Al\ pVERSIGHT 3 EXT-18-248-A-000241 000242 ~ections to be completed by -..111, jiit and DRSare highlighted as indicated.I Placements DCF procures URM services and contracts with Ascentria Care Alliance (a LIRS affiliate) for case management and placement services. DCF oversees placements in foster homes, therapeutic foster care, group homes, and specialized residential care settings across the Commonwealth. MORI has been exceptional in placing high needs youth including pregnant and parenting teens. URMs Served by Ma ssachusetts in FY 2016 City: Worcester Total for state Agency Name: Ascentria Care Alliance 194 194 Data in the above table was drawn.from the URM database on 3115/17 and is subject to change as database records are reconciled. 2. Refugee Social Services The Refugee Social Services Program funds services to refugees to help them obtain employment and achieve economic self-sufficiency in the shortest time possible. Employment and support services are designed to enable refugees to obtain jobs within one year of becoming enrolled in the program. • • Employment Services include: employability assessment , job search, vocational English Language services/ESL, vocational education , on the job training, case management, assistance with daycare, assistance in obtaining employment documents, translation/interpretation assistance, transportation assistance, job development, job upgrade services, and job retention services. Support services include: daycare, translation and interpretation for purposes other than employment , citizenship and naturalization preparation services, home manag ement, financial literacy services, and case management services. Refugees in the following categories receive service priority: • New arrivals in their first year in the U.S. • Those receiving cash assistance • Unemployed refugees not receiving cash assistance • Employed refugees in need of services to retain employment or to attain economic independence Eligibility for ORR-funded RES is limited to employable adults ages 18 through 64, who have not yet naturalized, 16 and 17 year olds who will not go to high school but plan to work fulltime, and high school students ages 16 through 22, who are in need of part-time jobs. Refugee Employment Services available to employable clients include pre-employment services, postemployment services, and ongoing employment-oriented case management. There are three primary employment services provided through RSS/Formula funds to support Refugee Employment Services (RES): I) Comprehensive Refugee Employment Services Program (CRES); 2) Re-Certification training grants, and 3) Transportation assistance. 4 /\MERICAi\ pVERSIGHT EXT-18-248-A-000242 000243 ~ections to be completed by. • - , M, llij, and DRSare highlighted as indicated.I CRES is an integrated employment/ESOL program for all eligible employable adults providing the following core services: Intake and orientation, including vocational and ESOL assessment, development of the FSSP; Core pre-emp loyment services Uob readiness training fully integrated with employment- oriented ESOL and literacy training where needed , job development, job counseling, vocational skills training when required for initial employment, job search and placement assistance, RES case management to remove barriers to employment , daycare assistance, transportation assistance, translation and interpreter services, and EAD assistance); Core post-employment services Uob retention assistance (follow-up and mediation with employer and employed client), job upgrade assistance, career and higher education counseling and planning , vocational skills training when required for job upgrade or re/certification, and ongoing RES case management and related assistance to remove barriers to job retention and employment upgrade). Employability Services offered under CRES are supplemented and complemented by additional programs for employable clients provided under TAG/Formula and TAG/Discretionary funding when available. These services target sub-populations with special needs and/or within specific geographic areas, and offer additional services, such as longer term/intensive vocational skills training , that may not be available through the primary basic employment services program , CRES. • Services to Older Refugees Set-Aside: MORI contracted with local partnerships to serve refugee elders in Worcester; Western Massachusetts (Greater Springfield); and the North Shore (Lynn); three areas with large numbers of older refugees, including Bhutanese , Burmese , Congolese, Iraqi, Somali and other African refugee s. Called the Program to Enhance Elder Refugee Services (PEERS), services include case management; referra ls to mainstream services; assistance with naturalization ; home visits; mental health support; farm/community garden and farmers' market participation; and assistance with housing applications. • Refugee School Impact Program Set-Aside : MORI contracts with Resettlement Agencies (3); School Districts (3) and MAAs (2) to provide School Impact programs in Boston , Lynn , Lowell, Worcester , and Hampden County (Springfield , West Springfield, and Westfield). Program s provided refugee students and their parents with school liaisons; tutoring; after-school and summer programs; English classes; translation and interpretation at the schools ; social and cultural adjustment activities; and other supports. 3. Targeted Assistance Grant (TAG) - The Targeted Assistance Grant service s are similar to Refugee Social Services; however they are distinctive in that they prioritize: • Cash assistance recipients , particularly long-term recipient s • Unemployed refugees not receiving cash assistance /\M lf 1 ll Al\ pVERSIGHT 5 EXT-18-248-A-000243 000244 ~ections to be completed by • - M and DRSare highlighted as indicated.I Employed refugees in need of services to retain employment or to attain economic independence MORI currently receives TAG/Formula funds for Suffolk, Middlesex , Worcester and Hampden Counties. The TAG/Formula services that are provided in these four counties complement the Wilson/Fish social services , and are intended to result in economic selfsufficiency and reduced welfare dependency of eligible populations through the attainment of employment in less than one year from enrollment. TAG/Formula services also provide skills training options (e.g. hospitality training , food service training , CNA/HHA training , customer service training , industry specific training , financial literacy, bank teller training and driver's education programs) which are generally not available through the RSS-F CRES program. V. Discretionary Grants State Administered Discretionary Grants in Massachusetts 1. Targeted Assistance Discretionary The TAG-D program , called Empowering Families (EF), assists TANF-eligible employable participants to gain higher-quality employment and higher wages. Empowering Families draws on core refugee employment services and integrated ESOL while providing enhanced assessment, case management , gender-specific discussion groups (Tea Circles), industryrelated vocational skills training , Driver ' s training, licensing assistance , and other supportive employability services. Empowering Families has been provided by two contracted service providers in the Lynn and Lowell refugee resettlement regions. 2. Health Promotion Massachusetts Office for Refugees and Immigrants (ORI) in Boston is awarded $120 ,000 in Refugee Health Promotion (RHP) funds. RHP funds support the Massachusetts Refugee Health Promotion Program coordinator staff position at ORI. ORI provides the majority of RHP funds, through contractual agreements , to 5 local organizations and partnerships throughout the state that provide health workshops, assistance enrolling in health insurance programs , and coordination of health services for refugees , and trainings for service providers on refugee-specific needs. These contracts are held with: 1) Lutheran Social Services of New England (LSS) in partnership with Jewish Family Services of Western Massachusetts (JFSWM) in Western Massachusetts , 2) Somali Development Center in partnership with Ethiopian Community MAA and Haitian American Public Health Initiative in Greater Boston , 3) Russian Community Association of Massachusetts (RCAM) in partnership with Bosnian Community Center for Resource Development (BCCRD) , Congolese Development Center (CDC), Refugee and Immigrant Assistance Center (RIAC) , and Southern Sudanese Solidarity Organization (SSSO) in Lynn, 4) Edward M. Kennedy Health Center (EMKHC) in Worcester , and 5) International Institute of New England (IINE). Discretionary Grants Administered by Resettlement Agency or Other Service Providers 1. Survivors of Torture Program 6 /\MERll Al\ pVERSIGHT EXT-18-248-A-000244 000245 ~ection s to be completed by. - Ml-- and DRSare highlighted as indicated.I The Boston Center for Refugee Health and Human Rights at Boston Medical Center receives $395,200 each year to provide comprehensive care and case management services to 275 survivors and their families annually in the domains of mental health, primary care, case management, career development, patient navigation, and asylum evaluations was awarded to this grantee. The Harvard Program in Refugee Trauma (HPRT) receives $360,620 annually to serve approximately 800 Cambodian survivors and newly arrived survivors from other ethnic groups through the Lynn Community Health Center (LCHC) by providing mental health care and specialized treatment for those who fail conventional treatment. HPRT offers programs in health promotion, diabetes complex care management, and a training-of-trainers program for community hea lth clinics serving torture survivors statewide. HPRT also continues to disseminate the specialized assessment tools, Harvard Trauma Questionnaire and Hopkins Symptoms Checklist-25. 2. Matching Grant Program The Resettlement Agencies Matching Grant Program (MG) was created in 1979 as an intensive case management program with the objective to fast track new arrivals toward economic selfsufficiency within four to six months (120 - 180 days) of program eligibility, without accessing public cash assistance. Enrollment in MG is available to all ORR-eligible populations meeting minimum employabi lity requ irements and to the extent funding is available. However, clients must be enrolled within 31 days of becoming eligible to ensure adequate services are provided and self-sufficiency is achieved and maintained within the period of eligibility. As demand for MG Program services continues to exceed ava ilable funding, enrollment is not available to all those eligib le and desirous of program services. - Client services provided through the Resettlement Agencies Matching Grant Program include , but are not limited to, case management , employment services, housing and utilities , food, transportation , cash allowance , health and medica l, English language training, social adjustment, and other support services. The MG Program is designed to work in concert with the Reception and Placement (R&P) program for refugees offered by the Department of State (DOS), and the Cuban & Haitian Entrant Reception and Placement (R&P) program offered by the Department of Home land Security (OHS). Thus, funding under the MG Program is open only to those resettlement agencies that already provide R&P services through a cooperative agreement with the DOS or OHS. Congress confirmed this approach to the program in the 1986 Refugee Assistance Extension Act. The MG Program requires a grantee match of$1 (cash and/or in-kind) for every $2 in Federal funding. City • /\Mlf Grantee Local MG Service Provider FY 2017 Projected Enrollment Slots FY 2017 Projected Federal Funding ...,ocalContact 7 1 IC,AI\ pVERSIGHT EXT-18-248-A-000245 000246 MH,and DRSare highlighted as indicated.I ~ections to be completed by .., Miriam A. Gas WORCESTER ECDC Refugee and Immigrant Assistance Center (RIAC) WEST SPRINGFIELD LIRS Ascentria Care Alliance 40 WORCESTER LIRS Ascentria Care Alliance 40 LOWELL USCRI 40 $88,000 $88,000 mgas @riac boston.org Mohammed Najeeb mnajeeb@ascentria .org ..,isa Ann Brennan International Institute of New EnglandLowell State Total $88,000 brennan @ascentria .or~ TeffreyThielman 100 $220,000 220 $484,000 ~thielman@iine .us 3. Pref erred Communities Program The Preferred Communities Program's goals are the successfu l resettlement and integration of especially vulnerab le ORR client populations and the enhancement of agencies' capacity to serve such populations at new or estab lished PC locations. Specialized services such as intensive case management is intended to result in these refugees' attainment of selfsufficiency in the area of their lives impacted by their particular vulnerability, which may include , but is not limited to, medical disabilities, traum a, and lack of access to supporting services. PC Project Location Springfield Resettlement Agency Loca l Affiliate Name AmeriCorps Site Focus HIAS Jewish Family Service of Western Massachusetts LIRS Ascentria Care Alliance NIA Refugee & Immigrant Assistance Center Case management ; emergency assistance ; health ; youth Physical & mental health N y Loca l !Fundin g !Amount Loca l Contact llnformation ~57,000 !Deirdre Griffin ; kigriffin@jfswm.org $19,000 Westfield Worce ster ECDC !Mohammed Najeeb; lmnajeeb@ascentria .01 g $60,000 N IAnab Egal; laegal@riacboston.org 8 /\MERICAi\ pVERSIGHT EXT-18-248-A-000246 000247 PRij,and DRSare highlighted ~ections to be completed by-pjM, • as indicated.I I support 4. Microenterprise Development Program The Microenterprise Development Program helps refugees develop, expand, or maintain their own businesses and become financially independent. To equip refugees with the skills and resources they need to become successful entrepreneurs , the program provides training and technical assistance in business plan development, management , bookkeeping , and marketing; credit in the form of micro-loan s up to a maximum of $15,000 which is repayable with interest during the project period. MED projects are encouraged to leverage funding for the project from other sources in order to meet the capital need of the clients and to enhance the sustainability of the program . Boston - The Massachusetts Office of Refugee and Immigrants (MORI) 600 Washington Street , Boston , MA Jennifer Schamel: jennifer.schamel@state.ma.u s MORI was funded $250,000 per year for four years (09/29/2013-09/30/2017) to implement a Microenterprise Development Project. The project is being be implemented in the Greater Boston area in partnership with Jewish Vocational Services and in the Greater area of Worcester and Springfie ld in partnership with Lutheran Social Services of New England. The main goal of the program is to assist newly arrived refugees in attaining economic selfsufficiency by giving them loan capital and providing them sustained technical assistance. As of September 30, 2016 , the project has made 122 loans for $1,712,515, created/retained 203 jobs , and leveraged $106 ,500. - 5. Refugee Individual Development Accounts Program Individu al Development Accounts (IDA) are matched savings accounts designed to help refugees save for a specific purchase. Under the IDA program, the matching funds , together with the refugee's own savings from their employment, are available for purchasing one (or more) of four savings goals: home purchase, sma ll business development , post-secondary education or training , or an automobile for employment purpose s. Refugees also receive basic financial literacy training and training focused on their specific savings goal(s). -- .. -- - -- - GRANTEE C ITY r s TATE j_ International Institute of Boston I L Bo :ton LA --- PROJECT START 9/30/2016 rPRoJEci -[ AMOUNT coNT AcT END -1 9/29/20 19- $245~8I 7 jlEmil ; L; sl~ f b)(5) l@iine.org I I 9 /\Mlf K /\I\ pVERSIGHT EXT-18-248-A-000247 000248 ~ections to be completed by .. , lii;t and DRSare highlighted as indicated.I Boston - International Institute of Boston $245,817 The organization is a previous grantee of the program but is in the first year of a new threeyear project period. While progress for the grant has not been reported yet, the grantee proposed to accomplish the following during its project period: • Enroll 223 eligible refugee individuals and families into the program • Establish saving s accounts for all 223 clients • Provide financial literacy training for all clients and their family members • Assist in the purchase of at least 200 assets to help establish economic self-sustainability VI. Employment Outcomes Massachusetts reported 71 percent of Match Grant participants as self-sufficient at Day 180. Within the GPRA-AOGP caseload that is over seven times larger than the MG caseload, outcomes are slightly better, with 71 % of clients entering employment, 86% achieving 90-day retention , and an average wage of $11.15 VII. Major Issues/Concerns Catholic Charities of Boston Pauses Refugee R&P: USCCB placed a temporary halt on resettlemen t through Catholic Charities of Boston (CCB) in FY2016, due to challenges the agency has been facing in securing affordable housing in the greater Boston and Merrimack Valley areas. The affiliate reopened its R&P program at the start of FY2017, but continues to face challenges with hou sing. Jewish Family Service of Metrowest (JFS) to Re-Open: The HIAS affiliate, located in Framingham, had halted the provision of resettlement services at this location in FY2016 , but planned to re-initiate services in FY2017 with the expanded caseload, utilizing a modified community-sponsored mod el with extensive volunteer involve ment. However, recent changes to the admissions ceiling may put another pause on arrivals through the agency this year. Catholic Charities of Western Massachusetts: This office ofUSCCB was approved as an expanded resettlement site for FY2017, to resettle in the Springfield/Northampton area. With recent changes to the resettlement ceiling, the agency has not received any arrivals to date. MORI Staffing: ORR has recommended in recent years that MORI work to reduce staffing, espec ially under the WF funding. Since FY 20 11, FTEs charged to the WF program have been incrementally rising , as have staff positions overall, despite statements each year that MORI has worked to trim staff positions. For FY 2016 , there are 18 staff positions, with 9.09 FTEs (part of 15 positions) charged to WF. VIII. Program Highlights/Best Practices The New Americans Center (NAC) in Lynn (greater Boston/North Shore) is a consortium of ECBOs and resettlement agency partners , providing a range of social services under one roof. Located in an area where refugees live and work , the NAC is a strong community resource, and a good example of collaborative practices. 10 /\Mlf 1 ICAI\ pVERSIGHT EXT-18-248-A-000248 000249 ~ections to be completed by •• • , pjH,and DRS are highlighted as indicated.! Appendix A- ORR Funding Overview for FY 2016 - Massachusetts ORR Funding Massachusetts - FY2016 - Cash & Medical Assistance (CMA) 1 $14,803,860 Social Services (SS) 1 $1,447,813 Targeted Assistance Formula (TA-F) 1 $818,391 Wilson Fish (WF) 2 $3,814,588 Refugee School Impact (RSI) 3 $471,749 Targeted Assistance Discretionary (TA-D) 3 $ 186,225 Services to Older Refugees (SOR) 3 $97,200 Cuban/Haitian (C/H) 3 $0 Refugee Health Promotion (RHP) 3 $128,0 55 Matching Grant (MG) 4 $484,000 Preferr ed Communities (PC) 5 $0 Individual Development Accounts (IDA) 6 $0 6 Micro-enterprise Development (MED) Family Child Care Microenterprise Development (RFCCMED) 6 $250,000 Ethnic Community Self-Help (ECS-H) 6 Refugee Agricultural Partnership (RAPP) 6 $0 $0 Survivors of Torture (SOT) 6 Total $775,820 $19,143,143 $0 Footnotes: This table represents a snapshot of ORR funding available to date for FY 2016. Amounts may vary as new funding opportunities are awarded and as continuation applications are processed. In addition, amounts may also vary as grantees sub-award funds throughout their network. • /\Mlf 1 CMA amounts listed here are for FY 20 16 awards to date. SS and TA-F Grant amounts listed here are for FY 2016 allocation s listed in the FY 2016 Final Notices. 2 WF figures are FY 20 15/ 16 awards for use in FY 2016 . 3 Funding figures for the State Discretionary grants: RSI, T AG -O, RHP, and C/H are FY 2016/16 award s for use in FY 2016. SOR funds are a set-aside of the RSS formu la grant. 4 FY 2016 MG funds are awarded to the national Rese ttlemen t Agencie s, which allocate these funds to their local affiliates. MG funds are awarded on a per cap ita basis , so the funds available within the state are listed here. 5 FY 2016 PC funds are awarded to the national Resett lement Agencies , which allocate these fund s to their local affiliates on a programmatic rather than a per capita basis, so the PC funds available within the state may not be shown on this chart. 6 Funding figures for the IDA, MED, SOT, ECS-H , and RAPP shown in this table are FY 2015/16 award s for use in FY 2016. These grants are not managed by the state and may be awarded to different organizations within a state . 11 1 ICAI\ pVERSIGHT EXT-18-248-A-000249 000250 , 000251 Massachusetts FY2016 State: Profile FFY: - ORRRegional Representative: ORREligiblePopulations Julie Munro Asylee C/H Other 1688 144 85 99 1,734 88 ORRPopulationsTotal Haiti Iraq 348 100 Somalia 2,270 Bhutan TotalFFY Expenditures Cashand Medical Assistance(CMA) Program Refuge CashAssistance (include WF CMA as applicable) $0 !cMA Total ORRAuthorizedFFYAward $10,169,3801 RefugeeSocialServicesFFYAllocation $1,447,813 $818,391 Targeted Assistance Formula FFYAllocation 2017 Monitoring (year last conducted) I 2015 Medicaid Expanded State? I yes Caseload 1,66 : Entered Employments 1,17 71'¾ 642 Cash Termination s Termination 72'¾ Rate Retentions (90-day) 86'¾ $11 .l FFYOUTCOMES(MG) Amount MatchingGrant Reaching 120 Days Refugee School Impact $471,749 120-day Self-Sufficient (SS) $97,200 Outcome Rate $0 Average Wage Grant $128,055 Individual Development Account Preferred Communities (funded through Volags) Micro Enterprise Development Refugee Agricultural /\Mlf EmployabilityServices(0-60 monthse $186,225 Health Promotion $428 FFYOUTCOMES(GPRA-AOC Targeted Assistance Cuban/Haitian $428 Average Wage $3,814,588 Services to Older Refugees - $428 Outcome Rate $14,803,860 Current FFY CMA Budget Estimate Total Wilson/Fish Refugee CashAssistance $1,758,132 Unaccompanied Refugee Minors ORR Discretionary Grants Single Temporary Assistance for Needy Families (TANF) Wilson/Fish or $7,109,143 Public/Private Partnership Refugee Medical Screening (include WF CMA as applicable) - CashAssistanceLevels $3,050,321 Refugee Medical Assistance (include WF CMA as applicable) State Plan (year last approved) 339 334 332 263 221 Dem. Rep. Congo 2,016 ORRPopulationsTotal Number Top 5 Countries Refugee PreviousFFYNumbers Profile FFYYear Numbers Regional Offices to complete for profi 5/l of the current FFYyear $0 Reaching 180 days SSon 180-day Outcome Rate YES $250,000 State Refugee Coordinator Project $0 Mary Truoung Micro -Enterprise Development Home Based Childcare $0 Phone Ethnic Community Self-Help $0 Survivors of Torture $755,820 Matching Grant $484,000 Total ORR Discretionary Funding Total ORR Funding ll Al\ pVERSIGHT $6,187,637 I 617-727- State Refugee Health Coordina, Jennifer Cochran Phone! 617-983- $18,623,221 EXT-18-248-A-000251 000252 % of ORR Popul. 15% 15% 15% 12% 10% Family of 3 $633 $633 $633 3P) llglble} 3 7 . I . .5 210 147 70% $11.88 181 128 71% 7888 tor 6596 /\MEf 1 ll Al\ pVERSIGHT EXT-18-248-A-000252 000253 Boston, MA Agenda August 3 -5, 2017 Wednesday, August 2 Flight: United Flight 822, Leaving IAD @ 5:13pm, Arriving BOS @ 6:54pm Hotel: Courtyard Cambridge Marriott 777 Memorial Drive Cambridge MA 02139 I Confirmationfbl/4) Phone: 617-492-7777 Mass: Please see last page of Agenda Thursday, August 3 11:00am - 12:00pm Repatriation Briefing MEMA Headquarters 400 _Worcester Road (Route 9 East) Farmingham MA 01702-5399 l :00pm - 3 :00pm Site Name: New Americans Center Site Address: 20 Wheeler St, Lynn, MA (JB Flood Build in Special Instructions : Call~ upon,;,..:;.;ar;,:,.r ;;..;. iv.::.a ;J.. I C_ bl_ <6_l _____ _ Site POC: Natasha Soolkin, Director , b)(B) mail.com Phone: 781-593-0100 >fii:ill ORR Grants: RSS,TAG-D, Health Promotion Attendees: Elaine Zimmerman, ACF Regional Administrator ► Friday, August 4 1:1)() ~ I 0:00am - ~pm Site Name: International Institute of New England (Boston office) rd Site Address: 2 Boylston Street, 3 floor, Boston, MA Site POC: Alexandra Weber, Chief Program Officer ,j,.,,. Cb..,., )(""' 6)- ..... ~ iine.org, Phone: 617-695-9990 x !_~ /\Mlf I pVERSIGHT VSakeenah Shabazz (C): 619fL.. b_ )<6_ >_ ____. EXT-18-248-A-000255 000256 000257 Sunday, August 6 -10:15 - 11:15 a.m. Putting Workers to Work: Addressing Labor Needs and the H-2A Program Boston Convention Center 257 A Summary: Agricultural producers have looked to the federal H-2A program to fill temporary jobs with foreign nationals. This session will provide information on state approaches and current federal efforts to address this agricultural need through the guest worker program. Speakers: Joe Young, New England Apple Council Mark Amato, American Farm Bureau Federation's Labor Committee 2:15 - 3:45 Immigration in 2017 (CLE) Boston Convention Center 156 BC Summary: The role of state and local law enforcement in federal immigration policy is back in the forefront of public debate . Learn about sanctuary policies, and actions by states and Congress. What do the administration's orders on immigration enforcement mean for states? How have the courts weighed in? Moderator: Representative Craig Tieszen, South Dakota Speakers: Shoba Sivaprasad Wadhia, Esq., The Pennsylvania State University , Pennsylvania Representative Thomas U. Reynolds, Mississippi a This session is cosponsored by the Task Force on Immigration and the States and the Law, Criminal Justice and W Public Safety Committee. /\Mlf 1 ICAI\ pVERSIGHT EXT-18-248-A-000257 000258 000259 CHIIffREN ~ FAMILIES - Office of Refugee Resettlement www.acf.hhs.gov/programs/orr I 330 C Street, S.W., Washington. DC 20201 OPENING REMARKS b)(S) - /\Mlf 1 ll Al\ pVERSIGHT EXT-18-248-A-000259 000260 000261 000262 000263 (W5) 000264 000265 (W5) 000266 000267 003(5) 000268 000269 000270 000271 . CLOSING REMARKS (W5) 000272 000000 Charlottesville, VA Thursday, July 2017 Friday, July 21,2017 000274 Table000275 of Contents D Trip Agenda Hotel/Car Reservation f IRC Agenda & Briefing Materials Church World Service Agenda & Briefing Materials Iii..__ ___ _ II______ II _ ' ~Canlinal 1Vjlf pVERSIGHT EXT-18-248-A-000275 000276 000277 Charlottesville, VA Agenda July 20 -21, 2017 Thursday, July 20 Hotel: Courtyard by Marriott 638 Hillside Dr. Charlottesville, VA 22901 I Confirmation: !(b)(4) Phone:434-973-7100 Car Rental: Enterprise 1500 N Shenandoah Ave. Front Royal , VA 22630 Confirmation: l(b)(4) Phone: 540-63 6-8181 I 8:00am Pick up Rental Car Address: 1500 N Shenandoah Ave. Front Royal , VA 22630 8:30am Drive to UAC Site Visit Address: Shenandoah Valley Juvenile Center, (b)(5);(b)(7)(C);(b)(7)(F) Staunton, VA ~~l~?l;~~ I 10:30am - 12:00pm UAC Site Visit Site Name: Shenandoah Valle Juvenile Center .,,...,...,.,..,....,,..,...., Site Address: (b)(6);(b)(7)(C);(b)(7)(F) Staunton VA b)(5);(b) ' 7 \tr'\ ·/h\ ORR Grants: UAC Pro~am Contact: .._K b_)(_6)___ ___,J 12:00pm - 1:00pm Lunch 1:00pm - 2:00pm Drive to Charlottesville drive est. 45min) Site Address: b)(5);(b)(7)(C);(b)(7)(F) Charlottesville, V A!~b !(?_) ;~b_)~ 2:30pm - 4:00pm Refugee Site visit Site Name: IRC -Charlottesville Site Address: ~b)(6);(b)(7)(C) ;(b)(7)(F) Charlottesville, VA~~~~!;~)~ ORR Grants: Preferred Communities, Matching Grant , RAPP, Refugee Social Services, School Impact Contact: Harriet Kuhr I Executive Director , fbl(6) @rescue.org. 434-979-nn x 1(bl.<6 1 I I EXT-18-248-A-000277 000278 Friday, July 21 p 8:00am - 9:00am Travel to Harrisonburg (drive est. 57 minutes) 9:00am - 11 :00am Refugee Site Visit Site Name: Church World Services !Harrisonburg, Virginia Site Addres d b)(5);(b)(?)(C);(b)(?)(F) ORR Grants: RSS Employment program , School Impact Contact: Jim Hershberger, Director Immigration & Refugee Program l(b)(6) t@cwsglobal.org I 540-Kb)(6) 11:30am- 12:45pm Lunch Bella Luna Wood Fired Pizza 80 W. Water Street Harrisonburg , VA 22801 Phone:540-433-1366 1:00pm -4:00pm Return rental car Address: 1500 N Shenandoah Ave. Front Royal , VA 22630 l(b)(6);(b)(I EXT-18-248-A-000278 000279 Omega Trave l.com Federal Services Hotel/Car/Air/Rail 855 .326.54 11 7A-10P EST 855-326-5411 Emergency Your Connection to the World I l___ I Agency Record Locator r )(4) _. »View Trip » TSA Pre Check »FAA Airport Info »Federal Travel Online Please do not reply to this ema il. This is an unattended email box Omega Wor ld Travel must be notified within 24 hours regard ing corrections. Thank you . CAR Thursday, 20JUL 2017 l (b)(4) Enterprise Cars Plckup:._f b_)(4_) __ Confinnation Number: _. Pick up Time: 08:00 AM Location: 1500 N SHENANDOA H AVE Phone: 540-636 -8181 Drop Off:._K b_)(4_) ___ Return: Friday, 21JUL 2017 04:00 PM _. Type: Standard Car Auto A/C Rate: USD 66.00 Dai ly Rate - unlimited free mi Car membership Nbr: Reserved For: LLOYD EDWARD SCOTT Corp Discount ID: I< =b~l<~6~ ) ---~ Approximate tota l: USD156.75 Base rate does not include taxes and surcharges Government Rate Car renter must be 18 years of age with a valid drivers license. Car renter must be 25 years of age with a valid drivers license . Credit card in the name of driver is requ ired for rental HOTEL Thursday, 20JUL 2017 Courtyard North Marriott (COURTYARD BY MARRIOTT) 638 Hillsdale Dr Char lottesville VA 22901 US Phone: 1 434-9737100 Confinnation Numbef b)(4) Fax: 1 434-9737128 .______ Rate: USD 126.00 Room GUARANTEED TO VISA Number of Rooms: 1 Check Out: Friday , 21JUL 2017 Hotel membersh ip: ~l (b_)(_6)____ _. Reserved For: LLOYD EDWARD SCOTT ~ Room Type : GOV AMl f ll Al\ pVERSIGHT Page 1 of 2 EXT-18-248-A-000279 000280 CY14211ARR:;>~,HH CXI ·PERMITTED UP TO 02 DAYS BEFORE ARRIVAL ] Guaranteed to : b)(4 ) Approximate total : 138.98USD Credit card required at check-in TOUR Friday, 17NOV 2017 THANK YOU FOR BOOKING WITH OMEGA WORLD TRAVEL CHECK-IN TIME ARE 90 MINUTES PRIOR TO DEPARTURE FOR DOMESTIC FLIGHTS OR 120 MINUTES FOR INTERNATIONAL OMEGATRAVEL.COM FEDERAL SERVICES-HOTEUCAR/AIR/RAIL 855.326.5411 7A-1 OP EST 855-326-5411 EMERGENCY Ticket/Invoicelnfonnatlon: Service Fee: Date issued : EDWARDS LLOYD 07 /17 12017 Document Nbrf~b-)(_4)____ Amount: 7.66 USD ___, Total Tickets: 0.00 Total Fees: 7.66 Total Amount: 7.66 Facebook lnstagram /\M f ll Al\ pVERSIGHT Llnkl!dln Twitter VouTobt Page 2 of 2 EXT-18-248-A-000280 000281 I I( State FFY I I VA IRC-lnternational Rescue Committee 2016 City Charlottesvill e LRIS-Lutheran Social Services of the National Capitol Ar Falls Church Top 20 resettl ement locations in the state City ResettlementAgenciesIn the state by Name ORR Population USCCB - Refugee Services Fredericksbur g CWS- Church World Service Harrisonburg USCCB - Immigration and Refugee Services Newport News CWS- Church World Service Richmond Falls Church 80 2 USCCB - Commonwealth Catholic Charities Richmond Newport News 333 306 USCCB- Commonw ealth Catholic Charities Roanoke Richmond Charlottesville 291 Harrisonburg 266 Roanoke 228 Alexandria 149 Other -100 or fewer 1,020 Volags in th e stat e by nam e CWS - Church World Service IRC - International Rescue Committee URS - Lutheran Immigrant & Refugee Service USCCB- U.S. Conference of Catholic Bishops I -\,_ /\Mlf 1 ll Al\ pVERSIGHT EXT-18-248-A-000281 000282 000283 1------,-,--::- - ~ S_ta........_ t e.... :.... ,___ Prof;l e·i:FY :_ (( ,- _ 5/10/tfrecurie,ntFFYyear .. ORR ffijglrinal Pierrot Rugaba ReP,esent!ltfve~ ORRElljlble,PQP~ ratlons' --t , -RegiOnalO/flcesto complete for pro/lie 'FFYby _ __ V _I_R_G _I_N_I _A_____ - Refu,ee P,;evJ~s FFY Nun,bers . . ORRPopulations T'Otal 1312 ·.Proflie.FFY Ye~r !'4un,bers 1,471 C/H 33 ~lee 98 Otfler Afghanistan 1005 Iraq 1,728 Syria 2,44$ 87 QRRPopulitionsT~I - Cash and Medical Assistance (CMA) Program .RefugeCashAssistan1= e (includeWFCMAas appUcable)_ Buthan total -FFY ~mendltµres ~efugeeMedicalAssistance(lncl~deWFCMAasapplicable)· .. -cash Assista nce l evels $0 $0 RefugeeCashAssistanct! T1!mpora;yAsslstan ce: for Needy Familiesff,<\N_F) Wilson/Fishor $0 Public/Private _Partnersf:!ip $0 Unaccompanied -RefugeeMinots lcMA TotalORRAuthorizedFFYAward I RefugeeSodalServicesFFYAllocation ltargetedAsslstance ·FormulafFY·Allocation $8,737,536 1 $1,951,108 I State Plan (year last approv~) Current FFYCMA BudgetEstimateTotal $0 Monltorlni (year lastconducted) Medlcal~ Expanded -State? 2016 No ORRDiscretionaryGrants Amount EmployabHlty ~ces $0 .Reachingi20 Days Health Promotion $453,839 $97,200 ,• Micro Enterpris~ Development RefugeeAgricultural Project Micro-EnterpriseDevelopmentHomeBasedChildcare $0 $85,000 $0 MatchingGrant $2,213,200 Total ORRDlscretlc;,nary Funding $3,382,2~4 pVERSIGHT $0 1,055 50% 238 69% 95% $11.01 920 l2_0-d _ay Self"Sufficlent(SS) 589 OutcomeRate 64'¼ $10.62 Re_aching180 days 965 83'¼ $150,000 ll Al\ $0 OutcomeRate YESor NO $250,000 1 $0 798 Survivors of Torture /\Mlf $0 $0 SSon 180-day Ethnic Community Self-Help tot al ORAFunding $364 $0 AverageWage $133,055 Individual Development Account Preferred Communities· (funded throu~h Volags) , $213 FFYOUTCOM~S(MG) atdllngGrant $0 '-_1 Cuban/Haitian Grant Family of3 (o-60 monthseligible) Entered Employrnents Outq;,me.Rate_ CashTerminations Terml_natloo Rate Ret entic;>ns (9Q-dav) Avera11:~ Wa11:e Targeted Assistance Servicesto Older Refugees Single 2,096 Wilson/Fish Refugee School Impact 9'% . 6% 3% ,FFY .. OUTCOMES (GPRA-AOGP) $406, 541 ( Caseload 2017 $0%: 14~ ,· . ,' RefugeeMedicaf·Screening(IncludeWFCMAas applicable) · Poput._, 1,703 468 311 199 115 Dem.Rep. .of Congo 109 3,395 " •ofORII Number ,. Top 5 Countri es . StateRefugeeCoordinator Seyoum Berhe Phonej 804-726-7927 State RefugeeHealth Coordinator Jill Grumbine Phone! 804-864-7911 ~14,4n,479 EXT-18-248-A-000283 000284 000285 ~ectionsto be completed by PMPflitpjjij,and DRSare highlightedas indicated.) ORR clients determined ineligible for Temporary Assistance for Needy Families (TANF) and Medicaid may be eligible for RCA and RMA for up to eight months from the date of arrival in the U.S ., date of final grant of asylum for asylees, or date of certification for trafficking victims. a) Refugee Cash Assistance and TANF VA local departments of social services (LDSS) are responsible for processing applications for T ANF and RCA programs. Refugees who meet the TANF financial requirements, but are ineligible for TANF due to a categorical reason, are eligible for RCA. RCA income and standard of need requirements are the same as TANF. RCA is limited to eight months from the date of arrival or date asylum is granted. The monthly payment level for an RCA family of one is $213; the TANF assistance level for a family of three is $364. b) Refugee Medical Assistance (RMA) and Refugee Medical Screening (RMS) The Department of Social Services (VDSS) oversees the RMA program including providing RMA policy guidance to local DSS offices which determine eligibility for RMA. In collaboration with the Department of Medical Assistance Services (DMAS), DSS shares responsibility for the provision of RMA benefits. The RMA income standard follows the state's Medically Needy financial eligibility standards. Virginia has not expanded Medicaid to lowincome adults without dependent children. VDSS has a contract with the Department of Health (VDH) for the administration of the medical screening. Local health departments (LHD) in Virginia provide screenings to refugees through RMA funds. VDH provides coordination and technical assistance to local resettlement agencies and LHDs and reimburses LHDs for the provision of medical screenings. VDH tracks medical screening data in an ACCESS database; ·however , VDH is currently working with VDSS to transition into a web-based system. c) Unaccompanied Refugee Minors (URM) Program Background The Unaccompanied Refugee Minors (URM) program was developed in the late 1970s to · address the needs of children who entered the U.S. as refugees without a parent or guardian to care for them. Over the years Congress has passed additional legislation authorizing URM eligibility to other categories of unaccompanied children such as asylees, Cuban/Haitian Entrants, trafficking victims, certain Special Immigrant Juveniles, and U-visa recipients. Eligible children are placed into the URM program and receive the same range of child welfare benefits and services available to other children in the State, including those identified in the State's plans under Title IV-Band IV-E of the Social Security Act. The purpose of the URM program is to help unaccompanied minors develop appropriate skills to enter adulthood_and to achieve economic and social self-sufficiency through delivery of child welfare services in a culturally sensitive manner. Grantee/ Administration 2 /\Mlf 1 ll Al\ pVERSIGHT EXT-18-248-A-000285 000286 000287 ~ections to be completed by~ ~ { Ptjil,, ~!ftand DRSare highlighted as indicated.j The Virginia Office of Newcomer Services (ONS) within the State's Department of Social Services receives the ORR's Cash and Medical Assistance (CMA) funds to operate its URM program. ONS then contracts for the services with a licensed child welfare agency , Commonwealth Catholic Charities (CCC). URM services have been provided in and around Richmond since 1979. ( Legal Responsibility While the State's child welfare system can be described as a county-administered system, CCC obtains legal responsibility for URM children in their care. As a result of being in private agency custody , URMs in Virginia do not qualify for the Education and Training Vouchers (ETV) and independent living services which are partially funded through the state's Chafee allocation from the Children's Bureau. For a parity of services, ONS provides an ORR-funded equivalent educational training or services for eligible youth. Placem ents/Services CCC is affiliated with and receives placements from the U.S. Conference of Catholic Bishops (USCCB), one of the two national resettlement agencies that receive Reception and Placement funds from the Department of State for resettlement of unaccompanied refugee minors from overseas. CCC is accredited by the Council on Accreditation and is licensed and authorized under Virginia law to accept custody of foster children and adoptive placement and provide supervision and case management services. Placements are made in about five counties, while legal responsibility is established in Henrico County court. A few years ago, ONS contracted with CCC for a trial sub-office in Roanoke, where custody was established in Roanoke County court. ONS has been expressing its intention to close URM operations in Roanoke when the last youth terminates from the program. However, to meet the growing need for capacity, ORR is working with ONS for the possible continuation and further development of the Roanoke suboffice. Currently, URM children are placed in foster care, therapeutic foster care, group homes, semi-independent living, independent living, or residential treatment center placements. URMs Served by Virginia in FY 2016 Richmond (and suboffice of Roanoke) Commonwealth Catholic Charities Total for state 71 71 Data in the above table was drawn from the URM database on 3/ 14/2 017and is subject to change as database records are reconciled 2. Refugee Social Services The Refugee Social Services Program funds services to refugees to help them obtain employment and achieve economic self-sufficiency in the shortest time possible. Employment and support services are designed to enable refugees to obtain jobs within one year of becoming enrolled in the program. 3 /\Mlf 1 ll Al\ pVERSIGHT EXT-18-248-A-000287 000288 000289 and DRSare highlightedas indicated.I ~ections to be completed by~~~, (( ONS contracts with community based non-profit organizations to provide eligible refugee populations with services funded through the Refugee Social Services and Targeted Assistance Program grant funding. Virginia's refugee employment program is called the Refugee Social Services Employment Program (RSSEP). • • Employment Services include: employability assessment , job search, vocational English Language services/ESL, vocational education, on the job training, case management , assistance with daycare, assistance in obtaining employment documents, translation/interpretation assistance, transportation assistance, job development, job upgrade services, and job retention services. Support services include: daycare, translation and interpretation for purposes other than employment, citizenship and naturalization preparation services, home management, financial literacy services, and case management services. Refugees in the following categories receive service priority: • New arrivals in their first year in the U.S. • Those receiving cash assistance • Unemployed refugees not receiving cash assistance • Employed refugees in need of services to retain employment or to attain economic independence Services to Older Refugees Set-Aside: This project assists older refugees in accessing community support networks and facilitates in becoming and remaining independent in the communities where they are resettled. Cuban/Haitian Set-Aside: Under this program, VA prepares Cuban and Haitian Entrants with assistance in preparing for the U.S citizenship test and encourages civic engagement. Cuban and Haitian entrants are eligible for cash and medical assistance from the same agencies and under the same conditions as other individuals with refugee-eligible immigration documents . • 3. Targeted Assistance Grant (TAG) The Targeted Assistance Grant services are similar to Refugee Social Services; however they are distinctive in that they prioritize: • Cash assistance recipients , particularly long-term recipients • Unemployed refugees not receiving cash assistance • Employed refugees in need of services to retain employment or to attain economic independence TAG funds are used to supplement, and not to replace other funded programs. Funding under this program is used to provide intensive services in the targeted area. County Name Refugees C-H Entrants Asylees SIVs Total Total Allocation Amount Fairfax 586 0 6 572 1,164 $242,386 4 /\Mlf"lll Al\ pVERSIGHT EXT-18-248-A-000289 000290 000291 ~ections to be completed by Henrico PM~ P!IB ,and DRSare highlighted as indicated] 464 0 104 569 $118,486 V. Discretionary Grants State Administered Discretionary Grants in VA 1. Targeted Assistance Discretionary NIA 2. Refugee School Impact Also called the Virginia Refugee Achievement Project (VRAP), this project assists refugee children in the geographic area covered by the grant to succeed in school. Under this project, parents are provided with the needed support to understand the U.S education system and educators are provided with the understanding of the needs of refugee children. 3. Health Promotion I The Virginia Department of Health (VDH) in Richmond is awarded $125,000 in Refugee Health Promotion (RHP) funds. VDH utilizes RHP funds to purchase thermometers for refugees, and to maintain a contractual agreement with the Virginia Department of Behavioral Health and Development Services (DBHDS). The contract with DBHDS supports an annual refugee summit, an emergency interpreter funding pool, and the following trainings for service providers: 1) Question Persuade Refer (QPR) Suicide Prevention, 2) Multicultural Mental Health F_irstAid, 3) Virginia Language Access Collaborative workshops held at an annual conference, 4) Trauma Informed Cultural Orientation for New Refugees, 5) Center for International Stabilization and Recovery Adolescent Peer Support Training, 6) Refugee Cultural and Linguistic Competence Facilitator Certification, 7) Qualified Bilingual Staff Training, Mental Health Interpreter Training. I Discretionary Grants Administered by Resettlement Agency or Other Service Providers 1. Survivors of Torture Program Northern Virginia Family Services' (NVFS) Program for Survivors of Torture and Severe Trauma (PSTT) receives $250,000 annually to serve 130 clients each year. NVFS provides inhouse mental health, case management, and legal services. NVFS' health access program provides PSTT clients with access to affordable health and dental care in the community. PSTT has a longstanding relationship with George Washington University Medical Center for psychiatric services and medication management. In addition, PSTT provides on-site counseling services for refugees at Lutheran Social Services/National Capitol Area's resettlement center. 2. Matching Grant Program The Resettlement Agencies Matching Grant Program (MG) was created in 1979 as an intensive case management program with the objective to fast track new arrivals toward economic self- s /\Mlf 1 ll Al\ pVERSIGHT EXT-18-248-A-000291 000292 000293 ~ections to be completed by P!M i,RM; ~ and DRSare highlightedas indicatedJ sufficiency within four to six months (120- 180 days) of program eligibility, without accessing public cash assistance. Enrollment in MG is available to all ORR-eligible populations meeting minimum employability requirements and to the extent funding is available. However , clients must be enrolled within 31 days of becoming eligible to ensure adequate services are provided and self-sufficiency is achieved and maintained within the period of eligibility. As demand for MG Program services continues to exceed available funding, enrollment is not available to all those eligible and desirous of program services. f I Client services provided through the Resettlement Agencies Matching Grant Program include, but are not limited to, case management, employment services, housing and utilities , food, transportation, cash allowance, health and medical , English language training , social adjustment, and other support services. The MG Program is designed to work in concert with the Reception and Placement (R&P) program for refugees offered by the Department of State (DOS), and the Cuban & Haitian Entrant Reception and Placement (R&P) program offered by the Department of Homeland Security (DHS). Thus, funding under the MG Program is open only to those resettlement agencies that already provide R&P services through a cooperative agreement with the DOS or DHS. Congress confirmed this approach to the program in the 1986 Refugee Assistance Extension Act. The MG Program requires a grantee match of$! (cash and/or in-kind) for every $2 in Federal funding. I Grantee Local MG Service Provider FY 2017 Projected Enrollmen t Slots HARRJSONBURG cws CWSHarrisonburg 85 Jim Hershberger $187,000 ·hershberger@cwsglobal.or g RICHMOND cws CWS Richmond 120 $264,000 John Baumann jbaumann@cwsglobal.org CHARLOTTESVll., LE IRC IRC Charlottesville 147 $323,400 Harriet Kuhr harriet.kuhr @rescue.org RICHMOND IRC IRC Richmond 10 $22,000 Harriet Kuhr harriet .kuhr@rescue.org FALLS CHURCH LIRS Lutheran Social Services of National Capitol Area 110 $242,000 Razan Osman osmanr@lssnca.org ARLINGTON USCCB Refugee Services 400 $880,000 Patricia Maloof pmaloof@ccda.net RICHMOND USCCB Commonwealth Catholic Charities 150 Amar Bhattarai $330,000 amar.bhattarai@cccofva.or g City \ I --"-/ FY2017 Porjecte d Federal Fundin~ Local Contact 6 /\Mlf 1 ll Al\ pVERSIGHT EXT-18-248-A-000293 000294 000295 ~ectionsto be completed by USCCB NEWPORT NEWS '' USCCB ROANOKE PM W!M, ~ and DRSare highlightedas indicated./ Commonwealth Catholic Charities TBD Commonwealth Catholic Charities TBD TBD g TBD Amar Bhattarai amar.bhattarai@cccofva.or g $2,248,4 00 1,022 State Totals Amar Bhattarai a.mar.bhattarai @cccofva.or 3. Preferred Communities Program The Preferred Communities Program's goals are the successful resettlement and integration of especially vulnerable ORR client populations and the enhancement of agencies' capacity to serve such populations at new or established PC locations. Specialized services such as intensive case management is intended to result in these refugees' attainment of self-sufficiency in the area of their lives impacted by their particular vulnerability, which may include, but is not limited to, medical disabilities, trauma, and lack of access to supporting services. PC Project Location Resettlement Agency Charlottesvill e IRC Local Affiliate Name IRC cws cws Harrisonburg Harrison bu rg Richmond cws cws Local Contact Information Focus AmeriCorps Site Medical, mental health; Congolese; sing le parents Medical & mental health case management; youth services ICM y Local Funding Amount $66,) 46 y $74,900 Jim Hershberger; jhershberger @c ws global.org y $62,900 John Baumann ; "baumannt@cws!!lo bal.org Richmond Harriet Kuhr; harriet.kuhr t@rescu e.org 4. Refugee Agricultural Partnership Program The Refugee Agricultural Partnership Program (RAPP) improves the supply and quality of food in urban and rural areas through refugee farming projects, which provide income opportunities for refugees while also encouraging a healthy diet. RAPP supports collaboration among refugees and other community-based organizations to participate in activities such as community gardens, small acreage farming, farm-to-school programs, school gardens, health and nutrition classes, and farmers' markets and local food banks. ·-U GRANTEE CITY I STATE I PROJECT I PROJECT AMOUNT CONTACT 7 /\Mlf 1 ll Al\ pVERSIGHT EXT-18-248-A-000295 000296 000297 ~ections to be completed by ~!~ m.M JJH, and DRSare highlightedas indicated.I END START ( International Rescue Committee ( Charlottesvill e VA 9/30/16 9/29/19 $100,000 Brooke Ray Brooke.ray@resc ue.org Charlottesville- International Rescue Committee QRC) $100,000 The grantee is in the first year of a three-year project period. While progress for the grant has not been reported yet, the grantee proposed to accomplish the following during its project period: • • • • • • • ; • ( Increase access to land and other resources for the purpose of farming. Incorporate relevant refugee cultural backgrounds and allow refugees to use their experience and skills in farming. Increase refugee knowledge and skills in nutrition and food safety for personal consumption and where relevant, processing for market. Increase knowledge of fanning safety . . Provide farming business development and training to refugees interested in pursuing farming as a means towards self-sufficiency. Increase potential for supplemental income through refugee farming initiatives. Increase access to healthy and nutritious foods through farming-particularly in urban areas, or areas defined as food deserts by USDA. Increase the psychosocial development of refugees. VI. Employment Outcomes Virginia's state employability programs served 2,096 refugees in FYI 6, with the state reporting 50% (1,055) of participants entering employment and a 95% 90-day job retention rate. The average wage was $11.01 per hour. Among RCA and TANF recipients, 238 participants (69%) terminated cash assistance. VII. Maior Issues/Concerns NIA VIII. Program Highlights/Best Practices Skills Training for Earning Potential (STEP) Program that focuses on the strengths that newly arrived eligible population bring. The state allows for flexibility at the local affiliate level to tailor the program to meet the diverse clients, skill-set and employment opportunities in each community. STEP key feature includes working closely with the WIOA Employment and Administration programs in VA by assisting refugee dislocated workers to rapidly access relevant training and certifications. I ~( Appendix A - ORR Funding Overview for FY 2016-VA 8 /\Mlf 1 ll Al\ pVERSIGHT EXT-18-248-A-000297 000298 000299 j:!tM, ~ and DRS are highlighted as indicatedj ~ections to be completed by~ ORR Fundine STA TE - FY 2016 Cash & Medical Assistance (CMA) Social Services (SS) 1 1 $1,951, l 08 Targeted Assistance Formula (T A-F) Wilson Fish (WF) $8,737,536 1 $406,541 2 $ Refugee School Impact (RSI) 3 $453,839 Targeted Assistance DiscretioQary (TA-D) Services to Older Refugees (SOR) Cuban/Haitian (CIH) 3 3 $97,200 3 $0 Refugee Health Promotion (RHP) Matching Grant (MG) 3 $133,055 4 $2,213,200 Preferred Communities (PC) 5 $ Individual Develooment Accounts (IDA) Micro-enterprise Development 100% .. .-..:-~ .~--..l,--1..-.::.......-.~-- . • '/4 "'t,.. _ _:_,,_J!ao-,_J.--]. > 93.59% ~, • •'f •._:; ' -'r' • . :.• _ ____ bh }- tf 97.92% •t ,.. •T• 'J .•r• • ,• l_ who are self :-9uffici~nt at the·1so u • • :(,!_.L. _...:__ ,, ,_ . - .~ .,_, .......... --.- - • .1,. IQ ..._ __ ,. __ ,,,,_ >, r - rt-'20'lS f 82 .14% ~-:. .,ob .., .._,.3...__~ ~::....:rfil.• l. •• ':.,# .l .. ' -.,--- r -..,•-: '.'I,.., 1 ....... r ~ _- . .._ -~-{s.ta.......:'~~.;.lf...,__:.,;_..J....,..._"• ...,;~ ,.. ••-•~ -~ .. PY20U 1 100% • r ,.. -:- .-· 'j day Average rate for CWS in FY2015: 88.00%. FY2018: 86.44%, and FY2017:81.40% ~•••'-• • :FYm~ -: r th Matching Grant (MG) clients -~!...-•-....:__. . .. 96.00% , Clients who have Out Migrated Averag~ outmigrationrate~for CWS in FY20.15: 4.74%, FY2016: 3,55%,.and FY2017:2.00% /1,. I FY201S 0.56% 8.78% l 0% Family Reunification Applications ·--. ' . . Since FY2012, CWS affiliates have filed more than 1,800+ family reunificationapplications _1,J. ~lug /\Mlf 1 (VA) -1!' FYto'fl . -- --'• ~ -~ - - , -. f'l20M • ·- -·· FV201t - ~ ..... • .... • ••• FY2011 FY~ ~ - - • , .. ....... Ta•~ 0 1 4 4 2 0 11 CAM-AORs 0 0 0 38 7 6 51 Lautenberg s 8 0 4 14 0 0 26 RIFs 0 0 1 0 7 0 8 Total 8 1 9 56 16 6 96 pVERSIGHT ... . AORs ll Al\ ·" .· '. EXT-18-248-A-000319 000320 'o> r- t 000321 <:~ m .,~ ~...·· -· ]J ( ~ ~" oo-;(/---·· -:--~'."• ~ , c5 ,."~ ;··~- I ..,. :I: -I HOW TO13ET INVOLVED WHO ISAREFUGEE? t ;~r.\;1:2~ i~aperson whoisouts idehis orhercountr ofynationality andisunable toreturn duetoawellfounded fear of persecuti bec onau seofhisorher ... . WELC OME ,,~ Start awelcom team e forrefugee arri s ving toShenandoa Valhley ofVirginia . .,.__ r7 . t. r1-· ! ~ ! I, •, ~ . ~ :-· _,;. . ' ~; Race , , ,J• ·""' \· ' ,. . A ,,• ~ ' ..•{:m, r ~ ,· i I,, ~ :,.•. ·t1-..,.-. .·..; AHISTOO RF Y . >:~~: •::;•;~d ,.. '.' ,•:, . : .. ,!.L ...t l.,:"! .- ~ EXT-18-248-A-000321 In194,6 intheafte rmath of World Wa11 r,churches intheUnited States camtoge e ther torespond to theneeds ofrefugee left shomeles bysthewarin Europe The . form y ed anecumenical organization called Church World Service. CW' faith S -based commitmto ent M welcoming the strange " has r endure ove d the r decade ass thousanof ds churche hav s emb e race the d challento geassist andbefriend refueges,andto welcome newimmigrasnttotheUnited Statse. ~ Reigio l n ~ ·P. "' ~~ LEARN Invite cw sstafto f holdaneducational D l)Political Opinion sessionabout ourrefugee neig s hboinrs Virg inia. ·1t RAISE SUPPORT Collect needed itemand s maksup e ply baskets forrefugee insneed. ·- ,, -· ' Membersinhip aSocia Gr l oup . . t ti~.r . .•._ · ,r...,..r-~V" :T : O GEIN -:~if/< T V1LY''E 0 D IN '· " .1. ,: ·,·1.~ ·i.,-1 - '\ ,.. t,.,...__ . Nationa lity .--·, ')• HELPIA NG ~. r,..-,, ~t...,~L ,-_., i'-11\, ~ ,, ,~ilF ...... I ~~- . ,?l~ .~ ,i. "l ~ • · • 'ltf • ·• "W , : 1 •· ,, -" ~--\,,:-,," TOO/!.~ ---·A t ":" ·~ ' J i' \~ l~-{1 I._, ..,, I 540-217-4588 oremail ourDirector atjhershberge@c r wsglobal org 000322 ~m C 000323 areover - ......There -: :.= :,"'. i"~~;t:refugeeinstheworld ,. JJ en - today - more than atanypoint since World WaII. r Ci) ~ ~ ...,,,_HelpUs ...,,.. f t «!;.,:~,r,,•.•··· forafamily today. .t,• r 11.r,!'it-.P•; -----·---- 1 l 1i V 'k 1~;~ ~Ztf ~......:,. cws AFUTUO RE FHOPE Refugees fleetheirhomes andcountries amidviole st nce andpersecution .They are looking forasafeplacto e begilife n anew . EXT-18-248-A-000323 CWS aims toprovide themosvuln t erable refugees withanopportuni toty begiannew lifeintheUniteState d Thos s. refug e ees who arestillatriskinacamp, somhavi e ng spent decades inextremely harscond h ition are s, givean n opportuni start ty again. HARRISONBU Ifyouwould liketogetinvolved withhelping refugees inyourcommunority overseas ,CWS is here tohelp .TohelpinVirginia please writetoour OfficDire e ctor ,JimHershberat ger jhershberg @cw er sglobaloFor rg. other inquiries youcanwritetousat immigra@ tion cwsglobal.org. ., ..,. t~ / ', _ \, .·~- Helpin Re g fugees and Immigrant ResbuiThe ld ir Lives www.cwsharrisonburg.or ChurcWortd h ServiceHarrisonlllg 250EastElizabeth St..Suite215 HarrisonburVA g.22802 phone :540-217-4588 000324 000325 ORR Director Scott Lloyd Visit to CWS Harrisonburg (VA) July 21, 2017 ' ~ -. .. --, Time Activity 09:00 Welcome, office tour . staff introductions 1.J'r -- ... Facilitators Jim Hershberger, CWS Harrisonburg Office Director 09 :15 CWS Harrisonburg Overview Jim Hershberger; Raisin Ford, CWS Eastern Region Director 09 :20 Staff Reports on Programs : CWS Harrisonburg Staff Matching Grant Lucia Canizares Refugee Health Educat ion and Outreach Megan Matteson mh Program Virginia Refugee Student Achievement Sarah Alice Coleman Program Preferred Communities 09 :45 Rebecca Sprague Discussion with Refugee Clients CWS Harrisonburg staff b)(6) Megan Matteson Rebecca Sprague Lucia Canizares Rebec ca Sprague 10:15 Discussion with Community Stakeholders Jim Hershberger & staff TJX Marshals: Ana Gorta HR staff Cargill Inc: Melinda Wills HR staff Purdue: Ana Nethkin HR staff Christophel Properties : Abby Christophel Wanda Revercomb: Rockingham Harrisonburg Health Department Public Health Nurse Laura Feichtinger McGrath : Harrisonburg City Schools ESL Coordinator 10:45 /\Mlf Wrap-Up and Departure ll Al\ pVERSIGHT EXT-18-248-A-000325 000326 CWS Harrisonburg Address: 250 East Elizabeth Street, Suite 215 Harrisonburg , Virginia 22802 (540) ,. .. . 217-4588 ,, ..:,,., !I,·,-:-';, "i· ~,, \·. l,1,; ( ' 1·• .. . .;ff "= -.:: .• ,, . ':, < >TSA PreCheck >>FAA Airport Info >>Federal Travel Online Please do not reply to this email. This is an unattended email box Omega World Travel must be notified within 24 hours regarding corrections. Thank you. AIR Tuesday, 4APR 2017 United Airlines Flight Number : 1954 From : (DCA) Washington Reagan Natl DC, USA Depart : 05:41 PM To : (IAH) George Bush Intercontinental Houston, TX Stops: Nonstop Class: Y-Coach/Economy Arrive : 08:26 PM Duration: 3 hour(s) 45 minute(s) Seats: 26E Status: CONFIRMED Equipment: Boeing 737-700 Jet MEAL: FOOD TO PURCHASE Miles: 1203 / 1925 KM DEPARTS DCA TERMINAL B - ARRIVES IAH TERMINAL C PREFERRED SEAT NOT AVAILABLE. CHECKS CONTINUE UNTIL DEPARTURE DATE NO FREQUENT FLYER NUMBER IN YOUR PROFILE FOR CARRIER BOOKED United Airlines Confirmation numbe r is L6S0YN Check in on-line to obtain boarding pass: United Click here for Baggage policies and fees: United - AIR Tuesday , 4APR 2017 United Airlines Operated By: EXPRESSJET AIRLINES DBA AMlf l._,1 l"-l pVERSIGHT Flight Number : 4317 Class: U-Coach/Economy 1 EXT-18-248-A-000333 000334 UNITED EXP ~~om: (IAH) George Bush Intercontinental Houston, Depart : 09 :20 PM To : (HRL) Harlingen TX, USA Arrive : 10:33 PM Stops: Nonstop Duration: 1 hour(s) 13 minute(s) Seats: 23C Status: CONFIRMED Miles: 292 I 467 KM Equipment: Embraer Jet DEPARTS IAH TERMINAL B United Airlines Confirmation number is '-! (b_)(_5)__ Check in on-line to obtain boarding pass: United Click here for Baggage policies and fees: United ____. HOTEL Tuesday, 4APR 2017 Courtyard Harlingen Marriott (COURTYARD BY MARRIOTT) 1725 W Filmore AVE Harlingen TX 78550 US Confirmation Numberl ..... (b_)(5 _l__ Number of Rooms : 1 _. Phone : 1 956-4127800 Fax: 1 956-4127889 Rate: USO 101.00 Room GUARANTEED TO VISA Check Out: Thursday, 6APR 2017 6 ___. Hotel membership: ...b-)(- )____ Reserved For: LLOYD EDWARD SCOTT f CY73432ARR04APR CXL:PERMITTED UP TO 01 DAYS BEFORE ARRIVAL Guaranteed to:l(b)(6) Approximate total: 228.260$D Credit card required at check-in I AIR Thursday , 6APR 2017 United Airlines Operated By: EXPRESSJET AIRLINES OBA UNITED EXP Flight Number : 4086 From : (HRL) Harlingen TX, USA Depart: 04:14 PM To: (IAH) George Bush Intercontinental Houston, TX Arrive : 05:29 PM Stops: Nonstop Duration: 1 hour(s) 15 minute(s) Seats: 20C Status: CONFIRMED Miles: 292 / 467 KM Flight Number: 1955 Class: S-Coach/Economy Class: U-Coach/Economy Equipment: Embraer Jet ARR IVES IAH TERMINAL B 5 United Airlines Confirmation number i.._J _b)_( _) _ __. Check in on-line to obtain boarding pass : United Click here for Baggage policies and fees: United AIR Thursday, 6APR 2017 United Airlines ~~om: (IAH) George Bush Intercontinental Houston, Depart : 07 :10 PM To : (DCA) Washi ngton Reagan Natl DC, USA Arrive : 11 :05 PM Stops: Nonstop Duration: 2 hour(s) 55 minute(s) Seats: 298 Status: CONFIRMED Equipment: Airbus Jet MEAL: FOOD TO PURCHASE Miles: 1203 / 1925 KM DEPARTS IAH TERMINAL C - ARRIVES DCA TERMINAL B United Airlines Confirmation number 1~(b)(6) Check in on-line to obtain boarding pass: United /\Mlf ll Al\ pVERSIGHT I 2 EXT-18-248-A-000334 000335 Click here for Baggage policies and fees: United TOUR Friday, 4AUG 2017 - THANK YOU FOR BOOKING WITH OMEGA WORLD TRAVEL CHECK-IN TIME ARE 90 MINUTES PRIOR TO DEPARTURE FOR DOMESTIC FLIGHTS OR 120 MINUTES FOR INTERNATIONAL CHECK CARRIER WEB SITE FOR CHANGE/CANCEL AND BAGGAGE POLICIES OMEGATRAVEL.COM FEDERAL SERVICES-HOTEL/CAR/AIR/RAIL 855.326.5411 7 A-1OP EST 855-326-5411 EMERGENCY Ticket/Invoice Information: Ticket for: EDWARDSCOTT LLOYD Date issued: 03/30/2017 Invoice nbr: 159024 Ticket Nbr: 0167917734376 Electronic: Yes Amount: 1247.60 USO Base: 1118.13 USO US Tax: 83.87 USO XT Tax: 45.60 USD Charged to: fb )(6) I Service Fee: EDWARDS LLOYD Date issued: 03/30/2017 __. Document Nbr: l(b ...._)(_4)_____ Amount: 8.26 USO Total Tickets: 1247.60 Total Fees: 8.26 Total Amount: 1255.86 . ges to airline reservations may result in an increase in fare and/or carrier penalties /\Mlf ll /\I\ pVERSIGHT 3 EXT-18-248-A-000335 000336 000337 - Request Request Close Request Status/History Travel Itinerary TRIPOVERVIEW Trip Name: Site Visit for UC Program in Texas Start Date: April 04, 2017 End Date: April 06, 2017 Created : March 29, 2017, Marquittia Coleman (Modifi ed: March 30, 2017) Description: Site Vi sit for UC Pro ram in Texas Agency Record Locator: (b)(4 ) Ticket Number(s): "" !(b'"'"' )(=6)____ __, Passengers : Edward Scott Lloyd Total Estimated Cost: $1,475.86 USD Agency Name: Omega - HHS RESERVATIONS - Tuesday, April 04,2017 0 Flight Washington , DC (DCA) to Houston, TX (IAH ) United1954 Departure : 05:41PM Confirmationj(lii{6)7 Seat: Noseatassignment Status : ConfirmJ----------J Ronald ReaganNational Arpt(DCA ) Termina l: B Duration : 3 hours,45 minutes Nonstop Arrival:08:26PM GeorgeBushIntercontinenta l (IAH) Terminal: C Additional Details Aircraft : Boeing 737-700 Distance : 1205miles Hickel Emissions : 470.0 lbsCO2 Cabin: Economy (Y) • /\Mlf Meal:Foodfor purchase Remarks PREFER REDSEA T NOTAVAILABL E. CHECKS CONT INUEUNTIL DEPARTUR EDATE NOFREQUENT FLYERNUMBER IN YOURPROF ILEFORCARR IERBOOKED • 54minlayoverat GeorgeBushIntercontinental (!AH) ll Al\ pVERSIGHT EXT-18-248-A-000337 000338 000339 Flight - Houston, TX (IA H) to Harlingen, TX (HRL) United4317 Operatedby: EXPRESSJET AIRLINES OBA UNITED EXPRESS Departure: 09:20PM i(b}(6f7 Confirmation: \___J Seat:23C(Confirmed) Status : Confirmed GeorgeBushIntercontinental (IAH) Termina l: B Duration:I hour,13minutes Nonstop Arrival:10:33PM RioGrandeValleyIntl Arpt (HRL) Additional Details Aircraft: EmbraerRJB5 Distance: 295miles E-Ticket Emissions: 156.4lbsCO2 Cabin:Economy(U) 0 Courtyard by Marriott Harlingen 1725 W Filmore Ave Harlingen , Texas, 78550 us 956-412-7800 Checking In:TueApr4 Confirmati0J b)(5) 15:00 Status: RoomI, Days2, GuestsI FrequentGuestNumber:.... l(b_)(_6)__ Confi rm'J.ei,.---;;.:::.:;:::.:::::::::_:: _, Checking Out:ThuApr6 11:00 Additional lnfonnation DailyRate : $101.00USD TotalRate:$228.26USD Room Details RoomDescription: RoomDescrip tionCodeGOVCOO Cancellation Policy 114.13UsdCxlFee PerRoomCance llationPermittedUpTo I DaysBeforeArrival Remarks m3432ARR04APR CXL:PERMITTED UPTO01 DAYSBEFORE ARRIVAL • Thursday, April06, 2017 /\Mlf 0 Flight Harlingen, TX (HRL) to Houston, TX (!AH ) United4086 ll Al\ pVERSIGHT EXT-18-248-A-000339 000340 000341 Operatedby: EXPRESSJET AIRLINES DBA UNITED EXPRESS - Departure:04:14PM Confirmation¥ b)(5) Seat: 20C(Confirmed) Status:Confirmed Rio Grande ValleyIntl Arpt (HRL) Duration:1 hour,15minutes Nonstop Arrival: 05:29PM GeorgeBushIntercontinenta l (IAH) Terminal: B Additional Details Aircraft: Embraer RJ135 Distance: 295miles E·Ticket Emiss ions:156.4lbsCO2 Cabin:Economy(U) • 1 hr,41minlayoverat George BushIntercontinental (/AH) Flight Houston , TX (IAH ) to Washington, DC {DCA) United1955 - Departure: 07:10PM Seat 29B(Confirmed) f 5 Confirmation: b)( ) Status:Confirmed._____ _. George Bush Intercontinental(IAH) Terminal:C Duration: 2 hours,55minutes Nonstop Arrival: 11:05PM Ronald Reagan National Arpt (DCA) Terminal: B Additional Details Aircraft:AirbusA319 Distance: 1205miles E-Ticket Emissions:470.0lbs CO2 Cabin:Economy (S) Meal: Foodfor purchase • TOTAL ESTIMATED COST • Air ViewFare Rules Ticket Number: 0167917734376:$1, 118.13 USD $129.47 USD Taxes and fees : Air Total Price : $1,247.60 USD Hotel: $228.26 USD $1,475.86 USD Total Estimated Cost: On-line Check-in UnitedCheck -in AMlf \. l\i pVERSIGHT EXT-18-248-A-000341 000342 000343 Youcancheck-in on-lineupto 24 hoursbeforeyourflight.You mayprint your boardingpassat yourhomeor officeto avoid ticketcountersandkiosksandgorightto security. Clickthe Check-i n buttonto find out more. - Confirmation :~ REMARKS CHECK- IN TIME ARE 90 MINUTES PRIOR TO DEPARTURE FOR DOMESTIC FLIGHTS OR 120 MINUTES FOR I NTERNATIONAL CHECK CARRIER WEB SITE FOR CHANGE/CANCEL AND BAGGAGE POLICIES OMEGATRAVEL . COM FEDERAL SERVICES -HOTEL/CAR/ AIR/RAIL 855 . 326 . 5411 7A- 10P EST 855 - 326 -5 411 EMERGENCY Change Trip ] ['-___ ci_os _e__ _, - • /\Mlf IC'AI\ pVERSIGHT EXT-18-248-A-000343 000344 000345 - BCFS-HH S HA RLINGEN Location : Harlingen,TX Type of Facility: EmergencyShelter Grant No: # 90ZU0224-01 Project Period: February 1, 2017 - January31, 2017 capacity : 290 .,,.. b,..,., >< s,,... >---------------------. FY 17 Funding: $29,495,193 Census: 85 as of 03/29/2017 Primary Point of Contact SonyaThompson, ExecutiveDirector (210) 262-9127 sthompson@bcfs .net Andrew Carter, RegionalDirector (956) 367-1585 Andrew.Carter@BCFS.net (b)(5) - b)(5) Shelter Location: (b)(6) b)(5) Harlingen, Texas b)(5 Overview BCFSHealth & Human erv1ces ar mgen ampus is a licensedchildcareprogram. BCFSHHS Harlingencampus is licensedthrough the Texas Departmentof Protectiveand RegulatoryServices (TDPRS)as a BasicChild care Facilityfor male youth between the agesof 5 to 17. The program is locatedin Harlingen,Texas and is situated on a 94 acre campusand providesyouth care that meetstheir physicaland emotional needsin the least restrictiveenvironment as a basicchild care operation. Currently, BCFSHHSprovidesshelter to 331 male youth ages 13-17 within three dormitoriesand four homes.The first dormitory is the BrandDormitory,which can accommodate up to 112 youth. The second dormitory is the HennesseeDormitory,which can accommodateup to 100 youth. The third dormitory is the North Dormitory, which can accommodateup to 94 youths. The fourth setting consistsof four homes that can accommodate25 additionalyouth and are typically usedfor siblinggroups, younger children and children that may program better in a smallersetting. All residentialareasare locatedon the same b)(5) remisesand can accommodate331 outh. AM _f ll Al\ P\'ERSIGHT EXT-18-248-A-000345 000346 A basicchildcareprogram (licensedin the State of Texas) may not accept placementof a child that is consideredmedicallyfragile without a variance.BCFSHHShas taken, and will continue to take, children with specialmedical needs.The BCFSHHSMedicalteam is able to provideexceptionalcare to children with specialmedical needsand as such will considereach and every child. A basicchildcareprogram (licensedin the State of Texas) cannot take a child diagnosedwith mental retardationor with autism without a variance. BCFSHHShas taken, and will continueto take, children with developmentaldisabilities. Tender Age: Youth may be acceptedif placementcannot be accommodatedelsewhere. /\MERICAi\ pVERSIGHT 2 EXT-18-248-A-000346 000347 - Date: May 31, 2016 Program: b)(7)(A) ;(b)(7)(C) ;(b)(7)(D Issue: OIG Investigation into the following allegations b)(7)(A); (b)(7)( C); (b)(7)(0) /\Mlf ll Al\ pVERSIGHT EXT-18-248-A-000347 000348 000349 Office of Refugee Resettlement Division of Unaccompanied Children Operations (DUCO) Facility Name: Casa Antigua Facility Type: General Residential Operations Physical Location of Shelter and Mailing Address: fb) (6) San Benito TXj(b)(6) I I Primary Point of Contact: Nidia Gonzlaes, Program Director Phone Contact: 956-247-7501 Email Address: NGonzales@swkey.org Primary Points of Contact, ORR/DCS/Unaccompanied Children Program Project Officer: Tanzeena Shireena FFS: Servando Barrera FFSSupervisor: Teresa Brooks FY2017 Funding: $13,977,890 Grant Number: 90ZU0148 Population Served: Age: 10-17 Capacity : 201 Type of beds: Males and Females Census as of 3/30/2017: 95 Program Overview: History- Program started in April 2013 and received first youth on May 11, 2013. Since then program has had two additional phases added to the facility to increase number of beds to 201. Without variance they house 109 girls and 92 boys. Facility Structure - The program has two sections. One is a one story building and the other is a two story building. They have 37 rooms on the first floor in the one story building, and in the two story building they have a total of 24 rooms. The program has 9 class rooms, 3 day r9oms, a large kitchen area and a /\Mlf large area for youth to have recreational activities (play soccer, volleyball, kickball and other sports). 1 ll Al\ pVERSIGHT EXT-18-248-A-000349 000350 Strengths- They have a team of dedicated workers that are always looking out for the best interest of the youth .. Challenges-The program deals with some challenging behavior with youth but as long as they work as a team, have proper training , build rapport with youth , they can overcome the challenge and provide the needs to all youth. 2 /\MERICAi\ pVERSIGHT EXT-18-248-A-000350 000351 REFERENCE:SWK CasaAntigua MONI TORING TRIP: July 25-July 29, 2016 - FINDINGS FROM: ORR Project Officer/ Monitor Summary: (b)(5) PRELIMINARY FINDINGS AND RECOMMENDATIONS b)(5) • /\Mlf 1 ll Al\ pVERSIGHT EXT-18-248-A-000351 000352 000353 - IES-Casa Norma Linder Shelter Location : Type of Facility: Grant No: Project Period: Capacity: FY 16 Funding : San Benito, TX Shelter Program 90ZU0119 October 1, 2015 - September 30, 2016 100 (Male & Females) $5,552 ,163 Census: Primary Points of Contact Program Director: Marivel Herrera , Phone: Office (956) 626-1820~ ---v ;i.t./~ ~/.'2oo ~ft>"° ~~~ ~ ,.,,.....,,,......-------. , r b)(B) I Email: marivel. herrera@iestex.org rb )(6) Assistant Program Director: Belinda Delgado, Phone: Office (956) 626-1820 *b )(6)l, Email: belinda.delgado@iestex.org ~---------~ EJ Primary Points of Contact, ORR/Division of Unaccompanied Children's Services PO: Rachel Jacobs, Rachel.Tacobs@acf.hhs.gov FFS: Servando Barrera, Servando.Barre ra@acf.hhs.gov CFS: Jaime Garcia, jaime.garcia@acf.hhs.gov - Shelter Location b)(6) San Benito, Texas (b)(6) Main Number: 956-626-1820 Mailing Address: P.O. Box 112 Lox Fresnos, TX 78566 Overview Inte rnationa l Educational Services, Inc. (IES) Casa Norma Linda Shelter provides 100 shelter beds for Unaccompanied Children, and has done so successfully since August 2016. IES is a nonprofit organization founded in 1984 who currently runs 5 TFC programs and 4 shelter programs, all serving the UC population. All IES programs are monitored and licensed by Texas Department of Family and Protective Services- State Licensing, which conduc ts announced and unannounced m onitoring inspections on a regular basis. - IES Casa Norma Linda Shelter focuses on caring for tender age minors 8-12 year of age and standard age minors ages 13-17. All children placed in IES's care are screened and assessed. This young and vulnerable population is provided with basic care services from the time of placement to the time of discharge. Minors receive on-site schooling, group and individual coun seling, medical and mental health services, psychiatr ic care, recreation, and safe and expeditio us family reunification. All program staff is fully trained to meet the needs of the children on a day to day basis. AMlf ll Al\ pVERSIGHT 1 EXT-18-248-A-000353 000354 000355 • Office of Refugee Resettlement Division of Children's Services Unaccompanied Alien Children's Program Facility Name: Southwest Key Programs- Casa Padre Facility Type: Shelter Care Physical Location of Shelter and Mailing Address: fb)(6) IBrownsville, Texa1-cb_lC_6l-~ Primary Point of Contact: Olga Garcia, Execut ive Program Director Pho~e Contact:fb )(6) Email Address: bga, uaeyswKey.u, g I Primary Points of Contact, ORR/DCS/Unaccompanied Children Program Project Officer: Mark Boss, Mark.Boss@ACF.hhs.gov; FFS: Bellevue, Elsie, Elsie.Bellevue@acf.hhs.gov FFSSupervisor: Brooks, Teresa, Teresa.Brooks@ACF.hhs.gov FY2016 (Oct 2016 to Sept 2017) Funding: $57,226,430.00 Grant Number : 90ZU0148-03-03 Population Served: Age: 10-17 Capacity: 286 (Quadrant 1) Males and Females Censusasof3/29/2017:0 Program Overview: On March 28, 2017 SWK Casa Padre " Quadrant 1" became a Licensed Residential Program by the Texas Department of Family Protective Services with a capacity of 286 children between the ages of 10 to 17, males and females. Casa Padre Facility was formerly a Walmart, located close to the port of Brownsville. The program offers a highly structured program of services which includes education, recreation, social skills training, behavior management, life skills, and whenever possible family involvement. Programming is goal-directed which allows youth to function safely at optimal performance levels. Through a wellrounded program, all youth are ensured a safe environment which facilitates developmental progress. AMlf ll Al\ pVERSIGHT EXT-18-248-A-000355 000356 000357 Page 357 of 360 Withhe ld pursuant to exemption Referred to DHS of the Freedom of Information and Privacy Act /\Mlf ll Al\ pVERSIGHT EXT-18-248-A-000357 000358 000359 5 ~r b-)(_l ____ 11:05 am N oon ~IAve ., McAllen, TXfb)( 5 ) Arrive at RGV Cen tr alized Pro cess in g Cen ter Led by: Acting Patrol Agent in Charge jt~ b~)(5~);-(b~)(7=l(~C)--~ designee • Briefin g/ Walkin g Tour • Qu estion s and An sw er s p r his End of Tour ***NOTE TO VISITORS*** • • • - Only those who RSVP'd to the RGV Communications Division will be permitted into the RGV facilities visited during this tour. No recording devices of any kind will be allowed . No interacting with staff and children or families at the Border Patrol Stations visited on this tour without prior approval from RGV headquarte rs. No picture taking or interview ing of children is permitted . RGV Sector Points of Contact so s 1(b)(6) (A)SBPA!(b)(6l BPA ~l(b_)(6_) ---~ I □ Mobile (956 Mo bile (619 Mobil e (406 ORR Acting Director Tota 2 /\Mlf ll Al\ pVERSIGHT I2 EXT-18-248-A-000359 000360 / ..!IP ,.t-1suv1c·1s DEPARTMENT OF HEALTH & HUMAN SERVICES t ~~'f!..-----------------A-DM-IN-1S_T_R_A_T_IO_N_F_O_R_C_H_IL_D_R_E_N_A_N_D_F_A_M_I_LI_E_S Mary E. Switzer Building 330 CST, S.W. Washington , D.C. 20201 Case No: 18-F-0029 Civil Action l 8-cv-0248 September 20, 2018 Ms. Katie O' Connor Legal Counsel Campaign for Accountability 611 Pennsylvania Avenue , SE, #337 Washington , D.C. 20003 Dear Ms. O' Connor: This is the second interim response of the Administration for Children and Families to Ms. Katie O'Connor's October 27, 2017, Freedom of Information Act (FOIA) request for records related to services for pregnant unaccompanied immigrant minors. Specifically , Ms. O' Connor sought the following items : 1. All records related to Office of Refugee Resettlement ("ORR ") policy regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters . This request includes memoranda, directives , policy statements , policy interpretations , policy guidance , talking points, and other similar documents reflecting ORR policy. 2. All records related to ORR Director Scott Lloyd ' s visits to ORR grantee shelters that house unaccompanied immigrant minors. This request includes calendar entries, travel and accommodation requests and approvals, itineraries, briefing memoranda, and meeting notes. 3. All communications , meeting notices , meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and representatives of the Susan B. Anthony List, Concerned Women for America, the Heritage Foundation, the Center for Family and Human Rights ("C-Fam"), National Right to Life, Alliance Defending Freedom , Legal Works Apostolate , or the Knights of Columbus regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters . This request includes communications to or from anyone using email addresses from the following domains : a. @sba-list.org b.@cwfa.org c. @heritage.org d.@c-fam .org e. @nrlc .org f. @adflegal.org g. @legalworks.com h. @kofc.org 4. All communications, meeting notices , meeting agendas, informational materials, talking points , or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged AM[ HICAN PVERSIGHT Case No. 18-F-0029 Civil Action l 8-cv-0248 Page 2 of2 between representatives of ORR and representatives of the White House regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. 5. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and members and staff of the U.S. Congress regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. This partial release consists of 500 pages that have been reviewed and are responsive to items one and three above. Of this number, 340 pages are being provided to you at this time. Portions of these pages have been redacted pursuant to FOIA Exemptions (b)(5) and (b)(6). Approximately 160 pages processed by ACF will be sent for consultation with other federal entities. The exemption (b)(5) protects inter-agency or intra-agency memorandums or letters which would not be available by law to a party other than an agency in litigation with the agency. The exemption protects agency deliberations, both internal and with agency contractors and consultants, attorney-client privileged records and attorney work product. In this case, the withheld infom1ation includes predecisional discussions within the agency and between agency staff and contractors about management of ORR programs and/or individual children and sensitive communications between agency staff seeking legal advice and counsel on policy and other matters . The FOIA exemption (b)(6) permits the withholding ofrecords which, if released, would constitute a clearly unwarranted invasion of personal privacy. In this case, the withheld information consists of the names, identity and/or other private information of private individuals and/or the identities of federal employees in sensitive positions and the work cell phones of federal employees. The withheld information also includes the locations of shelters housing vulnerable unaccompanied children and refugee centers. Public disclosure of this information would constitute an invasion of privacy of those individuals whose identifying information was disclosed. In particular, disclosing the locations of shelters subject the children to unwanted publicity and harassment. In withholding the information, the individual's privacy interest was balanced against any public interest in disclosure. In each instance where information was withheld, it was determined that the individual's privacy interests outweighed any public interest in disclosure of the withheld information. Disclosure of the withheld information would invade the privacy of the subject individuals but would reveal nothing about the operations or activities of the government. Sincerely yours, Acting FOIA Officer Administration for Children and Families AM[HICAN PVERSIGHT White, Jonathan (ACF) "Wynne, Maggie (HHS/IOS) "; "Tota, Kenneth (ACF) "; To: "Lloyd, Scott E. (ACF) "i "Barlow, Amanda (ACF) "; "Gregg, Laura (ACF) " Subject: RE: Medical Recommendationsfor UCtom Date: 2017/03/03 22:28:22 Priority: Normal Type: Note Received. I will consult with the medical team. From: Wynne, Maggie (HHS/10S) Sent: Friday, March 03, 2017 10:28 PM To: White, Jonathan (ACF); Tota, Kenneth (ACF); Lloyd, Scott E. (ACF); Barlow, Amanda (ACF); Gregg, Laura (ACF) Subject: Re: Medical Recommendations for UC tom - Jonathan, I have heard that the administration of progesterone - which Mifeprix blocks - can counteract the drug if administered before Cytotec is taken. Is there any serious side effect from that treatment? Maggie On: 03 March 2017 21:4 1, "White, Jonathan (ACF)" wrote: I have been in coordination tonight with the two ORR DHUC medical officers who have been consulting with the OB-GYNand Southwest Key medical team, to determine options and next steps for the UCwho was today initiated on the pill procedure. They have consulted with the medical team working on the patient's case and reviewed the medical records, which we had Southwest Key provide us. Our medical t eam was disconcerted to learn of this as they had provided medical recommendations against the pill procedure met hod in earlier communications with the grantee . When we learned tonight of the /\MERICAi\ pVERSIGHT EXT-18-248-B-000001 currently unfolding procedure, I instr ucted our medical team to learn what they could and provide options, including a review of the option to not administer the second scheduled drug tomorrow. Here is what we have learned: the UC took Mifeprex 200mg Tablet - around 12pm today (this disrupts fetus from uterine lining); once Mifeprex is taken, you have to take Cytotec (which expels pregnancy contents); Minor will take Cytotec as early as 24hr after taking Mifeprex, no later than 48hrs as per FDA for termination of pregnancy. The Medica l Team has reviewed the safety plan for this child and next steps and their recommendation isl(b)(5) 1~)(5) The DHUCteam is standing by to provide guidance to the program based on their recommendations about next steps. In the very unfortunate situation in which we find ourselves, it is my recommendation that (b)(S) (b)(5) Jonathan From: Meyerstein, Shaanan (ACF) Sent : Friday, March 03, 2017 8:59 PM To : White, Jonathan (ACF) Cc: Bartholomew, Michael (ACF); Misegades, Lara (ACF) Subject: Medical Recommendations for UC tom Jonathan, As expected, the documents provided by the shelter are not helpful. After a lengthy discussion with Michael, since the termination has bene initiated and in essence has already been accomplished with the first pill, in the best interests of the child, it would be unwise to withhold giving the dose of Cytotec in the next 24-48hrs. We have been reassured by the O8-GYN that this method, the pill method, is acceptable versus a DNC with good outcomes and minimal complications. The minor and shelter staff (there will be a nurse available ATC) have been provided with the appropriate information as to how to properly administer the medication. The program should adhere to the specific recommendations and clinical management guidel ines for any anticipated complications as described in detail both in person in the clinic today and in the handouts/discharge instructions. They are notify the clinic for any compl ications and if instructed to go to nearest Emergency Room. The only remaining thing to do is notify the program staff of our medical guidance. I just wanted to make sure you are on board. Will you notify the shelter or would you like me to do so? Shaanan /\MERll Al\ pVERSIGHT EXT-18-248-B-000002 From: White, Jonathan (ACF) Sent: Friday, March 03, 2017 8:27 PM To : Meyerstein, Shaanan (ACF); Bartholomew, Michael (ACF); Misegades, Lara (ACF) Subject: RE: Timeline and Summary for TOP Thank you. I appreciate all your help. I think what will be most helpful is to know what the plan will be for the UC tomorrow. It' s fine to update me by email later. From: Meyerstein, Shaanan (ACF) Sent: Friday, March 03, 2017 8:05 PM To : White, Jonathan (ACF); Bartholomew, Michael (ACF); Misegades, Lara (ACF) Subject: Timeline and Summary fo r TOP Jonathan, lswK Please find attache d timelin e of events of the past week for fb)(5) Casa Blanca as I see them and what I have in my email. I am going to eat dinn er for a few minutes with l(b )(6) I I have my phone on me to discuss furthe r if you need any further clarification or need to have a conference call. Shaanan Meyerst ein, MD, MPH, FAAP LCDR, US Public Health Service Medical Officer - Unaccompanied Children's Program Off ice of Refugee Resettlement Administration for Children and Famil ies U.S. Department of Health and Human Services (202) 401-4639 (office) (30l)l (b)(6) l(cell) Shaanan.meyerstein@acf.hhs.gov Sender: White, Jonathan (ACF) "Wynne, Maggie (HHS/1O5) "; "Tota, Kenneth (ACF) "; "Lloyd, Scott E. (ACF) "; "Barlow, Amanda (ACF) "; "Gregg, Laura (ACF) " Sent Date: 2017/03/03 22:28:21 /\MERICAi\ pVERSIGHT EXT-18-248-B-000003 Delivered 22:23:22 Gonzalez,Jose (ACF) To: "Lloyd, Scott (ACF) " Subj ect: Re: Quick thoughts Date: 2017/03/14 14:55:01 Priority: Normal Type: Note On it sir. From: Lloyd , Scott (ACF) Sent: Tuesday, March 14, 2017 1:51:16 PM To: Gonzalez, Jose (ACF) Subject: Quick thou ghts Jose, Just a few things, while they are fresh in my mind: 1) !(b)(6) I said she preferred the food at Seton-that it wasn't Honduran enough at BCFS (she mentioned bananas, which I thought BCFShas, and soup). If there is a way to accommodate at BCFSwith any food requests, please find a way. She's feeling very nauseous because of the pregnancy . 2) She also says she has pain in her arms and legs at night and thinks it might be the mattress. This is one to keep in mind, if there is an extra mattress laying around, maybe plywood instead of the planks underneath as you were saying at the extended care facility, maybe foam or something on top of the mattress. Something to look into. ~please have her clinician keep a close eye on her. As I've said, often these gir ls 3) ~b)(6l start to regret abortion, and if this comes up, we need to connect her with resources for psychological and/ or religious counseling. It's not going to affect some girls right away or at all. If there are any additional updates on her case, I'd like to know. Isponsor, I know a few good families with a heart for 4) If things get dicey with !(b)(6) these situations who would take her in in a heartbeat and see her through her pregnancy and beyond . !(b)(6) I said she would accept this if things can't work out with her aunt soon . I am unclear at this point how to match these two together, if this becomes necessary. How do potential foster parents get into the pipeline for these situations? That's all I can think of right now . Thanks again for everything, and for the hard work and dedication of you and your team . Scott *** E. Scott Lloyd U.S. Department of Health and Human Services /\MERICAi\ pVERSIGHT EXT-18-248-B-000005 (202) 260-7387 (202) !{b l{6l I (cell) scott.lloyd@acf.hhs.gov Gonzalez,Jose (ACF) Recipient: " Lloyd, Scott (ACF) " Sent Date: 2017/03/14 14:55:00 Delivered Date: 2017/03/1 4 14:55:01 /\MERICAi\ pVERSIGHT EXT-18-248-B-000006 Gonzalez,Jose (ACF) To: "Lloyd, Scott (ACF) " "White, Jonathan (ACF) "; CC: "De LA Cruz, James (ACF) " Subject: RE: Quick thoughts Messagefrom Mr. Scott Lloyd Date : 2017/03/14 18:22:22 Priority : Normal Type: Note Sir all requests have been sent to local FFS and providers. i don ' t foresee any issues with these request s, but I do have a question and a comment about these bullets. • I I got her pre-release plan with a list of resources to assist with l(b)(6l pregnancy. I asked them to firm up plan a bit and will send for your review if you would like to see it. I have also attached the resources close to her house that will assist with her post release services and are close to her future address ofJ "Lloyd, Scott (ACF) "i "White, Jonathan (ACF) "; " De LA Cruz, James (ACF) " Sent Date: 2017/03/14 18:22:21 Delivered Date: 2017/03/14 18:22:22 /\MERICAi\ pVERSIGHT EXT-18-248-B-000009 White, Jonathan (ACF) To: "Lloyd, Scott (ACF) " CC: "Tota, Kenneth (ACF) " Subject: Abortion services processes Date: 2017/03/2118:18 :36 Priority: Normal Type: Note Scott, Per your question today, I am writing to provide some additional infonnation on procedures that ORR staff were following from the last Administration. It appears that there was an Ops Guide for Family Planning procedure as part of a larger family planning services policy and procedure package, which was iteratively passed back and forth between appointed officials--the Acting Assistant Secretary , the Deputy Director for the UC Program, the Deputy Assistant Secretary for Policy, and staff at IOS. While never formalized, this policy and procedure was what staff appear to have understood to be the direction. I am attaching the zip file of documents left behind by Bobbie Gregg, which should provide some background on this process . Jonathan Jonathan D. White Commander , U.S. Public Health Service Deputy Director for Children ' s Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services 330 C Street SW (202) 690-6984 j onathan. white@acf. hhs. gov White, Jonathan (ACF) "Lloyd, Scott (ACF) "; Recipient : "Tota, Kenneth (ACF) " Sent Date : 2017/03/21 18:18:23 /\MERICAi\ pVERSIGHT EXT-18-248-B-000010 Delivered Date:1201?f03f21 18:18:36 EXT-1 8-248-B-000011 Suh, Victor (HHS/OGC)(ACF) (CTR) "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; "Sualog, Jallyn (ACF) "; " Bartholomew, Michael (ACF) "; "Bena, Anna Marie (HHS/OGC)(ACF) " "Gregg, Laura (ACF) "; " Kurkjy, Brian (ACF)(CTR) "; "Biswas, Toby RM (ACF) " Subject: FW: RFP1 Date: 2017/03/ 24 15:45:54 Importance: High Priority: Urgent Type: Note Directors, By 3/27, would you please identify an indiv idua l in your division who w ill be respons ible for collecting the items reques ted in the RFP (attached)? • Office of the Director - ? • DPP - Victor Suh • DUCO - ? • DHUC - ? These individua lsl "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; "Sualog, Jallyn (ACF) "; " Bartholomew, Michael (ACF) "; Recipient: "Bena, Anna Marie (HHS/OGC)(ACF) "; "Gregg, Laura (ACF) "; "Kurkj y, Brian (ACF)(CTR) "; "Biswas, Toby RM (ACF) " /\MERICAi\ pVERSIGHT EXT-18-248-B-000013 Sent Date: 20 17/03/2 4 15:45:52 Delivered Date: 20 17/03/24 15:45:54 /\MERICAi\ pVERSIGHT EXT-18-248-B-000014 From: Bena, Anna Marie (HHS/OGC)(ACF) To: "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) " "Gregg, Laura (ACF) "; CC: "Kurkjy, Brian (ACF)(CTR) " Subject: FW: ACLUV. Price Date: 2017/03/28 08:21:05 Importance: High Priority: Urgent Type: Note (b)(5) From: Suh, Victor (HHS/OGC) (ACF) (CTR) Sent: Monday, March 27, 2017 6:10 PM To: Lloyd, Scott (ACF); Tota, Kenneth (ACF); White, Jonathan (ACF); Swartz, Tricia (ACF); Kim, Curi (ACF); Bartholomew, Michael (ACF); Simmons, Joann (ACF); Bena, Anna Marie (HHS/OGC) (ACF); Sualog, Jallyn (ACF); Viola, Sarah (ACF); De LA Cruz, James (ACF); Kurkjy, Brian (ACF) (CTR); Gregg, Laura (ACF) Cc: Biswas, Toby R M (ACF); Schmalz, Jennifer (ACF); T heiler, Patricia (ACF) Subject: RE: ACLU v. Price Hi all, As communicated earlier today , tomorrow' s meeting about these Reque sts for Admi ssions has been cancelled . Attached for your awareness are the responses prepared by OGC, as confinned internally by ORR staff. We plan to discuss these answers with OGC tomorrow. FYI. In addition to this Request for Admissions , ORR must also submit the following: • Response to Plaintiffs Inten-ogatories (requested by Wednesday); and • Request for Production (with a due date in April) /\MERICAi\ pVERSIGHT EXT-18-248-B-000015 We may request an extension w/r/t the Interrogatories. Thanks, Victor Suh Policy Analyst, ORR From: Bena, Anna Marie (HHS/OGC) (ACF) Sent: Friday, March 24, 2017 8:29 AM To: Sualog, Jallyn (ACF); White, Jonathan (ACF); Swartz, Tricia (ACF); Viola, Sarah (ACF); De LA Cruz, James (ACF); Bartholomew, Michael (ACF); Kurkjy, Brian (ACF) (CTR); Tota, Kenneth (ACF); Gregg, Laura (ACF); Simmons, Joann (ACF); Kim, Curi (ACF); Schmalz, Jennifer (ACF) Cc: Biswas, Toby R M (ACF); Suh, Victor (HHS/OGC) (ACF) (CTR); Theiler, Patricia (ACF) Subject: RE: ACLU v. Price Importanc e : High b)(5) For Jonathan: They need a signatory for the ORR discovery. It is most appropriate for it to be someone from the UC programs. I don't know if this is you or Jallyn or? - please let me know what you think. From: Bena, Anna Marie (HHS/OGC) (ACF) Sent : Wednesday, March 22, 2017 4:14 PM To: '(Jally n.Sualoq@ACF.hhs.gov)'; White, Jonathan (ACF); Swartz, Tricia (ACF); Viola, Sarah (ACF); 'De LA Cruz, James (ACF) (james.delacruz@acf. hhs.gov )'; Bartholomew, Michael (ACF); Kurkjy, Brian (ACF) (CTR); Tota, Kenneth (ACF); Gregg, Laura (ACF); Simmons, Joann (ACF); Kim, Curi (ACF); Schmalz, Jennifer (ACF) Cc: Biswas, Toby R M (ACF); Suh, Victor (HHS/OGC) (ACF) (CTR); Theiler, Patricia (ACF) Subject: FW: ACLU v. Price r OGC has asked us to review the attcJ J bed statements bv the plaintiffs in the ACLU case. . we norma 11 b)(S) . . has gone When respon dmg, y stat ~------~ o 1· icy n·1v1s10n through the statements and we cannot answer on behalf of the office. We need information from many of you on this email list. We're specifically looking at #s 1, 4, 5, 6, 9, 10 for the time period January 1, 2012 to present. We would like to set up a brief meeting to discuss the statements after you've had a chance to review them. Please let us know if you believe you have information on these statements or if you know someone who does who is not on this email list (please forward). /\MERICAi\ pVERSIGHT EXT-18-248-B-000016 Victor is our POC on this , and he will set up a meeting time /place /call-in . If you can't make the meeting or can provide assistance in writing, he will follow-up with you individually (Just let him know). We plan to set the meeting for early next week. Please check out the statements in the meantime and let us know if you have questions. Thanks! AnnaMarie Sender: Bena, Anna Marie (HHS/OGC)(ACF) " Lloyd, Scott (ACF) "i "White, Jonathan (ACF) "; Recipient: "Gregg, Laura (ACF) "; " Kurkjy, Brian (ACF)(CTR) " Sent Date: 2017/03/28 08:21:04 Delivered Date: 2017/03/28 08:21:05 /\MERICAi\ pVERSIGHT EXT-18-248-B-000017 From: To: Bena, Anna Marie (HHS/OGC)(ACF) "ORR Senior Leadership "; "Lloyd, Scott (ACF) " Subject: Weekly Litigation Update Date: 2017/03/30 14:57:45 Priority : Normal Type: Note I have attached the week ly litigation update . In UC litigation, in OGLS (habeas litigation) , the plaintiff filed a motion to expedite the proceedings. The court had set a deadline of 5/15 for the government to show cause why writ of habea s should not issue. In refugee litigation , in Alabama , oral arguments were calendared to the week of 5/15/ 17; and in Tennesse e, there was an order reassigning the case to a new judge, Chief Judge S. Thomas Anderson. Please let me know if you have any questions. Sender: Recipient: Bena, Anna Marie (HHS/OGC)(ACF) "ORR Senior Leadership"; " Lloyd, Scott (ACF) " Sent Date : 2017/03/30 14:57:43 Delivered Date : 2017/03/30 14:57:45 /\MERICAi\ pVERSIGHT EXT-18-248-B-000018 Kurkjy, Brian (ACF) (CTR) "Ferguson, Nancy (ACF) "; "Gregg, Laura (ACF) "; "Gwilliam, Rachel (ACF) "; " Kurkjy, Brian (ACF)(CTR) "; "Lloyd, Scott (ACF) "; "Mella, Emily (ACF) "; "Swartz, Tricia (ACF) "; "Vieyra, Miguel (ACF) "; "White, Jonathan (ACF) "; "Lucas, Sarah (ACF) (CTR) "; " Holt, Lydia (ACF) "; "Sebgoya, Mata (ACF) (CTR) 11 ; "Arias, Gabriela (ACF)(CTR) "; "Abbott, Sarah (ACF) (CTR) "; "Sandoval, Cynthia (ACF) (CTR) "; "Simmons, Joann (ACF) "; "Hall, Wanda (ACF) "; "Miller, Lora (ACF) "; " Mai, Dinh (ACF) "; " Kramar, Julia (ACF) "; " Papanicolas, Koula (ACF)(CTR) "; "Maisler, Rachel (ACF) "; "Ali, Khalil (ACF)(CTR) " CC: "Suh, Victor (HHS/OGC) (ACF) (CTR) " Subject: URGENT: ACLU v. Price Document Search Date: 2017/03/30 17:05:21 Due Date: 2017/03/30 20:00:00 Priority: Normal Type: Note OD Staff, /\MERICAi\ pVERSIGHT EXT-18-248-B-000019 ORR has received a Request for Production (RFP) for an act ive laws uit, ALCU v. Price . We will likely have a short window to produce documents , therefore you must begin search and production of documents as soon as you are able. Attac hed are instructions for the searc h and temp lates for Production Ind exes . Please ensure that you have carefully read and understand the attached instructions (the word docum ent) prior to conducting your searches. I will be check ing the shared drive cont inually for new document s and prov iding them to DPP (who will send to OGC) in batches on a rolling basis. If you do not find any relevant documents , please email me a statement saying that you have conducted all searc hes per the attached instructions and the searches produced no results. Note that ITIO will pe rform a search of your ACF email accounts. You wi ll be responsible for searches your electronic files , paper documents , any personal email accounts or laptops used for work-re lated purposes , and any other sources (see II. What to Search in attac hed instructions). Supervisors - If anyone in your team is out of the office and will be returning later than Wednesday , Apri l 5, please let me know the name and when he/she is expected back in the office. FA Os for Docum ent Searches Question : Do I upload everything I found based on my keyword searches? Answe r: No . You only need to upload documents that are found in your keywo rd search AND are relevant to the items listed under "What you are searching for" for each search (see pages 3-6 of the instruction s docum ent). Question : Do I need to search for documents on the shared drive? Answer: It depends. If you have a folder on the shared drive (S Drive) that you created and it is not used by anyone else - just you , then you will need to search that folder. [SUPERVISORS - For shared drive folders that are used collect ively by your team , you will be responsible for searching tho se fo lders. You may conduct the searc h yourse lf or deleg ate it to a member of your team.] Drive that everyone will need to searc h on their work laptop are your personal drive (U Dri ve), your local drive (C Drive), and you De sktop. Question : What is the best way to search for the keywords ? Answer: When using Windows Expl orer to search for keywords , make sure that W indows Exp lorer is search both the conte nt of the document s as well as the title. This will make you r search a lot eas ier. Here is a link with instruction on how to make sure Windows Exp lorer is search both content and title s. http://www.wikihow.com/MakeW indows -7-Search -File-Conte nts /\MERICAi\ pVERSIGHT EXT-18-248-B-000020 I know this will involve a lot of work for all of us, so thank you in advance for your prompt comp letion of this task . Please do not hesitate to reach out if you have any questions, I will do my best to work with DPP and OGC to answer them as promptly as possible. Best, Brian Brian Kurkjy Special Assistant to the Deputy Director for Children' s Programs Office of Refugee Resettlement U.S. Department of Health & Human Services Office: (202) 260-1249 brian.kurkjy @ac f.hhs.gov Kurkjy, Brian (ACF) (CTR) "Ferguson, Nancy (ACF) "; "Gregg, Laura (ACF) "; "Gwilliam, Rachel (ACF) "; " Kurkj y, Brian (ACF)(CTR) "; "Lloyd, Scott (ACF) "; "Mella, Emily (ACF) "; "Swartz, Tricia (ACF) "; "Vieyra, Miguel (ACF) "; "White, Jonathan (ACF) "; "Lucas, Sarah (ACF) (CTR) "; Recipient: "Holt, Lydia (ACF) "; "Sebgoya, Mata (ACF) (CTR) 11 ; "Arias, Gabriela (ACF)(CTR) "; "Abbott, Sarah (ACF) (CTR) "; "Sandoval, Cynthia (ACF) (CTR) "; "Simmons, Joann (ACF) "; "Hall, Wanda (ACF) "; "Miller, Lora (ACF) "; "Mai, Dinh (ACF) "; "Kramar, Iulia (ACF) " ; "Papanicolas, Koula (ACF)(CTR) "; "Maisler, Rachel (ACF) "i "Ali, Khalil (ACF)(CTR) "; "Suh, Victor (HHS/OGC)(ACF) (CTR) " Sent Date : 2017/03/30 17:05:17 Delivered Date : 2017/03/30 17:05:21 /\MERICAi\ pVERSIGHT EXT-18-248-B-000022 White, Jonathan (ACF) To: "Lloyd, Scott (ACF) " Subject: RE: UC requesting pregnancytermination Date: 2017/03/30 18:40:11 Priority: Normal Type: Note Acknowledged. I have provided direction to the FFSSupervisor and Medical Team to follow up with the grantee per your guidance. From: Lloyd, Scott (ACF) Sent: Thursday, March 30, 2017 6:26 PM To: White, Jonathan (ACF) Subject: RE: UC requesti ng pregnancy termination Jonathan, It's unclear what they mean here. Not sure what they mean by "services" and "abortion counseling." Please ask them to explain clearly, because if I recall, we were very clear about what they were to do. Grantees should not be supporting abortion services pre or post-release; only pregnancy services and life-affirming options counseling. Thank you, Scott From: White, Jonathan (ACF) Sent: Wednesday, March 29, 2017 5:19 PM To: Lloyd, Scott (ACF) Subject: FW: UC request ing pregnancy termination Per our discussion. From: Bartholomew, Michael (ACF) Sent: Wednesday, March 29, 2017 4:59 PM To: White, Jonathan (ACF) Subject: FW: UC requesting pregnancy termination Hi Jonathan, /\MERICAi\ pVERSIGHT EXT-18-248-B-000023 Can we proceed with the current recommendation? Michael L. Bartholomew, M.D., FAAP CDR, U.S. Public Health Service Director, Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Building 330 C St SW, MS 5123 Washington, DC 20201 Phone: 202-401-5375 michael. bartholomew@acf.hhs.gov www .acf.hhs.gov From~ (b)(6) tmailto fb )(6) ~swkev.orql Sent: Wednesday, March 29, 2017 4:22 PM To: Bartholomew, Michael (ACF); Sanchez, Alex (ACF) Cc: Diego Naranjo; Fanny Rivera; Monica Winbush; Silvia F. Mendoza; Claudia M Ruiz; Reina Cossio; Jennifer Matos Ramos; White, Jonathan (ACF); De LA Cruz, James (ACF); Velazquez, Ivonne (ACF) Subject: Re: UC requesting pregnancy termination Good afternoon, in response to your questions, We, at Las Palmas have staffed this case and here are the answers to your questions. 1. Minor has received services provided at shelter with her clinician. The progr am is moving toward s reunification and suppor ting the minor's plan of abortion once arriving to her destination in Flor ida, where she will receive abortion counseling services. Would you recommend otherwise? 2. Sponsor has been notified of pregnancy during a family session. Minor has disclosed that she would like to have an abortion. Minor has declined to inform mother in COO about the pregnan cy. The safety plan developed for minor includes that she would notify and get consent from mother before moving forward with abortion once in Florida . Sponsor has expressed full support of any decision client makes towards her pregnancy. 3. Safety plan has been developed with information of resources for both prenatal care and abortion services. Medical will develop a safety plan for referral to neuro logist once reunified with sponsor. /\MERICAi\ pVERSIGHT EXT-18-248-B-000024 Your guidance is greatly appreciated. Thank you for your time. Thank you, Southwest Key Program 924 5 Cell: .... l'b_><_>____ _, 'What we do for ourselves dies with us. What we dofor others an d theworld remain s and is immortal." -Albert Pine CONFIDENTIALITYNOTICE:This communication is intended on ly for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If you have received this email in error please notify the sender by emai l, delete and destroy this message and its attachments. If you are not the intended recipient, you are notified that any use, dissemination, distribution, or copying of the communication is strictly prohibited. Fro m : Bartholomew, Michael (ACF) Sent: Wednesdaj' March 29, 201712:00:19 PM To:fb )(B) _Sanchez, Alex (ACF) Cc: Diego Naranjo; Fanny Rivera; Monica Winbush; Silvia F. Mendoza; Claudia M Ruiz; Reina Cossio; Jennifer Matos Ramos; White, Jonathan (ACF); De LA Cruz, James (ACF); Ivonne Velazquez Subject : RE: UC requesting pregnancy termination Good Afternoon, Can you answer the following questions? /\MERICAi\ pVERSIGHT EXT-18-248-B-000025 • Can we confirm that the minor has received options counseling for the pregnancy as discussed? • Can we confirm that the sponsor and the minor's parents have been notified of the pregnancy? • Can we please ensure that resources for pregnancy supports in Florida where the minor is headed are part of the discharge plan? Michael L. Bartho lomew, M.D., FAAP CDR, U.S. Public Health Service Director, Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Building 330 C St SW, MS 5123 Washington, DC 20201 Phone: 202-401-5375 michael.bartholomew@acf .hhs.gov www .acf .hhs.gov r From:l(b)(6) mailto¥b)(6) @swkey.org] Sent: Tuesday, March 28, 2017 6:27 PM To: Bartholomew, Michael (ACF) Cc : Diego Naranjo; Fanny Rivera; Monica Winbush; Sanchez, Alex (ACF); Silvia F. Mendoza; Claudia M Ruiz; Reina Cossio; Jennifer Matos Ramos Subject: Re: UC requesting pregnancy termination My apologies, she is a category 2. She will be reunified with her aunt in Miami Florida. As per case managers case is ready to submit. Thank you, Casa Esperanza Southwest /\MERICAi\ pVERSIGHT Key Program 960 EXT-18-248-B-000026 Cell: ~l (b-)(6 _)____ ~ 'Whatwe dofor ourselvesdies wtth us. What we dofor othersandtheworld rematns andts immortal." -Albert Pine CONFIDENTIALITYNOTICE: This communication is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If you have received this email in error please notify the sender by email, delete and destroy this message and its attachments. If you are not the intended recipient, you are notified that any use, dissemination, distribution, or copying of the communication is strictly prohibited. From: ~l <_>___ ~l if there is no answer, please ca11 .<_l b_)<6_>___ 'What we do for ourselves dies with us. What we dofor others and __, theworld remains and is immortal." -Albert Pine CONFIDENTIALITY NOTICE:This communication is intended on ly for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under app licable law. If you have received this email in error please notify the sender by emai l, delete and destroy this message and its attachments. If you are not the intended recipient , you are notified that any use, dissem ination, distribution, or copying of the communication is strictly prohibited. /\MERICAi\ pVERSIGHT EXT-18-248-B-000028 White, Jonathan (ACF) Recipient: "Lloyd, Scott (ACF) " Sent Date: 2017/03/30 18:40:10 Delivered Date: 2017/03/30 18:40:11 /\MERICAi\ pVERSIGHT EXT-18-248-B-000029 From: To: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; "Tota, Kenneth (ACF) " "Brown, Anastasia(ACF) "; "Rubenstein, earl (ACF) "; "Simmons, Joann (ACF) " Subj ect : FW: Alabama v. US (11th Cir.) -- correspondencefrom State Date : 2017/03/31 14:55:47 Priority: Normal Type: Note Scott and Ken, b)(S) AnnaMarie From: Haron, Judith (HHS/OGC) Sent: Friday, March 31, 2017 2:49 PM To : Bena, Anna Marie (HHS/OGC) (ACF); Suh, Victor (HHS/OGC) (ACF) (CTR); Biswas, Toby R M (ACF) Subject: FW: Alabama v. US (11th Cir.) -- correspondence from State Good afternoon. I recommend b)(S) b)(5) (b)(5) /\MERll Al\ pVERSIGHT EXT-18-248-B-000030 (b)(S) - Judy Haron Deputy Associate General Counsel Children, Families and Aging Division HHS Office of the General Counsel (202) 690 8005 Notice: The contents of this message and any attachments are privileged and confidential. You should not disseminate or release this message and any attachments without the approval of the Office of the General Counsel. If you are not an intended recipient, or have received this message in error, please delete it without reading it and please do not print, copy, forward, disseminate, or otherwise use the information. Also, please notify the sender that you have received this communication in error. Your receipt of this message is not intended to waive any applicable privilege. From: Tenny, Daniel (CIV) [ mailto:Daniel.Tenny@usdoj.gov ] Sent: Friday, March 31, 2017 1:25 PM To: Powell, Lindsey E. (CIV); Owens, Jessica D; Whitney, Ronald W; Zengot itabengoa, Colleen R; Kreisberg, Jeremy (HHS/OGC); Haran, Judith (HHS/OGC); Bennett , Michelle (CIV); Gilligan, Jim (CIV); Robinson, Stuart J. (CIV); Shellito, Haley B; Pickering, Margaret S Cc: Stern, Mark (CIV); McIntosh, Scott (CIV) Subject: Alabama v . US (11th Cir.) -- correspondence from State All, (b)(S) Thanks, Daniel Daniel Tenny U.S. Department of Justice, Civil Division 950 Pennsylvania Avenue, NW, Room 7215 /\MERll Al\ pVERSIGHT EXT-18-248-B-000031 Washington, DC 20530 (202) 514-1838 fax (202) 514-9405 dan iel.tenny@usdoj.gov From : Powell, Lindsey E. (CIV) Sent : Monday, January 09, 2017 1:00 PM To: Owens, Jessica D ; Whitney, Ronald W ; Zengotitabengoa, Colleen R ; Kreisberg, Jeremy (HHS/OGC) ; Haron, Judith (HHS/OGC) ; Bennett, Michelle (CIV) ; Gilligan, Jim (CIV) ; Robinson, Stuart J. (CIV) ; Shellito, Haley B ; Pickering, Margaret S < Piekeri ngMS@state.gov > Cc: Stern, Mark (CIV) ; McIntosh, Scott (CIV) ; Tenny, Daniel (CIV) Subject: Reply Brief in Alabama v. US (11th Cir.) b)(5) Thanks very much , Lindsey Sender: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; "Tota, Kenneth (ACF) "; "Brown, Anastasia(ACF) "; "Rubenstein, earl (ACF) "; "Simmons, Joann (ACF) " Sent Date : 2017/03/31 14:55:47 /\MERll Al\ pVERSIGHT EXT-18-248-B-000032 White, Jonathan (ACF) To: "Lloyd, Scott (ACF) " CC: "Gregg, Laura (ACF) " Subject: Re: Heads up: UC requesting pregnancytermination Date: 2017/04/01 06:56:27 Priority: Normal Type: Note Scott, Sure thing . I'll see about today vs Monday a little later on when it's daytime in that time zone. Jonathan CDRJonathan White Deputy Director for Children's Programs Office of Refugee Resettlement Administration for Children and Families Incident Commander, Unaccompanied Children Influx Response 202 690-6984 (office) (b)(5 ) (blackberry) Jonathan.wh ite@acf.hhs.gov From: Lloyd , Scott (ACF) Sent: Saturday, Aprill, 2017 5:52:08 AM To: White, Jonathan (ACF) Cc: Gregg, Laura (ACF) Sub ject: Re: Heads up: UC reque sting pregnancy termination Jonathan , b)(5) Thank you, Scott /\MERICAi\ pVERSIGHT EXT-18-248-B-000033 On: 01 April 2017 00: 18, "White, Jonathan (ACF)" wrote: Scott, See Arizona FFSSupervisor response below. When we spoke on the phone, she indicated that she had thought Adelante "is part of CPC"--it appears that a *different* CPC(Chicanos por la Casa) is a major network of Spanish-language health and social services providers in AZ. We can talk in the morning if that's helpful. Jonathan CDRJonathan White Deputy Director for Children's Programs Office of Refugee Resettlement Administration for Children and Families Incident Commander, Unaccompanied Children Influx Response {202) 690-6984 (office) l wrote : Scott, Last night after midnight we received word that a UC at SWK Casa Las Palmas has requested abortion services . I don't have other details yet; should have those shortly but wanted to provide heads up. I am informed this is not the same UC as in earlier advisory. Will get more information; standing by to receive guidance re next steps. Jonathan CDR Jonathan White Deputy Director for Children's Programs Office of Refugee Resettlement Administration for Children and Families Incident Commander, Unaccompanied Children Influx Response 202 690-6984 (office) (b)(6) (blackberry) Jonathan.white @acf.hhs.gov White, Jonathan (ACF) Recipient: "Lloyd, Scott (ACF) "; "Gregg, Laura (ACF) " Sent Date: 2017/04/01 06:56:26 Delivered Date: 2017/04/01 06:56:27 /\MERICAi\ pVERSIGHT EXT-18-248-B-000038 From: Bena,Anna Marie (HHS/OGC)(ACF) To: "Lloyd, Scott (ACF) " CC: "Gregg, Laura (ACF) " Subject: RE: ACLUv. Price: DiscoveryResponses Date: 2017/04/04 12:13:44 Priority: Normal Type: Note Scott, When I sent this to you 01iginally, there were still comments in it, which may have caused the confusion. Sorry about that. I've removed the comments , and changed the date . Please review this version . AnnaMarie From: Lloyd, Scott (ACF) Sent: Tuesday, April 04, 2017 9:36 AM To: Bena, Anna Marie (HHS/OGC) (ACF) Cc: Gregg, Laura (ACF) Subject: RE: ACLU v . Price: Discovery Responses Anna Marie, Could you re-send? I am not finding them anywhere. Thank you, SCott From: Bena, Anna Marie (HHS/OGC) (ACF) Sent: Tuesday, April 04, 2017 8:34 AM To: Lloyd, Scott (ACF) Cc: Gregg, Laura (ACF) Subject: FW: ACLU v. Price: Discovery Responses Scott, I'm getting pinged by OGC on the RF As. Just wanted you to be aware. Please let me know if you have questions. Also, I'll send the interrogatory responses to you (and Jonathan/Jallyn/Tricia) later this week . AnnaMarie /\MERICAi\ pVERSIGHT EXT-18-248-B-000039 From: Palacios, Caitlin ( HHS/OGC) Sent: Friday, March 31, 2017 5:57 PM To: Bena, Anna Marie (HHS/OGC) (ACF) Subject: ACLU v. Price: Discovery Responses Anna Marie , I wanted to let vou know thalb )(5) lso the b)(5) Have a good weekend. Caitlin Sender: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; Recipient: "Gregg, Laura (ACF) " Sent Date: 2017/04/04 12:13:43 Delivered Date: 2017/04/04 12:13:44 /\MERICAi\ pVERSIGHT EXT-18-248-B-000040 From: Bena, Anna Marie (HHS/OGC)(ACF) To: "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) " CC: "Gregg, Laura (ACF) " Subject: RFAsUpdated Version Date: 2017/04/06 15:49:19 Priority : Normal Type: Note Here is a more updated version of the RF As. (Sorry sho uld have sent with last ema il) Th ere are some outsta nd.mg q &a m . th"1s vers10n, b ut wante d yo u to have t he latest. Sender: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; "Gregg, Laura (ACF) " Sent Date: 2017/04/06 15:49: 18 Delivered Date: 2017/04/06 15:49: 19 /\MERICAi\ pVERSIGHT EXT-18-248-B-000041 From: Bena, Anna Marie (HHS/OGC)(ACF) To: "ORR Senior Leadership "; "Lloyd, Scott (ACF) " Subject: RE: Weekly Litigation Update Date: 2017/04/06 16:08: 16 Priority: Normal Type: Note Sony gang - I've been forgetting my attachments all day. From: Bena, Anna Marie (HHS/OGC) (ACF) Sent: Thursday, April 06, 2017 3:44 PM To: ORR Senior Leadership; Lloyd, Scott (ACF) Subject: Weekly Litigat ion Update Attac hed is this week's litigation update . In UC litigation, in ACLU v Price (fami ly planning), the government filed a Reply to the ACLU ' s Opposition to the motion to transfer the case to the Washington , DC District Court; in OGLS (habeas) , an Evidentiary Hearing was set for 5/16/17. A new case on the tracker is Southwest Key Programs v City of Escondido , a suit brought by SWK against a city in San Diego , CA, alleging violations by the city of the federal Fair Housing Act. ORR filed a Statement oflnterest in the case, to explain the nature of its custodial settings for UC. There are no significant updates to refugee litigation since last week. Sender: Bena, Anna Marie (HHS/OGC)(ACF) "ORRSenior Leadership"; Recipient: "Lloyd, Scott (ACF) " Sent Date: 2017/04/06 16:08:15 Delivered Date: 2017/04/06 16:08:16 /\MERICAi\ pVERSIGHT EXT-18-248-B-000042 Subject: FW: resumes Date: 2017/04/13 07:27:11 Priority: Normal Type: Note Heidi, I have two emails coming to you this morning . First, please see below. Andrew Walther is the VP for communications at the Knights of Columbus-a former colleague. I mentioned to Andrew that we were looking for young movement conservatives for support positions per Tim's instruction . Among these resumes, Andrew vouches for hi~b)(B) l Date: Th u, Apr 6, 2017 at 6:29 AM Subject: resumes To: Edw ard Lloyd 4 Scott, Here's a stack of resumes. Most come from World Youth Alliance and are attorneys with healthcare law ~ a recent grad. The other is l(b)(6) who is just background, or in the case offbl(6) graduating from Columbia with an MSW and would fit in the "younger, more entry level" category we discussed. I Andrew I (See attached file: l(b)(6) resume.pdj)(See attached file: 6 fbl( ) resume.pdj)(S ee attached file: ~ etter and Resume.pdj) ------,-- Professional L egal Resum e 2016.pdj)(Se e attached fil e: OGX CONFIDENTIALITY NOTICE : This message and any attachments may contain confidentia l, proprietary or legally privileged information and is intended only for the use of the addressee or addressees named above for it s intended purpo se. If you are no t the intended recipient of this /\MERll Al\ pVERSIGHT EXT-18-248-B-000043 message, this message constitutes notice that any review, retransmission, distribution, copying or other use or taking any act ion in reliance on the information in this message and its attachments, is pro hibit ed. If you rece ive this communicat ion in error, p lease immediately adv ise the sende r by reply e-mail and delete this message and its attachments from your system without keeping a copy. Unless expressly stated in this e-mail, nothing in this message may be constr ued as a dig ital or electron ic signat ure. Thank you. Sent Date: 2017/04/13 07:27: 14 Delivered Date : 2017/04/13 07:27:11 Message Flags: Unread Unsent /\MERICAi\ pVERSIGHT EXT-18-248-B-000044 Lloyd, Scott (ACF) "Stirrup, Heidi (HHS/IOS) " Subject : FW: resumes Date: 2017/04/13 07:30:00 Priority: Normal Type : Note Heidi, I have two emails coming to you this morning. First, please see below. Andrew Walther is the VP for communications at the Knights of Columbus-a former colleague. I mentioned to Andrew that we were looking for young movement conservatives for support positions per Tim's instruction. Among these resumes, Andrew vouches for hisfb)(6) las fitting into that category. Her background is Social Work. I also told him that I am not sure whether you and Tim are looking for resumes to fill other roles throughout the department-the other four would be for other positions. I personally do not know any of these folks . Thank you, Scott ---------- Forwarded message ---------From: Date: Thu, Apr 6, 2017 at 6:29 AM Subject: resumes @gmail.com> To: Edward Lloyd 1b )(6) Scott, Here's a stack of resumes. Most come from World Youth Alliance and are attorneys with healthcare law a recent grad . The other is kb)(6) !who is just background, or in the case offb)(6) graduating from Columbia with an MSW and would fit in the "younger, more entry level" category we discussed. I Andrew See attached file: b)(6) 5 (b)( ) esume.pdj)(S ee attach ed file: /\MERICAi\ pVERSIGHT resume.pdj)(See attached file: etter and Resum e.pdj) b)(6 ) EXT-18-248-B-000045 rofessional Legal Resume 2016.pdj)(See attached file : ocx CONFIDENTIALITY NO TICE: This message and any attachments may contain confidentia l, proprietary or legally privileged information and is intended only for the use of the addressee or addressees named above for its intended purpose. If you are not the intended recip ient of this message, th is message const itutes notice that any review, retransmiss ion, distr ibution, copy ing or other use or taking any action in reliance on the infonnation in this message and its attachments, is prohib ited. If you receive this communication in error , please immediate ly adv ise the sender by rep ly e-mail and delete th is message and its attachments fro m your system without keep ing a copy. Un less express ly stated in th is e-ma il, nothing in this message may be const rued as a digital or electronic signa ture. Thank you. Sender: Recipient : Lloyd, Scott (ACF) "Stirrup, Heidi (HHS/IOS) " Sent Date : 2017/04/13 07:30:08 Delivered Date: 2017/04/13 07:30:00 /\MERICAi\ pVERSIGHT EXT-18-248-B-000046 l(b )(6) 202I._ (b)_(B)_ _.IIfb)(6) l@gmail.com I https://www.linkedin.com/in/ l(b)(6) Objective: Seeking a leadership role in government or international non-governmental organization to empower the world 's most vulnerable people with opportunity and assistance through effective policy, programs and partnerships. Experience includes: ► State leadership overseeing policy strategy development and implementation. ► Substantive experience in program management, grant acquisition and compliance oversight of large dollar federal and privately funded programs, including in complex international humanitarian disaster settings abroad. ► Effective communicator with extensive public speaking experience. ► Strong track record of collaboration and relationship building to develop and achieve strategic goals. ► Proven adaptability and sensitivity to diverse cultura l and work environments. PROFESSIONALEXPERIENCE Ohio Department of Public Safety, Columbus Ohio State Anti-Human Trafficking Coordinator, January 2013-present Lead Ohio Human Trafficking Task Force, the Governor's multi-agency priority initiative to combat human trafficking of children and adults. First person to hold role in Ohio and drive statewide initiative. Key contributions: • • • • • • • Strategy: Set strategic direction for cabinet agencies in responding to human trafficking. Consult stakeholders to develop priorities and created tool and plan to measure progress. Operations and Execution: Lead and oversee implementation of comprehensive strategic policy response through 11 state agencies, boards and commissions. Coordinate cabinet level response by working with agency directors and staff to implement strategies addressing complex policy issues and leverage state resources to address exploitation. High-Level Communication and Presentations: Brief Governor and senior advisors, elected officials and community leaders on state anti-trafficking efforts and related issues. Regularly write public communications and reports, including policy briefs and media responses. Relationship and Consensus Building: Engage and partner with multitude of diverse stakeholders including local, state and federal law enforcement agencies, survivors, national NGOs, grassroots advocates, social service agencies, judges, congressional officeholders and state and local government officials. Policy Development : Responsible for crafting and shepherding administ rat ion' s antitrafficking legislation. Worked with legislature and advocates to successfully pass 2014 antitrafficking law. Develop and oversee implementation of initiatives such as human trafficking screening tool in Ohio's prisons, mental health hospitals and juvenile detention facilities. Public Affairs : Act as Governor's representative in media interviews and press conferences (print, radio and television) and in national, state and local events. Responsible for overseeing development and launch of statewide public awareness campaign with contracted marketing group. Public Speaking: Deliver keynote addresses and other substant ive speeches for audiences such as public officials and the general public, and extensively train technical and non- /\MERICAi\ pVERSIGHT EXT-18-248-B-000047 • • • • • • technical audiences on behalf of the State of Ohio and Governor's office. Data Collection: Spearheaded first statewide systematic approach to human trafficking data collection. Content Creation: Created first state on line resource and guidance toolkit for those serving trafficking victims (via http://humantrafficking.ohio.gov). Developed training content for key stakeholders including the State Medical Board of Ohio (67,000 licensees). Grant writing and management: Demonstrated experience and management of complex federally funded programs. Successfully wrote and manage first statewide anti-trafficking partnership funded by competitive federal funds; successfully write other applications for federal training assistance for key stakeholders such as local prosecutors. Tasked to drive other Governor's office priorities: At request of Governor's office, led development of priority initiat ive to address sexual violence on Ohio's campuses; consulted on development of state awareness campaign on community-police relations. Management: Manage team members and interns; provide coaching, feedback and encouragement . Publications: Authored two Governor's Task Force reports (available on http :ljh u ma ntrafficki ng.oh io.gov ). World Vision, Washington DC Program Management Officer, Humanitarian & Emergency Affairs Team, May 2010-Jan 2013 Managed international relief and development programs for large humanitarian NGO. Worked in close collaboration with field staff, donors and other stakeholders to lead and operationalize aid programs. Progressively increased management responsibility and portfolio coverage. Key contributions: • Management: Provided oversight and accountability for multi-millions dollar portfolio of foreign aid and disaster assistance funded by USAIDand private donors for humanitarian crises in Latin America/the Caribbean, Southeast Asia and Syrian refugee crisis. Monitored grant financial implementation rate, performance, and compliance with federal policies to meet program goals. • High-Level Communications and Presentations: Represented World Vision in media inquiries and interviews on high-visibility disasters; brief leadership on Haiti earthquake • • • response; represent organization at meetings with federal donors and US embassy staff. Strategy: Assisted World Vision country field offices with developing program strategies, budgets and contingency plans. Publications: Wrote public biogs on aspects of humanitarian relief, including for the US Institute of Peace and World Vision's blog (https://www.linkedin.com/in/eranadejanis ). Operations and Execution: • Haiti Earthquake Response: Responsible for managing $40 million total in public and privately raised funds for earthquake response programming in Haiti. Spent 60% of time in fie ld supporting staff with program implementation, logistics, compliance review, etc. • Acting Program Director, Haiti Integrated Recovery Assistance Program, Aug-October 2010 (Port-au- Prince, Haiti) Managed $14.4 mill ion USAIDOffice of Foreign Disaster Assistance (OFDA) grant to provide shelter, economic recovery and clean water. Managed and recruited diverse international team-including engineers, water and sanitation experts and admin staff-to implement a shelter grant in exceptionally difficult post -earthqua ke field environment. /\MERICAi\ pVERSIGHT EXT-18-248-B-000048 World Vision, Washington DC Program Management Specialist, Child Development & Protection Team, Feb 2009-May 2010 Program Associate, Grants Acquisition & Management- Africa, Nov 2007-Feb 2009 • • • Program Management: Responsible for managing a portfolio of diverse federal grants addressing child protect ion, health and education programs. Provided technical support to the field , found solutions to gaps and served as liaison between the field and donors in USAID and State Department . Content Creation: Created USAID supported toolkit for serving individuals with disabilities in educational settings in Eastern Europe; created toolkit for global child protection program resources. Operations and Execution: Facilitated and developed grant compliance workshops for public and privately funded programs in Sub-Saharan Africa, Eastern Europe and Latin America. Principal driver for developing collaborative team work plans. US Department of Labor, Bureau of International Labor Affairs, Washington, DC Intern with Office of Trade & Labor Policy, October 2006 -May 2007 United States Senate, Washington, DC Intern to Senator Mike DeWine, September-December 2005 Ohio House of Representatives, Columbus, OH Legislative Aide to Representative Jim McGregor, January 2003-August 2005 Managed State Representative's office and subcommittee. Represented legislator in meetings and delivering presentations to diverse audiences. Wrote talking points, legislative testimony, press releases. EDUCATION Mccourt School of Public PJ'icy, leorgetown University, Washington, DC 5 Master of Public Policy, Ma b)( ) International Policy & Development Certificate in Refugees & Humanitarian Emergencies Ohio State University, Columbus, OH Bachelor of Arts in International Studies, June~ Spanish Minor, University Honors & Scholars Program /\MERICAi\ pVERSIGHT EXT-18-248-B-000049 l(b)(6) l(b)(6) (C) l(bH6l ~mail.com J vienna, VA ~ (H) !{bl6) ! EXPERIENCE Winston & Strawn LLP 1995-present (22 years) An Am Law 50 law firm with over 800 attorneys located in nine domestic offices and nine foreign offices • Partner in the Washington, D.C. office • Represent companies in commercial, energy, and health care litigation • Defend energy companies in controversies with, or investigations conducted by, federal and state agencies, including FERC, NERC, DOE , and the CFTC • Extensive first-chair trial, motion, and appellate experience (details attached) • Representative clients: Westar Energy, Inc., FirstEnergy Corp ., Midland Cogeneration Venture, LLP, USGen New England, Council for Urolog ical Interests • Have acted as ethics counsel for the D.C. office for the past seven years • Served on the firm's associate eva luation comm ittee for eight years Anderson, Hibey & Blair 1984- 1995 (10 years) A former boutique firm in Washington, D. C. • Assoc iate, then Partner • Handled civil and criminal litigation matters including first-chairing several bench and j ury trials • Participated in several high-profile cases defending spies and dictators PROFESSIONAL RECOGNITION Recommended , Energy Litigation, Legal 500, 2010, 2012 AV rated, Martindale-Hubbell COURT ADMISSIONS D.C. Circuit, Fourth Circuit, Federal Circuit, Ninth Circuit, Eleventh Circuit, District Court for the District of Columbia, Eastern District of Virginia, District of Maryland, Eastern District of Michigan, No rthern District of New York /\MERICAi\ pVERSIGHT EXT-18-248-B-000050 PUBLICATIONS AND PRESENTATION S Should Commissioners at Independent Federal Agencies Commit to Serve Their Full Terms? Wins ton & Strawn LLP blog, February 3, 2017 What Happens if the Supreme Court Decides that Federal Agency Disgorgement Orders Are Subject to a Five-Year Statute of Limitations? Wins ton & Strawn LLP blog, January 19, 2017 The Potential Impact of the Regulatory Accountability Act on Energy Regulators Winston & Strawn LLP blog, January 6, 2017 Regulatory Reform for Energy Companies: Scaling Back Reporting and Record-Keeping Requirements Winston & Strawn LLP blog, Decem ber 6, 20 16 Second Circuit to Address Legality of State Renewable Energy Procurement Program Winston & Strawn LLP blog, Nove mber 23, 2016 Can Federal Agency Commissioners Decline to Recuse Themselves to Maintain a Quorum? Winston & Strawn LLP blog, October 19, 20 16 Gas Demand Response Programs Are Appealing But Impractical Law360, September 21, 2016 Making Arbitration Less Costly: Submitting Written Instead of Live Testimony Winston & Strawn LLP blog, September 20, 2016 Market Manipulation in FERC's Eyes: Does a Profit Motive Save the Day? Winston & Strawn LLP blog, August 27, 2015 FERC Enforcement May Provide Ideal High Court Test Case Law36 0, Decembe r 3, 20 14 FERC Undermines Competitive Bidding for QFs under PURP A Winston & Strawn LLP blog, Marc h 21, 20 14 When NERC Comes Knocking Presentation, Energy Bar Assoc iation, Midwest Energy Conference, March 4, 2013 FERC 's Proposed P enalties May Violate 8th Amendment Law36 0, January 23, 2013 Cracking Down on Cross-Market Hedging Law36 0, May 2 1, 2012 2 /\MERICAi\ pVERSIGHT EXT-18-248-B-000051 Be Smart in Your Litigation D efen se Directors and Board s, October 2002 EDUCATION JD, University of Texas, fbl(5l BA, with distinction, Foreign Affairs, University of Virginia~ SELECTED CASES AND REPRESENTATIONS State of California (In re Lockyer) v. Allegheny Energy Supply Company Defended a $190 million claim by the California Attorney General seeking a refund on power sales made during the Ca liforni a energy crisis . Case involved multiple proceedings before FERC and appeals to the Ninth Circuit. Council/or Urological Interests v. Burwell Represented trade group in challeng ing regulation s promulgated by the Department of Health and Human Services that forbade physicians from charging technical fee s for urological procedures on a per-use basis. Argued on appeal to the D.C. Circuit. ConverDyn v. Moniz Represented uranium conve1ter in suit against Department of Energy alleging that DOE acted arbitrarily in authori zing transfer s of uranium conversion services. In re USGen New England Defended USGen New England , Inc., against $50 million claim after it elected to reject in bankruptcy a natural gas transportation contract with TransCanada Pipelines Ltd. Handled case before bankruptcy court and on appeal to district court and later the Fourth Circuit. Michigan Electric Transmission Co. v. Midland Cogeneration Venture Represented power generator in breach of contract action in federal district court , later referred to FERC , and ultimately appealed to the D.C. Circuit. Arbitration for a Midwestern energy company Led defense of a Midwestern utility in an arbitration proceeding against a claim that the utility was contractually obligated under a power purchase agreement to provide customers with capacity credits worth more than $30 million. In re USGen New England Defended USGen against a $41 million claim brought by Tennessee Gas Pipeline after USGen's rejection of a long-term gas transportation contract w ith Tennessee . 3 /\MERICAi\ pVERSIGHT EXT-18-248-B-000052 Attala Generating Co, LLC v. Attala Energy Company, LCC Defended a $4 77 million breach of contract claim aris ing from te1mination of a long-term tolling agreement with a power plant owner. American Lithotripsy Society v. Thompson Challenged effort of the Department of Health and Human Services to apply Stark II regulations to lithotr ipsy, a urological procedure. The Episcopal Church v. Falls Church Episcopal Church et al. Represented group of congregations in property dispute with national denomination arising from congregat ions' disaffiliation. Case raised difficult statutory and const itutional issues regarding ownership of church property. Mark Barron, O.D. v. Vision Service Plan Represented an optometrist in securing a preliminary injunction from a federa l district court to remain on the provider panel of the nation's largest vision care insurer. Administrative cases: • Defended a large international consulting firm in FERC administrative proceedings against allegations that the firm 's employees had withheld evidence during a FERC investigation into Enron 's activitie s. • Represented NorthWestern Energy in FERC rate case. • Represented North Western Energy in defending State of Montana PURP A regulations. • Defended Duquesne Light Co. in challen ging imposition of exit fee in FERC proceeding. Investigations: • Defended Westar Energy in a five-year FERC investigation of Westar's compliance with rules governing energy sales and transmi ssion service . • Defended Allegheny Energy Supply in CFTC investigation into reporting of gas trades. Represented mid-western utility in contesting NERC allegations that the utility had violated several Reliability Standards. Represented utility in challenging NERC's notice of 18 possible violations of Reliability Standards. • Defended utility against Regional Entity audit findings that utility had violated 15 Reliability Standards. 4 /\MERICAi\ pVERSIGHT EXT-18-248-B-000053 ----•••-- -•••-- •--- -- ••••-•- - •-- •- •- •·- ·--· ••·~•~pp•·•OA•-- · ·- ~ -~- P~- - -·- - •• -•- ••••- - ••- •• -- ~- .. , ... .. . •• ··· •·-••· •.. ·•• •.. •h·· •--·•••• • ··• • H• •• •·••••-••• ••••Poo•- • ••• • .0 ·-- ••• •--•• • •- • • •- •• ---- •• • •-• - •• • • ••• • - -· •-- · ---- •-• •••- O•••· • -• oo •• •--- • • ••---•• •- ·•-- •• •- • '" •-- • · • O• h • •-,O• b)(6) (bl(5 l venue NW Cambridge, MN fbl(6l fb l(6) fymotzlaw .com " Subject : polling Date: 2017/05/31 05:42:47 Priority: Normal Type: Note Scott, Per our conversation. Andrew (See attached file: Knights of Columbus-Marist Poll _Immigration in America _January 2017.pdj) CONFIDENTIALITY NOTICE: This message and any attachments may contain confidentia l, proprietary or legally privileged information and is intended only for the use of the addressee or addressees named above for its intended purpose. If you are not the intended recipient of this message, this message constitutes notice that any review, retrans mission, dish·ibution, copying or other use or taking any action in reliance on the information in this message and its attachments, is prohibited. If you receive this communication in error, please immediately advise the sender by reply e-mai l and delete this message and its attachments from your system without keeping a copy. Un less express ly stated in this e-mail, nothing in this message may be construed as a digital or electronic signature. Thank you. Sender: Andrew.Walther@Kofc.Org Recipient: "Lloyd, Scott (ACF) " Sent Date : 2017/05/31 05:41:33 /\MERICAi\ pVERSIGHT EXT-18-248-B-000061 Delivered 05:42:47 Marist Poll Immigration in America January 2017 Most Americans favor a Pathway to Citizenship if illegal immigrants meet certain requirements. Do you favor or oppose providing a way for illegal immigrants who are currently in the U.S. to gain legal citizenship if they learn English, pay fines and have jobs that pay taxes? Favor Oppose Unsure Catholics 90% 8% 1% Practicing Catholics 90% 8% 1% Non-Practicing Catholics 90% 8% 2% Democrat 91% 7% 3% Independent 88% 11% 1% Republican 81% 17% 2% Trump Supporters 79% 19% 2% Clinton Supporters 93% 5% 2% Americans Oppose Favor ) Unsure 2% Regardless of one's faith practice, political affiliation, and candidate support in the 2016 presidential election, for providing legal citizenship for illegal immigrants if they meet certain criteria. EXT-18-248-B-000064 p VeAS1CJf.rf support 1 Many Americans oppose indiscriminate deportation. There have been several proposals regarding how the United States should deal with immigrants who have come to this country illegally. Please tell me if you favor or oppose each of the following: Americans Favor Oppose Unsure Deport all immigrants who are living in the United States illegally back to their home countries 30% 66% 4% Deport illegal immigrants who have been involved in criminal activity 87% 11% 2% Deport many illegal immigrants, but have a separate process to allow families with children born in the United States to apply for legal status 70% 26% 4% As a hard and fast ruleI two-thirds of Americans do not support the deportation of illegal immigrants. HoweverI circumstances alter AmericansI views toward deportation. The views of American Catholics are similar to the overall population. AMERl(~Af\ pVERSIGHT EXT-18-248-B-000065 2 Attitudes toward deportation divide along party lines. There have been several proposals regarding how the United States should deal with immigrants who have come to this country illegally. Please tell me if you favor or oppose each of the following: Deport all immigrants who are living in the United States illegally back to their home countries. Americans Democrat Independent Republican Favor 17% 26% 49% Oppose 80% 69% 46% Unsure 2% 4% 4% Unsure Oppose Most Democrats oppose deporting all illegal immigrants while Republicans divide. AMERl(~Af\ pVERSIGHT EXT-18-248-B-000066 3 Regardless of partisanship, Americans favor deporting illegal immigrants if they are involved in criminal activity. There have been several proposals regarding how the United States should deal with immigrants who have come to this country illegally. Please tell me if you favor or oppose each of the following: Deport illegal immigrants who have been involved in criminal activity. Americans Unsure Democrat Independent Republican Favor 80% 87% 95% Oppose 17% 11% 3% Unsure 3% 2% 2% Favor AMERl(~Af\ pVERSIGHT EXT-18-248-B-000067 4 There is bipartisan agreement that a process should be in place to aid illegal immigrants with children born in the U.S. to gain legal status. There have been several proposals regarding how the United States should deal with immigrants who have come to this country illegally. Please tell me if you favor or oppose each of the following: Deport many illegal immigrants, but have a separate process to allow families with children born in the United States to apply for legal status. Americans Democrat Independent Republican Favor 66% 69% 74% Oppose 28% 27% 22% Unsure 6% 4% 3% Unsure Oppose AMERl(~Af\ pVERSIGHT EXT-18-248-B-000068 5 About one-third of Americans think illegal immigrants should be deported if they broke the law to come to this country, but ... Which one of the following best describes why the United States should deport immigrants who have come to this country illegally: NonPracticing Catholics Americans Catholics Practicing Catholics They broke the law to come to the U.S. 34% 32% 33% 31% They take jobs from Americans 11% 11% 11% 10% They increase crime 10% 10% 10% 11% 8% 8% 10% 6% There is no reason to deport illegal immigrants 30% 32% 30% 35% Unsure 7% 7% 7% 8% They pose a threat of terrorism ... Of note, three in ten Americans also believe there is no reason to deport illegal immigrants . Similarly, about one-third of Catholics, including 33% of practicing Catholics, believe deportation should only occur if a law was broken to enter the country. However, an additional 32% of Catholics overall believe illegal immigrants should not be forced to leave the country. AMERl(~Af\ pVERSIGHT EXT-18-248-B-000069 6 Half of Democrats say there is no reason to deport illegal immigrants. Most Republicans assert illegal entry is grounds for action. Which one of the following best describes why the United States should deport immigrants who have come to this country illegally: Americans Democrats Independents Republicans They broke the law to come to the U.S. 34% 19% 37% 47% They take jobs from Americans 11% 9% 9% 16% They increase crime 10% 7% 10% 14% 8% 6% 8% 10% There is no reason to deport illegal immigrants 30% 50% 29% 7% Unsure 7% 9% 6% 6% They pose a threat of terrorism AMERl(~Af\ pVERSIGHT EXT-18-248-B-000070 7 Many Americans do not consider building a wall along the Mexican border to be a priority. Plurality says deportation is not urgent. Thinking about specific policy issues/ do you think it is an immediate priority/ important but not an immediate priority/ or not a priority to do each of the following: Americans Americans Deport illegal immigrants Build a wall along the U.S. border with Mexico Immediate priority Important, but not an immediate priority Not a priority Unsure2% Unsure3% Democrats Independents Republicans 5% 16% 40% 7% 18% 31% Immediate Important 86% 65% 28% 1% 2% 1% Immediate Important Not a priority Unsure AMERl(~Af\ pVERSIGHT Democrats Independents Republicans 15% 20% 46% 22% 34% 34% Not a priority 61% 43% 17% Unsure 2% 4% 3% A partisan divide exists. EXT-18-248-B-000071 8 How the Study was Conducted • This study was undertaken by The Knights of Columbus and conducted by the Marist Institute for Public Opinion located at Marist College in Poughkeepsie, New York • This report presents the findings from a random digit dial telephone survey conducted in English or Spanish of 2,729 Americans, including both landline and cell phone sampling frames • Reports for Americans have a margin of error of+/- 1.9 percentage points • Data were collected in December 2016 • Analysis of sub-groups is included when noteworthy and/or statistically different AMERIC'Af\ pVERSIGHT • Please note that some totals may not add EXT-18-248-B-000072 to 100% due to rounding 9 Methodology Statement • This survey of 2,729 adults was conducted December 12, 2016 through December 19, 2016 by The Marist Poll sponsored and funded in partnership with The Knights of Columbus. Adults 18 years of age and older residing in the continental United States were interviewed in English or Spanish by telephone using live interviewers. • Landline telephone numbers were randomly selected based upon a list of telephone exchanges from throughout the nation from ASDE Survey Sampler, Inc. The exchanges were selected to ensure that each region was represented in proportion to its population. Respondents in the household were selected by asking for the youngest male. To increase coverage, this landline sample was supplemented by respondents reached through random dialing of mobile numbers from Survey Sampling International. After the interviews were completed, the two samples were combined and balanced to reflect the 2013 American Community Survey 1-year estimates for age, gender, income, race, and region . The results for this subset are statistically significant +1.9 percentage points. • There are 643 Catholic Americans and 341 Catholic Americans who practice their faith. The results for these subsets are statistically significant within +3 .9 percentage points and +5.3 percentage points, respectively. P ij~r rEi~ ~ ab~- rb't?s . l\ii T. _ n was not adjusted for sample weights and increases for cross- EXT-18-248-B-000073 10 Contact Information Knightsof Columbus Headquarters Mr . Carl Anderson, Supreme Knight M r. And rew Walther, Vice President, Com mu nicat ions and Strategic Planning 1 Columbus Plaza New Haven, CT 06510 (203) 752-4253 ~ ~~~ist Mari st College Institute for Public Opinion Lee M . M iring off, PhD Barbara L. Carvalho, PhD M arist College 3399 Nort h Road Poughkeepsie, NY 12601 (845) 575-5050 The Knights of Columbus is one of the nation's premiere volunteer and charitable organizations. Last year, Knights worldwide donated more than 71.5 million hours, and more than $173 .5 million to charitable causes in communities throughout the Americas, as well in Europe and Asia. From helping children in need, to providing wheelchairs for the disabled, to helping stock food banks, to offering top-rated and affordable life insurance to its members, the Knights has been at the service of the community for more than 130 years, and is the world's largest Catholic service organization. Founded in 1978, The Marist College Institute for Public Opinion (MIPO) is a survey research center at Marist College in Poughkeepsie, New York. The Marist Poll has conducted independent research on public priorities, elections, and a wide variety of social issues. The Marist Poll regularly partners with NBC News and The Wall Street Journal to conduct scientific public opinion polls in key electoral battleground states . It joins with McClatchy to take the pulse of the country, and with MSNBC and Telemundo to measure public opinion on issues important to the Latino community . AMERIC'Af\ pVERSIGHT EXT-18-248-B-000074 11 Tota, Kenneth (ACF) To: "Lloyd, Scott (ACF) " Subject : Re: Share with Scott Lloyd Date: 2017/06/ 13 09:00:46 Priority: Normal Type: Note Scott, Sure. I will connect them with the State Coordinator . Thanks. Ken On: 13 June 2017 05:45, "Lloyd, Scott (ACF)" wrote : Ken, Could you forward this to the appropria t e person? It's in reference to a monastery that wants to house refugees in Wisconsin. Thank you, Scott From: Andrew.Walther@Kofc.Org [ma ilto :Andrew.Walther@ Kofc.Org] /\MERICAi\ pVERSIGHT EXT-18-248-B-000075 Sent: Wednesday, April 26, 2017 9:30 AM To: Lloyd , Scott (ACF) Subject: Fw: Share with Scott Lloyd Scott, FYI. Please see below. Andrew Andrew T. Walthe r Vice Presid ent Commu nications and Strateg ic Planning Knight s of Columbus One Columbus Plaza New Haven, CT 06510 (203) 752-4253 (office) (203) 752-4400 (fax) /\MERICAi\ pVERSIGHT EXT-18-248-B-000076 _.I( cellular) (203) ._f bl_(6_ l _ --- - Forwarded by Rebecca Devine/HomeOffice / KofC on 04/26/2017 09:26 AM- ---- From: l(b)(6) l@gma il.com> To: Rebecca.Devine@kofc.org. Date: 04/26/20 17 12:15 AM Subject: Re: Francisca n property for refugees Hell o Rebecca , Thank you for The building Wisconsin your is (near Milwaukee) novitiate . The novitiate bui l ding /\MERICAi\ pVERSIGHT program wi ll re p l y . a large t ha t is monastery is curren moving to type t ly of building in SE t he U. S . Franciscan California and so the EXT-18-248-B-000077 become vacant owns the building be later an d will this be looking d i scuss in g t h a t a t our consider temporary Hurri cane housing summer . My Franciscan for for a use mee t in g in refugees if for early refugees ~~ b_l(6_l_______ Fr . ~f bu il d ing a n d will one to contact be in vo l ved for Hi s email ~l wrote : > Dear Father _>_~I, ~f b_)<5 > >Thank you very much Columbus regarding for reaching ou t t o t he Knigh ts >t he building t ha t migh t be available housing refugees . Would >you mind providing property , who owns us i t, >e t c so t ha t we can might be able to >make use of a few more reach for details ou t t o some of t emporarily about organiza the t ions t ha t it? > > Please you. feel free to call if that is more convenient for > >Thanks aga in , > >Rebecca > > > >--- >Rebecca Devine >Communications /\MERICAi\ pVERSIGHT Specialist , Knights of Columbus EXT-18-248-B-000079 > >rebecca.devine@kofc.org > 2 Q 3 . ~rb_)(6_) --~ > >CONFIDE NTIA LITY NOTICE : This may contain message and >confiden t ial , pr opr ie t ary information and is intended legally pr ivilege >only above for for the its use of the intended or addressee or >purpose . If you are no t t he in t ended message , t his message >constitutes distrib ution >other informa >message t his no t ice t ha t any , copying or use or taking t ion in t his and any action in i t s a tt achmen t s , is >communication in error sender by rep ly e-mail >and delete this message sys t em without keeping >a copy . Unless expressly this message may >be construed you . review as a digital , please and stated attachments d addressees recipien named t of , retransmission reliance attachments in t his o r electronic t his , on the pro hibi t ed . If immediately its any you receive advise the from your e - mail , no t hing signature in . Thank CONFIDENTIALITYNOTICE: This message and any attachmentsmay contain confidential,proprietaryor legally privileged infonnation and is intended only for the use of the addressee or addressees namedabove for its intended purpose. If you /\MERICAi\ pVERSIGHT EXT-18-248-B-000080 are not the intended recipient of this message , this message constitutes notice that any review, retrans mission, distribution, copy ing or other use or taking any action in reliance on the information in this message and its attachments, is prohibited. If you receive this communication in en-or, please immediately advise the sender by reply email and delete this message and its attachments from your system without keep ing a copy . Unless expressly stated in this e-mai l, nothing in this message may be construed as a digital or electronic signature. Thank you. Tota, Kenneth (ACF) Recipient: "Lloyd, Scott (ACF) " Sent Date: 2017/06/13 09:00:45 Delivered Date: 2017/06/13 09:00:46 /\MERICAi\ pVERSIGHT EXT-18-248-B-000081 Date: 20 17/06/17 23:36 : 13 Priority: Normal Type: Contact Display Name: Andrew.Walther@Kofc.Org Email Display Name: Andrew.Walther@Kofc.Org Email Address: Andrew.Walther@Kofc.Org I Sent Date: !2017/06/17 23:36:13 /\MERICAi\ pVERSIGHT EXT-18-248-B-000082 Gregg, Laura (ACF) To: "Lloyd, Scott (ACF) " CC: "Lucas, Sarah (ACF)(CTR) " Subject: FW: Meeting Request Date: 2017/08/15 08:57:53 Priority: Normal Type: Note Would you like Sarah to schedule a meet ing with Joshua? From: Meservey, Joshua [mailto:Joshua.Meservey@heritage.org] Sent: Monday, August 14, 2017 4:41 PM To : Lloyd, Scott (ACF) Subject: Meeting Request Dear Scott, I hope this email finds you well. I wanted to offer myself and several of my colleagues as resources as you work through refugee resett lement issues. We recently published a report (link below) on the topic, and would be happy to come talk with you in person about our findings, or to lend any other assistance that would be helpful. I also worked in refugee resettlement for more than two years based out of Nairobi, so I have a fair amount of personal insight into the overseas part of the process. Link: htt p://www .heritage .org/immigration/repo rt /the -us-refugee-admiss ions-prog ram-ro admapreform Please don't hesitate to let us know if we can be of use. Best, Josh Joshua Mese rvey Senior Policy Analyst, Africa and the Middle East Davis Institute for National Security and Foreign Policy The Heritage Foundation 214 Massachusetts A venue, NE Wash ington, DC 20002 /\MERICAi\ pVERSIGHT EXT-18-248-B-000083 l "Lloyd, Scott (ACF) "; Recipient : "Lucas, Sarah (ACF)(CTR) " Sent Date : 2017/08/15 08:57:53 /\MERll Al\ pVERSIGHT EXT-18-248-B-000084 From: Meservey,Joshua To: "Lucas, Sarah (ACF)(CTR) " "White, Laura (ACF) "; CC: "Lloyd, Scott (ACF) " Subject : Re: Meeting Request Date: 2017/08/2113:23:28 Priority : Normal Type: Note Dear Sarah , 5 Many thanks for the email. We can do 9/ 18 at 2pm ..... rb_)C_l _________ with me __.l will come On Aug 21, 2017 , at 11:40 AM , Lucas, Sarah (ACF) (CTR) wrote: Good mornin g Joshua, /\MERICAi\ pVERSIGHT EXT-18-248-B-000085 The Director is available on the dates and times below . Please let us know what works best. 9/13 at 10am or 2pm 9/14 at 11am 9/18 at 1pm or 2pm Kindly, Sarah Lucas Exec utive Ass istant , Office of the Director Office of Refugee Resettleme nt Adm inistration for Children and Fam ilies Mary E . Switzer Bu ilding, 330 C. Street SW 2020 I Ema il: Sarah.L uca s@acf.hhs.go v We b: http: //www.acf.hh s.gov/programs /orr/program s /\MERICAi\ pVERSIGHT EXT-18-248-B-000086 Joshua Meserny Senior Policy Analyst, Africa and the Middle East Davis Institute for Nationa l Security and Foreign Policy The Heritage Foundation 214 Massachusetts Avenue, NE Washington, DC 20002 f b)(6) heritage.org From: White, Laura (ACF) Sent: Mon day, August 21, 2017 10:27 AM To : Meservey , Joshua Cc: Lloyd, Scott (ACF); Lucas, Sarah (ACF) (CTR) Subject: RE: Meeting Re uest Good morning, Josh, /\MERll Al\ pVERSIGHT EXT-18-248-B-000087 Director Lloyd would be happy to meet with you-I the meeting. have cced his scheduler to coordinate Thanks, Laura From: Meservey, Joshua [ mailto:Joshua.Meservey@heritaqe.org1 Sent: Monday, August 14, 2017 4:41 PM To: Lloyd, Scott (ACF) Subject: Meeting Request Dear Scott, I hope this email finds you well. I wanted to offer myself and several of my colleagues as resources as you work through refugee resettlement issues. We recently published a report (link below) on the topic, and would be happy to come talk with you in person about our findings , or to lend any other assistance that would be helpful. I also worked in refugee resettlement for more than two years based out of Nairobi, so I have a fair amount of personal insight into the overseas part of the process. Link: http://www.heritage.org /immigration/report /the-us-refugee-admissions-programroadmap-reform /\MERICAi\ pVERSIGHT EXT-18-248-B-000088 Please don't hesitate to let us know if we can be of use. Best, Josh Joshua Meservey Senior Policy Analys t, Africa and the Middl e Eas t Davis Institute for National Security and Foreign Policy The Heritage Foundation 214 Massachusetts Avenue , NE Washington , DC 20002 rb)(6) heritage.org /\MERICAi\ pVERSIGHT EXT-18-248-B-000089 itage.org> Sender: Meservey,Joshua "; "White, Laura (ACF) "; "Lloyd, Scott (ACF) " Sent Date: 2017/08/2113:23:10 Delivered Date: 2017/08/21 13:23:28 Message Flags: Unread /\MERICAi\ pVERSIGHT EXT-18-248-B-000090 From: Meservey,Joshua To: "Lucas, Sarah (ACF)(CTR) " "White, Laura (ACF) "; CC: "Lloyd, Scott (ACF) " Subject: Re: Meeting Request Date: 2017/08/2113:27:40 Priority: Normal Type: Note Dear Sarah , Sorry about that, I think a previous draft went throuf h before I had completed it. Regardless , many thanks for the email. 9/ 18 at 2pm works well. (b)(B) lwill come with me. Where will the meeting be? Best, Josh Joshua Meserny /\MERICAi\ pVERSIGHT EXT-18-248-B-000091 Senior Policy Analyst, Africa and the Middle East Davis Institute for Nationa l Security and Foreign Po licy The Heritage Foundation 214 Massachusetts Avenue, NE Wash ington, DC 20002 l(b )(6) heritage.org On Aug 21, 2017, at 11:40 AM , Lucas , Sarah (ACF) (CTR) wrote: Good morning Joshua, The Director is available on the dates and times below. Please let us know what works best . 9/13 at 10am or 2pm 9/14 at 11am 9/18 at 1pm or 2pm /\MERICAi\ pVERSIGHT EXT-18-248-B-000092 Kindly, Sarah Lucas Execu tive Ass istant , Office of the Director Office of Refugee Resettleme nt Adm inistration for Children and Families Mary E . Switzer Buil ding, 330 C. Stree t SW 2020 I Ema il: Sarah.L ucas@acf. hhs. gov Web: http ://www. acf.hh s.gov/program s/orr/program s From: White, Laura (ACF) Sent: Monday , August 21, 2017 10:27 AM To: Mese rvey, Jos hua Cc: Lloyd , Scott (ACF); Lucas , Sarah (ACF) (CTR) Subject : RE : Meeti ng Request /\MERICAi\ pVERSIGHT EXT-18-248-B-000093 Good morning, Josh, Director Lloyd would be happy to meet with you-I the meeting. have cced his scheduler to coordinate Thanks, Laura From : Meservey, Joshua [ mailto:Joshua.Meservey@heritage.org ] Sent: Monday , August 14, 2017 4:41 PM To: Lloyd, Scott (ACF) Subj ect: Meeting Re uest Dear Scott, I hope this email finds you well. I wanted to offer myself and several of my colleagues as resources as you work through refugee resettlement issues. We recently published a report (link below) on the topic, and would be happy to come talk with you in person about our findings, or to lend any other assistance that would be helpfu l. I also worked in refugee resett lement for more than two years based out of Nairobi , so I have a fair amount of personal insight into the overseas part of the proce ss. Link: /\MERICAi\ pVERSIGHT EXT-18-248-B-000094 http://www.heritage.org /immigration/report /the-us-refugee-admissions-programroadmap-reform Please don't hesitate to let us know if we can be of use. Best, Josh Joshua Meservey Senior Policy Analyst, Africa and the Middle East Davis Institu te for National Security and Foreign Policy The Heritage Foundation 214 Massachusetts Avenue, NE Washington, DC 20002 l(b )(6) heritage.org /\MERICAi\ pVERSIGHT EXT-18-248-B-000095 Sender: Meservey,Joshua "Lucas, Sarah (ACF)(CTR) "; "White, Laura (ACF) "; "Lloyd, Scott (ACF) " Sent Date: 2017/08/2113:27:05 Delivered Date: 2017/08/2113:27:40 Message Flags: Unread /\MERICAi\ pVERSIGHT EXT-18-248-B-000096 Lloyd, Scott (ACF) Lucas, Sarah (ACF) (CTR) " Lloyd, Scott (ACF) "; "Meservey, Joshua "; To: "White, Laura (ACF) "; "Tota, Kenneth (ACF) " Subject: Meet w/ Joshua Mservey, Heritage Foundation Date: 2017/08/2115:14:06 Start Date: 2017/09/18 14:00:00 End Date: 2017/09/18 14:45:00 Priority: Normal Type: Appointment Location: Mary E. Switzer Bldg 330 C. St. SW DC 20201/ 5225A Heritage Fou ndation Guests: Joshua Mase rvey fbl(5) Ib)(6) I Lloyd, Scott (ACF) ; Lucas, Sarah (ACF) (CTR) "Lloyd, Scott (ACF) "; "Meservey, Joshua "; Recipient: "White, Laura (ACF) "; "Tota, Kenneth (ACF) " Sent Date: 2017/08/2115:16 : 16 Delivered Date : 2017/08/2115:14:06 /\MERICAi\ pVERSIGHT EXT-18-248-B-000097 Lloyd, Scott (ACF) Lucas, Sarah (ACF) (CTR) " Lloyd, Scott (ACF) "; "Meservey, Joshua "; To: "White, Laura (ACF) "; "Tota, Kenneth (ACF) " Subject: Meet w/ Joshua Mservey, Heritage Foundation Date: 2017/08/2115:14:06 Sta rt Date: 2017/09/18 14:00:00 End Date: 2017/09/18 14:30:00 Priority: Normal Type: Appointment Location: Mary E. Switzer Bldg 330 C. St. SW DC 20201 Lloyd, Scott (ACF) ; Lucas, Sarah (ACF) (CTR) "Lloyd, Scott (ACF) "; " Meservey,Joshua "; Recipient: "White, Laura (ACF) "; "Tota, Kenneth (ACF) " Sent Date: 2017/08/21 15: 16:16 Delivere d Date: 2017/08/2115:14 :06 /\MERICAi\ pVERSIGHT EXT-18-248-B-000098 Lloyd, Scott (ACF) Lucas, Sarah (ACF) (CTR) " Lloyd, Scott (ACF) "; "Meservey, Joshua "; To: "White, Laura (ACF) "; "Tota, Kenneth (ACF) " Subject: Meet w/ Joshua Mservey, Heritage Foundation Date: 2017/08/2115:14:06 Sta rt Date: 2017/09/18 14:00:00 End Date: 2017/09/18 14:45:00 Priority: Normal Type: Appointment Location: Mary E. Switzer Bldg 330 C. St. SW DC 20201 Lloyd, Scott (ACF) ; Lucas, Sarah (ACF) (CTR) "Lloyd, Scott (ACF) "; " Meservey,Joshua "; Recipient: "White, Laura (ACF) "; "Tota, Kenneth (ACF) " Sent Date: 2017/08/21 15: 16:16 Delivere d Date: 2017/08/2115:14 :06 /\MERICAi\ pVERSIGHT EXT-18-248-B-000099 Lloyd, Scott (ACF) "Meservey, Joshua "; "White, Laura (ACF) "; "Tota, Kenneth (ACF) " Subject: Meet w/ Joshua Mservey, Heritage Foundation Date: 2017/08/2115:32 :54 Start Date : 2017/09/ 18 14:00:00 End Date : 2017/09/ 18 14:45:00 Priority: Normal Type: Schedule.Meeting.Request.AttendeelistReplication Location: Mary E. Switzer Bldg 330 C. St. SW DC 20201 Your meeting was found to be out of date and has been automat ically updated. Sent by Microsoft Exchan "e Server Lloyd, Scott (ACF) " Meservey,Joshua "; "White, Laura (ACF) "; "Tota, Kenneth (ACF) " Sent Date: 2017/08/2115:32 :54 /\MERICAi\ pVERSIGHT EXT-18-248-B-000100 From: Meservey, Joshua To: "Lloyd, Scott (ACF) " Subject: Accepted: Meet w/ Joshua Mservey, Heritage Foundat ion Date: 20 17/08/2115:59:41 Start Date: 20 17/09/18 14:00:00 End Date: 2017/09/18 14:30:00 Priority: Normal Type: Schedule.Meeting. Resp.Pos Location: Mary E. Switzer Bldg 330 C. St. SW DC 20201 Sender: Meservey, Joshua Recipient: "Lloyd, Scott (ACF) " Sent Date: 2017/08/2115:59 :00 Delivered Date: 2017/08/2115:59:41 /\MERICAi\ pVERSIGHT EXT-18-248-B-000101 From: Meservey, Joshua To: "Lloyd, Scott (ACF) " Subject: Accepted: Meet w/ Joshua Mservey, Heritage Foundat ion Date: 20 17/08/2115:59:41 Start Date: 20 17/09/18 14:00:00 End Date: 20 17/09/18 14:30:00 Priority: Norma l Type: Schedule.Meet ing. Resp.Pos Location: Mary E. Switzer Bldg 330 C. St. SW DC 20201 Sender: Meservey, Joshua Recipient: "Lloyd, Scott (ACF) " Sent Date: 20 17/08/2115:59:00 Delivered Date: 2017/08/2115:59:41 /\MERICAi\ pVERSIGHT EXT-18-248-B-000102 Date: 20 17/08/2118:31 :46 Priority: Normal Type: Contact Display Name: Meservey, Joshua Email Display Name: Meservey, Joshua Email Address: Joshua.Meservey@heritage.org I Sent Date: !2017/08/21 18:31:46 /\MERICAi\ pVERSIGHT EXT-18-248-B-000103 Lloyd, Scott (ACF) "Powers, Mary (ACF) "; To: "Marriott, Brian (ACF) "; "Wagner, Steven (ACF) " Subject: RE: Texas Should Not Becomea Sanctuary State fo r Abortion Date: 2017/10/13 16:58:00 Priority: Normal Type : Note Nice! From: Powers, Mary (ACF) Sent: Friday, October 13, 2017 4:56 PM To: Marr iott , Brian (ACF); Wagner, Steven (ACF); Lloyd, Scott (ACF) Subject: FW: Texas Should Not Become a Sanctuary State for Abortion FYI Ma1y Powers Policy Advisor I Immediate Office of the Assistant Secretary Administration for Children and Families I Department of Health and Human Services 330 C Street, SW, Washington, DC 20201 Office : (202 260-0084 Cell : (202 , .__ (b)(B) __ __, Emai l : mary .powers@acf.hhs. gov From: Royce, Shannon (OS/CFBNP) Sent: Friday, October 13, 2017 4:55 PM To: Powe rs, Mary (ACF) Subject: FW: Texas Should Not Become a Sanctuary State for Abortion From: MalloryQuigley[mai lto:mqu igley@SBA-LIST.ORG) Sent: Friday, October 13, 2017 2:06 PM To: Royce, Shannon (OS/CFBNP) Subject: FW: Texas Should Not Become a Sanctuary Stat e for Abortion FYI Shannon! /\MERICAi\ pVERSIGHT EXT-18-248-B-000104 FOR IMMEDIATE RELEASE: October 13, 2017 Contact: Mallory Quigley , mguigley @sba-list.org 202-223 -8073 Texas Should Not Become a Sanctuary State for Abortion SBA List praises pro-life Trump Administration and TexasAG for asserting that abortion is not health care WASHINGTON, D.C. - Today the national pro-life group Susan B. Anthony List praised the U.S. Department of Health &Human Services (HHS), Texas Attorney General Ken Paxton and pro-life advocates in Texas for asserting that abortion is not health care in a case concerning a pregnant, 17-year old girl who is an undocumented immigrant from Central America. The ACLU has brought forth a lawsuit to try and force HHS to secure an abortion for the child. Yesterday the AP reported that a San Francisco judge has said that their legal challenge was not filed in the right court. "This young girl deserves compassion and quality health care. Abortion is not health care and the ACLU is taking advantage of a young woman in a desperate situation," said SBA List President Marjorie Dannenfelser. "This lawsuit is a nothing more than a ploy by the ACLU to tum the Lone Star State - one of the most pro-life states in the country - into a sanctuary state for abortion." "We thank the Trump Administration as well as Texa s Attorney General Paxton for show ing decisive leadership on this issue and for call ing out the ACLU for seeking to interfere with Texas' pro-life values." Susan B. Anthony List and its partner super PAC, Women Speak Out spent more than $18 million in the 2016 election cycle, knocking on more than 1.1 million doors in battleground states to defeat Hillary Clinton and maintain a pro-life Senate. SBA List is dedicated to pursuing policies and electing candidates who will reduce and ultimately end abortion. To that end, the SBA List emphasizes the education, promotion, mobilization, and election of pro-life women. The SBA List is a network of more than 465,000 pro-life Americans nationwide. ### /\MERICAi\ pVERSIGHT EXT-18-248-B-000105 Mallory Quigley Communicatio ns Director Susan B. Anthon y List (c) 703 !(b}(6) www.sba- list.org I Lloyd, Scott (ACF) "Powers, Mary (ACF) "; Recipient : "Marriott, Brian (ACF) "; "Wagner, Steven (ACF) " Sent Date: 2017/10/ 13 16:58:23 Delivere d Date: 2017/10/ 13 16:58:00 /\MERICAi\ pVERSIGHT EXT-18-248-B-000106 Marriott, Brian (ACF) "Powers, Mary (ACF) "; "Wagner, Steven {ACF) "; " Lloyd, Scott (ACF) " Subject: Re: Texas Should Not Becomea Sanctuary State for Abortion Date: 2017/10/13 18:04:55 Priority: Normal Type: Note Sweet On: 13 October 2017 16:56, "Powers, Mary (ACF)" wrote: FYI Mary Powers /\MERICAi\ pVERSIGHT EXT-18-248-B-000107 Policy Advisor I Immediate Office of the Assistant Secretary Adm inistration for Children and Fam ilies I Department of Health and Human Services 330 C Street, SW, Washington , DC 20201 Office: (202)260-0084 Cell: ._l (b_)(6_) __ ____. Ema il : mary .power s@acf.hhs.gov From: Royce, Shannon (OS/CFBNP) Sent: Friday , October 13, 2017 4:55 PM To: Power s, Mary (ACF) Subject: FW: Texas Should Not Become a Sanctuary State for Abortion From: Mallory Quigley [mailto:mguigley @SBA-LIST.ORG] Sent: Friday , October 13, 2017 2:06 PM To: Royce , Shannon (OS/CFBNP) Subject: FW: Texas Should Not Become a Sanctuary State for Abortion /\MERICAi\ pVERSIGHT EXT-18-248-B-000108 FYIShannon! FOR IMMEDIATE RELEASE : October 13, 2017 Contact : Mallory Quigley, mquigley@sba-list.org 202-223-8073 Texas Should Not Become a Sanctuary State for Abortion SBA List praises pro-life Trump Administration and TexasAG for asserting that abortion is not health care - W ASIDNGTON, D.C. - Today the national pro-li fe group Susan B. Anthony List praised the U.S. Department of Health &Human Services (HHS), Texas Attorney General Ken Paxton and pro-life advocates in Texas for assert ing that abortion is not health care in a case concerning a pregnant, 17-year old girl who is an undocumented immigrant from Centra l America. The ACLU has brought forth a laws uit to try and force HHS to secure an abo 1tion for the child. Yesterday the AP reported that a San Franc isco jud ge has said that their legal challenge was not filed in the right court. /\MERICAi\ pVERSIGHT EXT-18-248-B-000109 "This young girl deserves compassion and quality health care. Abortion is not health care and the ACLU is taking advantage of a young woman in a desperate situation," said SBA List President Marjorie Dannenfelser. "This lawsu it is a nothing more than a ploy by the ACLU to tum the Lone Star State - one of the most pro-life states in the country - into a sanctuary state for abortion." "We thank the Trump Administration as well as Texas Attorney General Paxton for show ing decisive leadership on this issue and for call ing out the ACLU for seeking to interfere with Texa s' pro-life values ." Susan B. Anthony List and its partner super PAC, Women Speak Out spent more than $18 million in the 2016 election cycle, knocking on more than 1.1 million doors in battleground states to defeat Hillary Clinton and maintain a pro-life Senate. SBA List is dedicated to pursuing policies and electing candidates who will reduce and ultimately end abortion. To that end, the SBA List emphasizes the educa tion, promotion, mobilization, and election of pro-life women. The SBA List is a network of more than 465,000 pro-lif e Americans nationwide. ft## Mallory Quigley Communications Director Susan B. Anthony List )(6_) _ (c) 703 .._~b- _, www.sba -list.org /\MERICAi\ pVERSIGHT EXT-18-248-B-000110 Marriott, Brian (ACF) "Powers, Mary (ACF) "; "Wagner, Steven (ACF) "; " Lloyd, Scott (ACF) " Sent Date: 2017/10/13 18:04:54 Delivered Date: 2017/10/13 18:04:55 /\MERICAi\ pVERSIGHT EXT-18-248-B-000111 From: KevinTheriot To: "Wagner, Steven(ACF) " "Lloyd, Scott (ACF) "; "DeniseHarle " Subject : RE: [Priviledged: Attorney/ClientCommunications] Summonsin ACLUCaseAttached Date: 2017/10/26 18:18:06 Priority: Normal Type: Note Thanks Steve. We will take a look at this right away and get back to you with a recommendation for you next week. Scott, we'll also make a recommendation about whether we think it advisable for you both have t he same counsel or separate . Feel free to contact me with any questions or concerns. Kevin 913-730 -5185 (direct line) /\MERICAi\ pVERSIGHT EXT-18-248-B-000112 Kevin Theriot Sr. Counsel, Vice President of Center for Life 0 Alli ance Defending Freedom 480-444-0020 (Office) 480-444-0028 (Fax) kt her iot@ ADFlegal.o rg ADFlegal.org From : Wagner, Steven (ACF) [mailto:Steven.Wagner@acf.hhs .gov] Sent: Thursday , October 26, 2017 2:26 PM To: Kevin Theriot Cc: Lloyd , Scott (ACF) Subject: [Priviledged: Attorney /Client Communications] Summon s in ACLU Case Attached Kevin, please find my summons, attached. I have told Scott Lloyd of our conversation, and he is interested in exploring the possibility of ADF representation as wel l. Thank you for considering this case. Best, /\MERICAi\ pVERSIGHT EXT-18-248-B-000113 Steven Wagner Acting Assistant Secretary Admi nistration for Children and Families U.S. Department of Health and Human Services 330 C Street, SW, Wash ington DC 20201 202-401-1822 Steven .Wagner @acf.hhs.gov This e-mail message from Alliance Defending Freedom and any accompany ing documents or embedded messages is intended for the named recip ients only. Because Alliance Defend ing Freedom is a legal entity engaged in the practice of law, this commun icat ion contains information, which may inc lude metada ta, that is confidential, privileged, attorney work product, or otherwise protected from disclosure under applicable law. If you have received this message in error, are not a named recipient, or are not the emp loyee or agent responsible fo r delivering th is message to a named recipient, be advised that any review, disclosure, use, disseminat ion, distribution, or reproduction of this message or its contents is strictly prohibited. If you have received this message in error, please immed iate ly not ify the sender and permanently delete the message. PR IVILEGED AND CONFIDENTIAL - ATTORNEY-CL IENT COMMU NICATION/ATTORNEY WORK PRODUCT. Sender: Kevin Theriot "Wagner, Steven (ACF) "; Recipient: "Lloyd, Scott (ACF) "; "Denise Harle " Sent Date: 2017/10/26 18:17:33 Delivered Date: 2017/10/26 18:18 :06 /\MERICAi\ pVERSIGHT EXT-18-248-B-000114 ALLIANCE DIFHNDING Lloyd, Scott (ACF) To: "Penny Nance " Subject : RE: Praying for you Date: 2017/10/27 13:35:00 Priority: Norma l Type: Note Dear Penny, Thank you for the kind words, and for your perspective. The support I've received in the past several days has been very encouraging. Thank you, likewise, for all you do. Sincerely, Scott -----Or iginal Message----From: Penny Nance [mailto:pynancel@cwfa.org ] Sent: Friday, October 27, 2017 9:04 AM To: Lloyd, Scott (ACF) Subject: Praying for you Scott, I just wanted to take a moment and tell you how much I appreciate you r support for life. Your efforts to protect "the least of these" is essential. President Trump committed to an ethic of life fo r his entire administration and your work at HHS has reflected that priority. I understand that you have taken fire to the point of threats against your family. I am so sorry. I experienced similar persecution years ago when I did work for the Bush Adminstration at the FCC. Apparently, pornog raphers did not appreciate my perspective.:) Regardless, as bad as th is feels know that you are the voice of millions of Americans who voted for this President expecting that thei r money would not be entang led in the taking of human life. We are gratefu l for your service. Remember, we ult imately all play to an audience of One and God is still on His throne. Please contact me if I am able to help you in some way. Sincerely, Penny Nance CEO and President Concerned Women for America Lloyd, Scott (ACF) Recipient: "Penny Nance " Sent Date: 2017/10/27 13:38:52 Delivere d Date: 2017/10/27 13:35:00 /\MERICAi\ pVERSIGHT EXT-18-248-B-000116 Date: 20 17/10/27 22:51 : 13 Priority: Norma l Type: Contact Display Name: Penny Nance Email Display Name: Penny Nance Email Address: pynance l @cwfa.org I Sent Date: !2017/10/27 22:51:13 /\MERICAi\ pVERSIGHT EXT-18-248-B-000117 From: Kevin Theriot To: "Wagner, Steven (ACF) " CC: "Lloyd, Scott (ACF) " Subject : RE: [Priviledged: Attorney/Client Communications] Summonsin ACLUcase Attached Date: 2017/11/02 12:42:32 Priority: Normal Type: Note Steve and Lloyd, Just wanted to let you know we should have a recommendation to you by tomorrow . Bottom line is, we think you have some very strong defenses. More details should be forthcoming tomorrow . Kevin /\MERICAi\ pVERSIGHT EXT-18-248-B-000118 Kevin Theriot Sr. Counsel, Vice President of Center for Life 0 Alliance Def ending Freedom 480-444-0020 (Office) 480-444-0028 (Fax) ktheriot@ADFlegal.org ADFlegal.org From : Wagner, Steven (ACF) [mailto:Steven.Wagner@acf.hhs.gov] Sent: Thursday, October 26, 2017 2:26 PM To: Kevin Theriot Cc: Lloyd, Scott (ACF) Subject: [Priv iledged: Attorney /Client Communications ] Summons in ACLU Case Attached Kevin, please find my summons, attached. I have told Scott Lloyd of our conversation, and he is interested in exploring the possibility of ADF representation as wel l. Thank you for considering this case. Best, Steven Wagner Acting Assistant Secretary Administration for Children and Families U.S . Department of Hea lth and Human Services /\MERICAi\ pVERSIGHT EXT-18-248-B-000119 330 C Street, SW, Washington DC 20201 202-401-1822 Steven. Wagner @acf.hhs.gov This e-mai l message from Alliance Defending Freedom and any accompany ing documents or embedded messages is intended for the named recipients only. Because Alliance Defend ing Freedom is a lega l entity engaged in the practice of law, this commun icat ion contains information , which may inc lude metadata, that is confidential, privileged, attorney work product, or otherwise protected from disclosure under applicable law. If you have received this message in error, are not a named recipient, or are not the emp loyee or agent responsible for deliver ing th is message to a named recipient , be advised that any review, disclosure , use, disseminat ion, distribution , or reproduction of this message or its contents is strictly prohibited. If you have received this message in error , please immed iate ly not ify the sender and permanently delete the message. PR IVILEGED AND CON FIDENTIAL - ATTORNEY-CLIENT COMMUNICA TION/ATTORNEY WORK PRODUCT. Sender: Kevin Theriot "Wagner, Steven (ACF) "; Recipient : "Lloyd, Scott (ACF) " Sent Date: 2017/11/02 12:41:45 Delivered Date: 2017/11/02 12:42:32 /\MERICAi\ pVERSIGHT EXT-18-248-B-000120 From: KevinTheriot To: "Wagner, Steven(ACF) " "Lloyd, Scott (ACF) "; "DeniseHarle " Subject : RE: [Priviledged: Attorney/ClientCommunications] Summonsin ACLUCaseAttached Date: 2017/11/06 13:15:15 Priority: Normal Type: Note Steve, Do you have time to talk today? We are ready to give you our recommendation. Kevin /\MERICAi\ pVERSIGHT EXT-18-248-B-000121 Kevin Theriot Sr. Counsel, Vice President of Center for Life 0 Alliance Def ending Freedom 480-444-0020 (Office) 480-444-0028 (Fax) ktheriot@ADFlegal.org ADFlegal.org From : Wagner, Steven (ACF) [mailto:Steven.Wagner@acf.hhs.gov] Sent: Thursday, October 26, 2017 2:26 PM To: Kevin Theriot Cc: Lloyd, Scott (ACF) Subject: [Priv iledged: Attorney /Client Communications ] Summons in ACLU Case Attached Kevin, please find my summons, attached. I have told Scott Lloyd of our conversation, and he is interested in exploring the possibility of ADF representation as wel l. Thank you for considering this case. Best, Steven Wagner Acting Assistant Secretary Administration for Children and Families U.S . Department of Hea lth and Human Services /\MERICAi\ pVERSIGHT EXT-18-248-B-000122 330 C Street, SW, Washington DC 20201 202-401-1822 Steven. Wagner @acf.hhs.gov This e-mai l message from Alliance Defending Freedom and any accompany ing documents or embedded messages is intended for the named recipients only. Because Alliance Defend ing Freedom is a lega l entity engaged in the practice of law, this commun icat ion contains information , which may inc lude metadata, that is confidential, privileged, attorney work product, or otherwise protected from disclosure under applicable law. If you have received this message in error, are not a named recipient, or are not the emp loyee or agent responsible for deliver ing th is message to a named recipient , be advised that any review, disclosure , use, disseminat ion, distribution , or reproduction of this message or its contents is strictly prohibited. If you have received this message in error , please immed iate ly not ify the sender and permanently delete the message. PR IVILEGED AND CON FIDENTIAL - ATTORNEY-CLIENT COMMUNICA TION/ATTORNEY WORK PRODUCT. Sender: Kevin Theriot "Wagner, Steven (ACF) "; Recipient: "Lloyd, Scott (ACF) "; "Denise Harle " Sent Date: 2017/11/06 13:14:44 Delive red Date: 2017/11/06 13:15:15 /\MERICAi\ pVERSIGHT EXT-18-248-B-000123 Wagner, Steven (ACF) To: "Kevin Theriot " "Lloyd, Scott (ACF) "; "Denise Harle " Subj ect: RE: [Priviledged: Attorney/Client Communications] Summonsin ACLUCaseAttached Date: 2017/11/06 17:31:52 Priority: Normal Type: Note When are you free? From: Kevin Theriot [mailto:ktheriot@adflegal.org] Sent: Monday, November 06, 2017 1:15 PM To: Wagner, Steven (ACF) Cc: Lloyd, Scott (ACF); Denise Harle Subject: RE: [Priviledged: Attorney/Client Communications] Summons in ACLU Case Attached Steve, Do you have time to talk today? We are ready to give you our recommendation. Kevin X Alli Kevin Therio t Sr. Counse l, V ice President of Center for Life 480-444 -0020 (Offic e) 480-444-0 028 (Fax) ktheriot@ADF legal.o rg ADF iegal.o rg ance Defending Freedom From: Wagner, Steven (ACF) [mailto :Steven.Wagner @acfhhs .gov] Sent: Thursday, October 26, 2017 2:26 PM To: Kevin Theriot Cc: Lloyd, Scott (ACF) Subject: [Priviledged : Attorney /Client Communications] Summons in ACLU Case Attached Kevin, please find my summons, attached . I have told Scott Lloyd of our conversation, and he is interested in exploring the possibility of ADF representation as well. Thank you for considering this case. Best, /\MERICAi\ pVERSIGHT EXT-18-248-B-000124 Steven Wagner Acting Assistant Secretary Administration for Children and Fam ilies U.S. Department of Health and Human Services 330 C Street, SW, Washington DC 20201 202-401-1822 Steven.Wagner@acf.hhs .gov This e-mail message from Alliance Defending Freedom and any accompanying documents or embedded messages is intended for the named recipients only. Because Alliance Defending Freedom is a legal entity engaged in the practice of law, this communication contains information , which may include metadata, that is confidential, privileged, attorney work product, or otherwise protected from disclosure under applicable law. If you have received this message in error, are not a named recipient, or are not the employee or agent responsible for delivering this message to a named recipient, be advised that any review, disclosure, use, dissemination, distribution, or reproduction of this message or its contents is strictly prohibited. If you have received this message in error, please immediately notify the sender and permanently delete the message. PRIVILEGED AND CONFIDENTIAL -ATTORNEY-CLIENT COMMUNICATION/ATTORNEY WORK PRODUCT. Wagner, Steven (ACF) Recipient: "Kevin Theriot "; "Lloyd, Scott (ACF) " Edwa> "; Sent Date: 2017/11/06 17:31 :52 Message Flags: Unread /\MERICAi\ pVERSIGHT EXT-18-248-B-000125 From: Edward Lloyd " Lloyd, Scott (ACF) " Subject: Fwd: Chaldean catho lic Memor ial Mass for Victims of ISIS' Genocide, Nov. 28 in Washington Date: 20 17/11/28 08:47:26 Priority: Normal Type: Note Sent from my iPhone Begin forwarded message: From : Andrew.Walther@Kofc .Org Date : November 2 1, 20 17 at 8:45: 16 AM EST To: Andrew .Walther@Kofc.Org Subject: Chaldean Catholic Memorial Mass for Victims of ISIS' Genocide , Nov. 28 in Washin gton /\MERICAi\ pVERSIGHT EXT-18-248-B-000126 You are cordially invited to a Memorial Mass for Victims of ISIS' Genocide on Tuesday, Nov. 28 at 6:00 pm at the St. John Paul II National Shrine in Washington . Archbishop Bashar Warda of Erbil, Iraq will be the principal celebrant and homi list. Please see attached flyer for deta ils. Sincerely , Andrew Andrew T. Walther Vice President Communications and Strategic Planning Knights of Columbus One Columbus Plaza New Haven , CT 06510 (203) 752-4253 (office) (203) 752-4400 (fax) (203) ~l< b~)(6 ~l -~I (cellular) (See attached file : memorial mass for victims of genocide.pdj) CONFIDENTIALITY NOTICE: This message and any attachments may contain confidential, proprietary or legally priv ileged information and is intended only for the use of the addressee or addressees named above for its intended purpose. If you are not the intended recipient of this message, this message constitutes notice that any review , retransm ission, distribution , copying or other use or taking any action in /\MERICAi\ pVERSIGHT EXT-18-248-B-000127 reliance on the information in this message and its attachments, is prohibited. If you receive this commun ication in erro r, please immediately advise the sender by reply e-mai l and delete this message and its attachments from your system without keeping a copy. Unless expressly stated in this e-mail, nothing in this message may be constr ued as a digita l or electronic signature. Thank you. Sender: Edward Lloyd "Lloyd, Scott (ACF) " Sent Dat e : 2017/ 11/28 08:46:42 De live red Dat e : 2017/11/28 08:47:26 /\MERICAi\ pVERSIGHT EXT-18-248-B-000128 Lloyd, Scott (ACF) "Moreno, Mr. Pedro (ACF) "; "Womack, Kimberley (ACF) "; "White, Laura (ACF) " Subject: FW: Chaldean Catholic Memorial Mass for Victims of ISIS' Genocide, Nov. 28 in Washington Date : 2017/11/28 09:00:00 Priority : Norma l Type : Note I wanted to share this in case you are interested (it's tonight near Catholic University-sor ry for the late notice!) Please feel free to share. Scott From: Edward Lloyd [mailto: (b)(5 ) gmail.com] Sent: Tuesday, November 2 , To: Lloyd, Scott (ACF) Subject : Fwd: Chaldean catholic Memorial Mass for Victims of ISIS' Genocide, Nov. 28 in Washington Sent from my iPhone Begin forwarded message: From: Andrew.Walther@Kofc.Org Date: November 21, 2017 at 8:45:16 AM EST To: Andrew.Walther@Kofc.Org Subject: Chaldean Catho lic Memorial Mass for Victims of ISIS' Genocide, Nov. 28 in Washington You are cordially invited to a Memorial Mass for Victims of ISIS' Genocide on Tuesday, Nov. 28 at 6:00 pm at the St. John Paul II National Shrine in Washington . Archbishop Bashar Warda of Erbil, Iraq will be the principal celebrant and homilist. Please see attached flyer for details . Sincerely , Andrew /\MERICAi\ pVERSIGHT EXT-18-248-B-000129 Andrew T. Walther Vice President Communications and Strategic Planning Knights of Columbus One Columbus Plaza New Haven, CT 06510 (203) 752-4253 (office) (203) 752-4400 (fax) I (cellular) (203) !{bl{6l (See attached file: memorial mass for victims of genocide.pdj) CONF ID ENTIALITY NOTICE: This message and any attachments may contain confident ial, propr ietary or legally priv ileged information and is inte nded only for the use of the addressee or addressees named above for its intended purpose. If you are not the intended recipient of this message, this message constitutes notice tha t any review, retransmission, distribution , copying or other use or taking any act ion in reliance on the info1mation in this message and its attach ments, is prohibited . If you rece ive this communication in error, please immediately advise the sender by reply email and delete this message and its attachments from your system without keeping a copy . Unless expressly stated in this e-ma il, nothin g in this message may be construed as a digital or electron ic signature. Thank you. Lloyd, Scott (ACF) " Moreno, Mr. Pedro (ACF) "; "Womack, Kimberley (ACF) " ; "Wh ite, Laura (ACF) " Sent Date: 2017/11/28 09:00:34 Delivered Date: 2017/11/28 09:00:00 /\MERICAi\ pVERSIGHT EXT-18-248-B-000130 SAINT J~~~~~~h!~ Join in prayer during the ·week of Awareness for Persecuted Christians at the CHALDEAN CATHOLIC MEMORIALMASS FOR VICTIMS OF ISIS' GENOCIDE NOVEMBER 28, 2017 AT6PM Archbishop Bashar Warda of Erbil, Iraq Principal Celebrant and Homilist 3900 HAREWOOD ROAD NE,WASHINGTON DC 20017 FREEPARKING • BROOKLAND- CUA METROSTOP • (202) 635-5400 Sponsoredby the Knights of Columbus EXT-18-248-B-000131 Fields, Marivic (Maria) (ACF) To: "Lloyd, Scott (ACF) " Subject : RE: Chaldean Catholic Memorial Massfor Victims of ISIS' Genocide,Nov. 28 in Washington Date: 2017/11/28 09:25:49 Priority: Normal Type: Note Hi Scott, Thank you for sharing. I will try to go tonight. v/r Marivic Fields, LMSW, BCD CDR, United States Public Health Service Senior Advisor for Child Well-being and Safety Administration for Children and Families (202) 795-7566 (office) (202) l(b)(6) !(cell) maria .fields@acf.hhs.gov From: Lloyd, Scott (ACF) Sent: Tuesday, November 28, 2017 9:01 AM To: Fields, Marivic (Maria) (ACF) Subject: FW: Chaldean Catholic Memorial Mass for Victims of ISIS' Genocide, Nov. 28 in Washington Marivic, In case you didn't see this I wanted to share with you - it's at the JPII Shrine tonight. Scott From: Edward Lloyd [ma ilto: l Recipient : /\MERICAi\ pVERSIGHT "Lloyd, Scott (ACF) " EXT-18-248-B-000133 Sent Date:l201?f11f28 09:25:49 EXT-1 8-248-B-0001 34 Huber, Valerie (HHS/OASH) To: "Lloyd, Scott (ACF) " Subject : RE: I nvitation Date: 2018/03/22 17:52:50 Priority: Normal Type: Note Great. Will do From: Lloyd, Scott (ACF) Sent: Thursday, March 22, 2018 5:5 1 PM To: Huber, Valerie (HHS/OASH) Subject: RE: Invitation Hi Valerie, I do know C-Fam-please share. Thank you, Scott From: Huber, Valerie (HHS/OASH) Sent: Thursday, March 22, 2018 5:49 PM To: Lloyd, Scott (ACF) Subject: Invitation Hi Scott, See below. If you're not family with this group, I'm happy to give you some background. I'm happy to pass on your email to them, if you'd like, but will not do so without your OK. Best, Valerie Deliberative and pre-decisional communication Valerie Huber Chief of Staff Office of the Assistant Secretary for Health (OASH) Acting Deputy Assistant Secretary for Population Affairs (OPA) 200 Independence Avenue, SW Washington, DC 20201 202 690 7694 202 4018034 /\MERICAi\ pVERSIGHT EXT-18-248-B-000135 From: Lisa Correnti (mailto:lisa@c-fam.org1 Sent: Thursday, March 22, 2018 3:42 PM To : Huber, Valerie (HHS/OASH) Subject: Scott Lloyd Dear Vale rie, We are organi zing a UN event on migration and we would like to extend an invitation to Scott Lloyd who heads up Office of Refugee Resettlement (ORR). Would you have an ema il for hi? Thank you, Lisa L isa CoITenti Exec utive Vice President Center for Family and Human Rights (C-Fam) lisa@c-fam.org NY: (212) 754-5948 DC: (202) 393-7002 Huber, Valerie (HHS/OASH) Recipient: "Lloyd, Scott (ACF) " Sent Date: 2018/03/22 17:52:49 Delivered Date: 2018/03/22 17:52:50 /\MERICAi\ pVERSIGHT EXT-18-248-B-000136 Huber, Valerie (HHS/OASH) To: "Lisa Correnti " CC: "Lloyd, Scott (ACF) " Subject: RE: Scott Lloyd Date: 2018/03/22 17:54: 13 Priority: Normal Type: Note Lisa, I've cc'd Scott to this email, so you can both converse about the invitation. Best, Valerie From: Lisa Correnti [mailto:lisa@c-fam.org] Sent: Thursday, March 22, 2018 3:42 PM To: Huber, Valerie (HHS/OASH) Subject: Scott Lloyd Dear Valerie, We are organizing a UN event on migration and we would like to extend an invitation to Scott Lloyd who heads up Office of Refu gee Resettlement (ORR) . Would you have an email for hi? Thank you, Lisa Lisa Correnti Execut ive Vice President Center for Family and Human Rights (C-Fam) lisa@c-fam .org NY: (212) 754-5948 DC: (202) 393-7002 Huber, Valerie (HHS/OASH) "Lisa Correnti "; Recipient: "Lloyd, Scott (ACF) " Sent Date: 2018/03/22 17:54:12 Delivered Date: 2018/03/22 17:54:13 /\MERICAi\ pVERSIGHT EXT-18-248-B-000137 Date: 20 18/03/22 18:05:04 Priority: Normal Type: Contact Display Name: Lisa Correnti Email Display Name: Lisa Correnti Email Address: lisa@c-fam.org I Sent Date: !2018/03/22 18:05:04 /\MERICAi\ pVERSIGHT EXT-18-248-B-000138 From: Lisa Correnti To: "Lloyd, Scott (ACF) " CC: "Huber, Valerie (HHS/OASH)" Subject: Re: Scott Lloyd Date: 2018/03/22 18:07:58 Priority: Normal Type: Note Excellent, Scott. Wi ll do! Thank you, Lisa On Mar 22, 2018, at 6:02 PM, Lloyd, Scott (ACF) wrote: Hi Lisa, In the morn ing after 10:30 is best, on my cell (below) . Thank you, Scott *** E. Scott Lloyd Director Office of Refugee Resettlement U.S. Department of Health and Human Services (202) 401- 7269 I(cell) (202) !{b)(6) sco tt.lloyd@acf. hhs.gov From: Lisa Correnti [ mailto :lisa@c-fam.or g1 Sent: Thursday, March 22, 2018 5:58 PM To: Huber, Valerie (HHS/OASH) Cc: Lloyd, Scott (ACF) Subject: Re: Scott Lloyd Thank you, Valerie. Scott, would there be a good time to call you tomorrow or Monday? Many thanks Lisa /\MERICAi\ pVERSIGHT EXT-18-248-B-000139 On Mar 22 , 2018 , at 5:54 PM, Huber , Valerie (HHS /OASH) wrote : Lisa, I've cc'd Scott to this email, so you can both converse about the invitation. Best, Valerie From: Lisa Correnti (mailto:lisa@c -fam.org] Sent: Thursday, March 22, 2018 3:42 PM To : Huber, Valerie (HHS/OASH) Subject : Scott Lloyd Dear Va lerie, We are organi zing a UN event on migration and we would like to extend an invitation to Scott Lloyd who heads up Office of Refugee Resettlement (ORR). Would you have an email for hi? Thank you, Lisa Lisa Con-ent i Executive Vice President Center for Family and Human Rights (C-Fam) lisa@c -fam.o rg NY: (212) 754 -5948 DC: (202) 393-7002 Sender: Lisa Correnti Recipient: "Huber, Valerie (HHS/OASH) "; " Lloyd, Scott (ACF) " Sent Date : 20 18/03/22 18:07:22 Delivered Date: 20 18/03/22 18:07:58 /\MERICAi\ pVERSIGHT EXT-18-248-B-000140 From: Lisa Correnti To: "Lloyd, Scott (ACF) " Subject: Re: Scott Lloyd Date: 2018/03/23 10:42 :31 Priority: Normal Type: Note Scott, My 1Oam call is going over. I' ll call you by 11. Thank you, Lisa On Mar 22, 2018, at 6:02 PM, Lloyd, Scott (ACF) wrote: Hi Lisa, In the morning after 10:30 is best, on my cell (below). Thank you, Scott *** E. Scott Lloyd Director /\MERICAi\ pVERSIGHT EXT-18-248-B-000141 Office of Refugee Resettlement U.S. Department of Health and Human Serv ices (202) 40 l- 7269 (202) !(b)(6) I(cell) scott. Iloyd @acf. hhs.gov From: Lisa Correnti [ma ilto :lisa@c-fam .org1 Sent: Thursday , March 22, 2018 5:58 PM To: Huber, Valer ie (HHS/OASH) Cc: Lloyd , Scott (ACF) Subject: Re : Scott Lloyd Thank you, Valerie . Scott, would there be a good time to call you tomorrow or Monday? Many thank s Lisa /\MERICAi\ pVERSIGHT EXT-18-248-B-000142 On Mar 22, 2018, at 5:54 PM , Huber, Valerie (HH S/OASH) wro te: Lisa, I've cc'd Scott to this email, so you can both converse about the invitation. Best, Valerie From : Lisa Corrent i [mailto:lisa@c-fam.org] Sent: Thursday , March 22, 20 18 3:42 PM To: Huber , Vale rie (HHS/OASH) Subject: Scott Lloyd /\MERICAi\ pVERSIGHT EXT-18-248-B-000143 Dear Valerie , We are organizing a UN event on migration and we would like to extend an invitation to Scott Lloyd who heads up Office of Refugee Resettlement (ORR). Would you have an email for hi? Thank you, Lisa /\MERICAi\ pVERSIGHT EXT-18-248-B-000144 Lisa Cor renti Executive Vice President Cente r for Family and Hu man Rights (C-Fam) lisa@c-fam.org NY: (2 12) 754-5948 DC: (202) 393-7002 /\MERICAi\ pVERSIGHT EXT-18-248-B-000145 Sender: Lisa Correnti Recipient: "Lloyd, Scott (ACF) " Sent Date: 2018/03/23 10:42: 18 Delivered Date: 2018/03/23 10:42:31 Message Flags: Unread /\MERICAi\ pVERSIGHT EXT-18-248-B-000146 ( C-Fam CENTER FOR FAMILY & HUMAN RlGH TS NEW YORK • W .\SHINGTON. DC March 23, 2018 E. Scott Lloyd Director Office of Refugee Resettlement U.S. Department of Health and Human Services 200 Independence Avenue, S.W. Washington, D.C. 20201 Dear Scott, The Commission on Population and Development will convene at United Nations headquarters in New York April 9-13 addressing the theme of Migration and Urbanization . To inform the discussion a side event is being organized by 23 Member States that comprise the Group of the Friends of the Family. C-Fam is partnering with the Member States in the organizing of this event. The event titled "The Effect of Urbanization and Migration on the Family" is scheduled for Tuesday, April 10 from 10am-12pm. We would like to extend an invitation to you to participate as a panelist presenting on the Trump administration migration policy related to unaccompanied minors, the exploitation and challenges confronting these children and the assistance that needs to be provided. I am attaching a concept note to provide more detail of the event. Manv thanks for your kind consideration. b)(6) Lisa Correnti Executive Vice President lisa@c-fam.org NY: (212) 754-5948 cell: (619) 992-1502 .b~ER~fd'f-tt"'°• N,w Yorl<,NY 10022 • Td (212) 754-59-JS • Fad211J 754-9291 , ;,fo@C-FA\i.ocg , ,o, w.C-FAM.o,g EXT-18-248-B-000147 SAVE THE DATE THE EFFECT OF URBANIZATION AND MIGRATION ON THE FAMILY ROUND TABLE TUESDAY, APRIL 10 , 2018 , 10 AM 12 AM UN , CONFERENCE ROOM 8 Bangladesh Belarus Comor os Egypt Indo nesia Iran Iraq Kuwa it Ky rgyzstan Libya The effects of urbanization and migration are frequent ly addressed in UN resolutions and deba t es on a whole host of top ics ranging from the eco nomy t o t he enviro nmen t and global health. Urbanizatio n and migration are the two most widespread and constant demographic factors that will affect populations wor ldwide over the course of the twenty-first century. Famil ies are disproportionally affected by urbanizat ion and migrat ion. Living and working conditions in cities as well as the risks and precariousness invo lved in migration too often contribute to fami lies be ing to rn apart and they make it harder for young people to form their ow n fami lies . Human mob ility and international migrat ion lead to increased vulnerab ility to poverty and human trafficki ng. Cities offer better infrastruc t ure, and increased opportu nit ies for educa ti on, access to healthcare, and housing. But they are not often friendly to the family . Creating fami ly-friendly cities that welcome children should be a priority in order cities to be sustainable and societies to thrive. OBJECTIVES Nicaragua This event t it led "The effect of urban ization and migration on the fami ly" wil l bring together a pane l of experts to contribute their insights on the topic. It wi ll examine the harm to children particu larly gir ls who are vulnerab le to exploitat ion trave ling without parents. It will be an opportun ity for t he pa rti cipants to brainstor m on how t o st rengt hen and protect t he family; to create tr uly sustainable cit ies and unbiased forms of mob ility. Nigeria SPEAKERS Malaysia Oma n 0 Moderator: Susan Yoshihara , Ph.D.; 0 H.E. Miroslav Lajcak , President of t he 72nd session of t he Genera l Assembly (tbc), 0 H.E. Andrei Dapkiunas , Deputy Minister of Foreign Affairs of Belarus (on behalf of the Pakist an Qatar 0 0 Russian Fede ration 0 Saudi Arabia Somalia Suda n Tajiki stan Turkmenistan Yem en Uganda 0 0 0 0 Group of Friends of t he Family); Member s of the Group of Friends of the Fa mily (tbc); W. Bradford Wilcox, Ph.D., Director of t he Nationa l Marr iage Projec t at the University of Virginia, Professor of Sociology at the University of Vi rgi nia, Senior Fellow at the Institute for Fam ily Studies, and a Visiting Scholar at the Amer ican Enterprise Institute (invited); Kathryn Edin, Bloomberg Dist inguished Professor in the Department of Sociology at t he Zanvy l Krieger School of Arts and Scie nces and in t he Department of Popula t ion, Fam ily, and Reproductive Health at the Bloombe rg School of Public Health at Johns Hopkins Univers ity(TBC); Timothy Nelson , Sen ior Lecturer in the Department of Sociology and a Research Associate in the Departme nt of Populat ion, Fam ily, and Reprodu ct ive Hea lt h at t he Bloomberg School of Publ ic Health at Johns Hopkins University {tbc); E. Scott Lloyd, Dir ector , Office of Refugee Resettlement, U.S. Dept. of Health and Human Services (invited) Timothy Herrmann, Attache, Holy See Mission , (confirme d) Stefano Gennarini, J.D., Directo r, Center for Legal St udies, C-Fam (confirmed); SUPPORTING ORGANIZATIONS Civil Society for the Family represents 180 Internatio nal NGOs. The organ izing committee for this platform includes the following: Center for Family and Human Rights (C-Fam), Family Researc h Counc il, Human Life International, HazteOir.o rg, Citizen Go, and Derecho a Vivi r Zimbabwe /\MERIC/\1\ pVERSIGHT As t he room's seat ing capacity is limited and to guarantee a namep late and a conve nient place at the m icrophone, it is advisable t o regis ter your delega t ion's attendance in adva nce by EXT-18-248-B-000148 contacting via e-mail:usaun@mfa.gov.by, /\MERICAi\ pVERSIGHT Permanent Mission of Belarus to the United Nations. EXT-18-248-B-000149 "Tota, Kenneth (ACF) "; "Edwards, Lauren (ACF) "; To: "Dukes, Amanda (ACF) "; "Kurkjy, Brian (ACF)(CTR) " Subj ect: FW: Scott Lloyd Date : 2018/03/26 09:54:40 Priority: Normal Type: Note U 0 , MO, 5 XA::o:o *tHt+ OD 1 0 U USl O U U.S. Govemmentl 0 U HHSl "O U Certification Authoritiesl$0" U HHS-FPKI-Inte1mediate-CA-ElO 170530162507Z180425165507Z0 - 10 U USlO U U.S. Govemmentl 0 U HHSl 0 U ACFl O U PeoplelAO '&%0"6,d 20019820610% U Brian T. 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We're still waiting on clearance for the consultation in Philadelphia the morn ing of Thursday, the 12th . I spoke with the PA SRCon Friday and we are planning for some refugee program site visits the afternoon of the 12t h• Right now we don't have any plans for the 11th , but the SoT provider knows we will likely be in town and so I can try to arrange for the SoT site visit for the 11th . It shouldn't be a problem for you to do both the NY engagement and the Philadelphia consultat ion and site visits . I'll keep you all posted as we firm up Philadelphia. Lauren From: Lloyd, Scott (ACF) Sent : Monday, March 26, 2018 9:59 AM To: Tota, Kenneth (ACF); Edwards, Lauren (ACF) ; Dukes, Amanda (ACF); Kurkjy, Brian (ACF) (CTR) Subject : FW: Scott Lloyd Hello Everyone, Pending approval from OA, I'd like to attend this event . That would have me in NYCon the 10th , which is close to our Philly trip . I wonder if it might be possible for us to move the Philly trip around a little bit so that we start on the 11th -that way I can take the train from NYCto Philly on the evening of the 10t h. If I recall preliminary planning for Philly we were planning to be there on the 12th and 13th , but we would be doing the 11th and 12th instead if I accepted the NYCinvite . I am not sure if I have that right . I am not sure how far along we are with planning for Philly-I Please let me know . /\MERICAi\ pVERSIGHT don't want to throw things into disarray. EXT-18-248-B-000156 Thank you, Scott From: Lisa Correnti (mailto: lisa@c-fam.orq l Sent: Friday, March 23, 2018 12:28 PM To: Lloyd, Scott (ACF) Subject: Re: Scott Lloyd Dear Scott, It was a pleasure speaking w ith you today. Attached please find an invitation to speak at the April 10 side event at UN headquarters. Also attached is a draft concept note. Many thanks for your cons ideration. Best, Lisa Lisa Corrent i Executive Vice President Center for Family and Human Rights (C-Fam) lisa@c-fam.org NY: (212) 754-5948 DC: (202) 393-7002 On Mar 22, 2018, at 6:02 PM, Lloyd, Scott (ACF) wrote: Hi Lisa, In the morning after 10:30 is best, on my cell (below). Thank you, Scott *** E. Scott Lloyd Director Office of Refugee Resettlement U .S. Department of Health and Human Services (202) 40 I -7269 (202) !{bl(6l I(cell) scott. Iloyd@acf. hhs. gov /\MERICAi\ pVERSIGHT EXT-18-248-B-000157 From : Lisa Correnti [mailto:lisa@c-fam .org 1 Sent: Thursday, March 22, 2018 5:58 PM To: Huber, Valerie (HHS/OASH) Cc: Lloyd, Scott (ACF) Subject: Re: Scott Lloyd Thank you, Valerie. Scott, would there be a good time to call you tomorrow or Monday? Many thanks Lisa On Mar 22, 2018, at 5:54 PM, Huber , Valerie (HH S/OASH) wrote: Lisa, I've cc'd Scott to this email, so you can both converse about the invitation. Best, Valerie From : Lisa Correnti [mailto:lisa@c-fam.org] Sent : Thursday, March 22, 2018 3:42 PM To: Huber, Valer ie (HHS/OASH) Subject : Scott Lloyd Dear Valerie, We are organ izing a UN event on migrat ion and we would like to extend an invitation to Scott Lloyd who heads up Office of Refugee Resettlement (ORR). Would you have an email for hi? Thank you, Lisa Lisa Correnti Execut ive Vice President Center for Family and Hu man Rights (C-Fam) lisa@c-fam.org NY: (212) 754-5948 DC : (202) 393-7002 Sender: Edwards, Lauren (ACF) "Lloyd, Scott (ACF) "; "Tota, Kenneth (ACF) "; "Dukes,Amanda (ACF) "; "Kurkjy, Brian (ACF) (CTR) " Sent Date: 2018/03/26 10:10:25 /\MERICAi\ pVERSIGHT EXT-18-248-B-000159 Edwards, Lauren (ACF) "Lloyd, Scott (ACF) " Subject: FW: Scott Lloyd Date: 2018/03/27 17:42:37 Priority: Normal Type : Note Hi Scott, Will you need help with talking points for this? Or someone on staff to go with you? Lauren From : Lloyd, Scott (ACF) Se nt : Monday, March 26, 2018 9:59 AM To: Tota, Kenneth (ACF) ; Edwards, Lauren (ACF) ; Dukes, Amanda (ACF); Kurkj y, Brian (ACF) (CTR) Subject : FW: Scott Lloyd Hello Everyone, Pending approval from OA, I'd like to attend this event . That would have me in NYCon the 10th , which is close to our Philly trip. I wonder if it might be possible for us to move the Philly trip around a little bit so that we start on the 11th -that way I can take the train from NYCto Philly on the evening of the 10th . If I recall preliminary planning for Philly we were planning to be there on the 12 th and 13 th , but we would be doing the 11th and 12 th instead if I accepted the NYCinvite. I am not sure if I have that right . I am not sure how far along we are with planning for Philly-I Please let me know. don't want to throw things into disarray. Thank you, Scott From: Lisa Correnti [mailto: lisa@c-fam.org 1 Sent: Friday, March 23, 2018 12:28 PM To : Lloyd, Scott (ACF) Subject: Re: Scott Lloyd Dear Scott, It was a pleasure speaking with you today. Attached please find an invitation to speak at the April 10 side event at UN headquarters. Also attached is a draft concept note. /\MERICAi\ pVERSIGHT EXT-18-248-B-000160 Many thanks for your consideration. Best , Lisa Lisa Corrent i Executive Vice President Center for Family and Human Rights (C-Fam) lisa@c-fam .org NY: (212) 754-5948 DC : (202) 393-7002 On Mar 22, 2018, at 6:02 PM, Lloyd, Scott (ACF) wrote: Hi Lisa, In the morning after 10:30 is best, on my cell (below). Thank you, Scott *** E. Scott Lloyd Director Office of Refugee Resettlement U.S. Depaitment of Health and Human Services (202) 40 I -7269 I(cell) (202) !{b)/6) scott. Iloyd@acf. hhs. gov From: Lisa Correnti [ma ilto :lisa@c-fam .org] Sent: Thursday, March 22, 2018 5:58 PM To: Huber, Valerie (HHS/OASH) Cc: Lloyd, Scott (ACF) Subject: Re: Scott Lloyd Thank you, Valerie. Scott, would there be a good time to call you tomorrow or Monday? Many thanks Lisa /\MERICAi\ pVERSIGHT EXT-18-248-B-000161 On Mar 22, 2018 , at 5:54 PM , Huber, Valerie (HHS/OASH) wrote: Lisa, I've cc'd Scott to this email, so you can both converse about the invitation. Best, Valerie From : Lisa Corrent i [mailto :lisa@c-fam.org] Sent : Thursday, March 22, 2018 3:42 PM To: Huber, Valer ie (HHS/OASH) Subject: Scott Lloyd Dear Va lerie, We are organizing a UN event on migration and we wou ld like to extend an invitation to Scott Lloyd who heads up Office of Refugee Resettlement (ORR) . Would you have an email for hi? Thank you , Lisa Lisa Corrent i Executive Vice President Center for Family and Human Rights (C-Fam) lisa@c-fa m. org NY: (2 12) 754-5948 DC: (202) 393-7002 Sender: Recipient : Edwards, Lauren (ACF) "Lloyd, Scott (ACF) " Sent Date: 2018/03/27 17:42:35 Delivered Date: 2018/03/27 17:42:37 /\MERICAi\ pVERSIGHT EXT-18-248-B-000162 Lloyd, Scott (ACF) "Dukes, Amanda (ACF) "; "Edwards, Lauren (ACF) " Subject : Fwd: Scott Lloyd Date: 2018/03/28 17:44:46 Priority: Normal Type: Note Amanda, Could you notify OGA and Global Affairs of this event and Anna ' s approval? Thank you, Scott Begin Forwarded Message: From: "Pilato, Anna (ACF)" Subject: RE: Scott Lloyd Date : 28 March 20 18 17:24 To: "Lloyd, Scott (ACF)" Cc : "Dukes, Amanda (ACF)" , "Marriott , Brian (ACF)" Hi Scott, I approve on my end. As you said in the email chain below, I am confirming that you are sending to OGA and Global Affairs. l m not sure about the Mission to 1 /\MERICAi\ pVERSIGHT EXT-18-248-B-000163 the UN, do you have a specific contact name? If you feel that's necessary then feel free, but I'm not requiring that. Please keep me posted and we will look for submission of your remarks. Thanks. Best, Anna From: Lloyd, Scott (ACF) Sent: Monday, March 26 , 2018 10:19 AM To: Pilato , Anna (ACF) Subject: FW: Scott Lloyd Importance: High Anna, I'm just putting this at the top of your inbox-we'd like approval to speak at this event on the 10th in NYC, (will send planned comments through clearance) and then to attend a refugee consultation on the 12th in Philadelphia , which we submitted separately. Thank you, Scott /\MERICAi\ pVERSIGHT EXT-18-248-B-000164 From: Lloyd, Scott (ACF) Sent: Friday , March 23, 2018 12:38 PM To: Holt , Lydia (ACF); Pilato, Anna (ACF) Cc: Dukes , Amanda (ACF); Wagner, Steven (ACF) Subject: FW: Scott Lloyd Anna, 1 l ve been invited to participate at a UN roundtable on April 10. I do not see anything preventing my attendance at this point, but we do need to run this through OGA, maybe Global Affa irs, and also run it by the Mis sion to the UN . Please let me know how we should proceed - what you need us to do. Thank you, Scott From: Lisa Correnti [mailto: lisa@c-fam.orq l /\MERICAi\ pVERSIGHT EXT-18-248-B-000165 Sent: Friday, March 23, 2018 12:28 PM To: Lloyd , Scott (ACF) Subject: Re: Scott Lloyd Dear Scott, It was a plea sure speaking with you today. Attached please find an invitation to speak at the April 10 side event at UN headquarter s. Also attac hed is a draft concep t note. Many thank s for your cons ideration . Best , Lisa /\MERICAi\ pVERSIGHT EXT-18-248-B-000166 Lisa Correnti Executive Vice President Center for Family and Hum an Rights (C-Fam) lisa@c-fam .org NY: (212) 754-5948 DC : (202) 393-7002 /\MERICAi\ pVERSIGHT EXT-18-248-B-000167 On Mar 22, 2018 , at 6:02 PM , Lloyd , Scott (ACF) wrote: Hi Lisa, In the morning after 10:30 is best, on my cell (below). Thank you , Scott *** /\MERICAi\ pVERSIGHT EXT-18-248-B-000168 E. Scott Lloyd Director Office of Refugee Resettlement U.S. Department of Health and Human Services (202) 401- 7269 (202) !(bl(6l I(cell) scott . lloyd@acf. hhs.gov From: Lisa Con-enti [mailto :lisa@c-fam.org] Sent: Thursday , March 22, 2018 5:58 PM /\MERICAi\ pVERSIGHT EXT-18-248-B-000169 To: Huber, Valerie (HHS/OASH) Cc: Lloyd , Scott (ACF) Subject: Re: Scott Lloyd Thank you, Valerie. Scott, would there be a good time to call you tomorrow or Monday? Many thank s Lisa On Mar 22, 2018, at 5:54 PM, Huber, Valerie (HHS/OASH) wrote: /\MERICAi\ pVERSIGHT EXT-18-248-B-000170 Lisa, I've cc'd Scott to this email, so you can both converse about the invitation. Best, Valerie From : Lisa Correnti [mailto:lisa@c -fam.org] Sent : Thursday , Marc h 22, 20 18 3:42 PM To: Huber, Valerie (HHS/OASH) Subject: Scott Lloyd /\MERICAi\ pVERSIGHT EXT-18-248-B-000171 Dear Valerie, We are organizing a UN event on migration and we would like to extend an invitation to Scott Lloyd who heads up Office of Refugee Resettlement (ORR). Would you have an email for hi? Thank you, /\MERICAi\ pVERSIGHT EXT-18-248-B-000172 Lisa Lisa Correnti Executive Vice President Center for Family and Human Rights (C-Fam) /\MERICAi\ pVERSIGHT EXT-18-248-B-000173 lisa@c-fa m.org NY: (2 12) 754-5948 DC : (202) 393-7002 Sender: Lloyd, Scott (ACF) "Dukes, Amanda (ACF) "; Recipient: "Edwards, Lauren (ACF) " Sent Date: 2018/03/28 17:44:45 /\MERICAi\ pVERSIGHT EXT-18-248-B-000174 Delivered 1:444:45 EXT-1 8-248-B-0001 75 Dukes, Amanda (ACF) "Lloyd, Scott (ACF) "; To: "Edwards, Lauren (ACF) " Subj ect : RE: Scott Lloyd Date: 2018/03/29 08:50:48 Priority : Normal Type: Note Will do. From : Lloyd, Scott (ACF) Se nt : Wednesday, March 28, 2018 5:45 PM To : Dukes, Amanda (ACF); Edwards, Lauren (ACF) Subject : Fwd: Scott Lloyd Amanda, Could you notify OGA and Globa l Affairs of this event and Anna's approval? Thank you, Scott Begin Forwarded Message: From : "Pilato, Anna (ACF)" Subject: RE: Scott Lloyd Date: 28 March 2018 17:24 To: "Lloyd, Scott (ACF)" Cc: "Dukes, Ama nda (ACF)" , "Marriott, Brian (ACF)" Hi Scott, I approve on my end. As you said in the email chain below, I am confirming that you are sending to OGA and Global Affairs. I'm not sure about the Mission to the UN, do you have a specific contact name? If you feel that's necessary then feel free, but I'm not requiring that. Please keep me posted and we will look for submission of your remarks. Thanks. Best, Anna /\MERICAi\ pVERSIGHT EXT-18-248-B-000176 From : Lloyd, Scott (ACF) Sent : Monday, March 26, 2018 10:19 AM To : Pilato, Anna (ACF) Subj ect: FW: Scott Lloyd Import ance: High Anna, I'm just putting this at the top of your inbox-we'd like approval to speak at this event on the 10th in NYC, (will send planned comments through clearance) and then to attend a refugee consultation on the 12th in Philadelphia, which we submitted separately. Thank you, Scott From: Lloyd, Scott (ACF) Sent: Friday, March 23, 2018 12:38 PM To : Holt, Lydia (ACF); Pilato, Anna (ACF) Cc: Dukes, Amanda (ACF); Wagner, Steven (ACF) Subject: FW: Scott Lloyd Anna, I've been invited to participate at a UN roundtable on April 10. I do not see anything preventing my attendance at this point, but we do need to run this through OGA, maybe Global Affairs, and also run it by the Mission to the UN. Please let me know how we should proceed-what you need us to do. Thank you, Scott From: Lisa Correnti [mailto: lisa@c-fam.org1 Sent: Friday, March 23, 2018 12:28 PM To : Lloyd, Scott (ACF) Subject: Re: Scott Lloyd Dear Scott, It was a pleasure speaking with you today. Attached please find an invitation to speak at the April 10 side event at UN headquarters. Also attached is a draft concept note. Many thanks for your consideration. Best, Lisa /\MERICAi\ pVERSIGHT EXT-18-248-B-000177 Lisa Correnti Exec utive Vice Pre sident Cente r for Fam ily and Human Right s (C-Fam) lisa@c -fam. org NY: (212) 754 -5948 DC: (202) 393-7002 On Mar 22, 2018 , at 6:02 PM , Lloyd , Scott (ACF) wrote: Hi Lisa, In the morning after 10:30 is best, on my cell (below). Thank you, Scott *** E. Scott Lloyd Director Office of Refugee Resettlement U.S. Department of Health and Human Services (202) 401- 7269 I(cell) (202) lcb}/6} scott. lloyd@acf.hhs .gov From: Lisa Corrent i [mailto: lisa@c-fam.org 1 Sent: Thursday, March 22, 2018 5:58 PM To: Huber, Valerie (HHS/OASH) Cc: Lloyd, Scott (ACF) Subject: Re: Scott Lloyd Thank yo u, Va lerie. Scott, wou ld there be a good time to call you tomorrow or Monday? Many thanks Lisa On Mar 22, 2018, at 5:54 PM , Huber , Valerie (HHS/OASH) wrote: Lisa, I've cc'd Scott to this email, so you can both converse about the invitation. /\MERICAi\ pVERSIGHT EXT-18-248-B-000178 Best, Valerie From : Lisa Correnti (mailto :lisa@c-fam.o rg] Sent: Thursday, March 22, 2018 3:42 PM To: Huber, Valerie (HHS/OASH) Subject : Scott Lloyd Dear Valerie, We are organizing a UN event on migration and we would like to extend an invitation to Scott Lloyd who heads up Office of Refugee Resettlement (ORR). Would you have an email for hi? Thank you , Lisa Lisa Correnti Executive Vice President Center for Fam ily and Human Rights (C-Fam) lisa@c-fa m. org NY: (2 12) 754-5948 DC: (202) 393-7002 Sender : Dukes, Amanda (ACF) "Lloyd, Scott (ACF) "; Recipient : "Edwards, Lauren (ACF) " Sent Date: 2018/03/29 08:50:48 /\MERICAi\ pVERSIGHT EXT-18-248-B-000179 From: Lisa Correnti To: "Lloyd, Scott (ACF) " Subject: Re: Scott Lloyd Date: 2018/03/30 14:17:36 Priority: Normal Type: Note Scott, That is fantas tic news! You will have 15-20 min to present on the administration policy and the challenges, dangers to unaccom panied minors. You can include how the administration addresses the needs of these children. Would you also be able to address how abortion advocates are using them to advance an agenda relat ive to the recent contro versy? We can have another phone call next week if helpful. Best, Lisa On Mar 30, 2018, at 10:11 AM, Lloyd, Scott (ACF) wrote: Lisa, I can make it. As part of the panel, should I have specific remarks prepared (if so, how long should they be), or is it more of a Q&A format? Thank you, Scott /\MERICAi\ pVERSIGHT EXT-18-248-B-000180 From: Lisa Corrent i [ma ilto :lisa@c-fam .org1 Sent: Friday , March 23, 2018 12:28 PM To: Lloyd, Scott (ACF) Subject: Re: Scott Lloyd Dear Scott, It was a pleasure speaking with you today . Attached please find an invitation to speak at the Apr il 10 side event at UN headquarters. Also attached is a draft concept note. Many thanks for your consid eration. Best, /\MERICAi\ pVERSIGHT EXT-18-248-B-000181 Lisa Lisa Correnti Executive Vice President Center for Family and Human Right s (C-Fam) lisa@c-fam.org NY: (212) 754-5948 DC: (202) 393-7002 /\MERICAi\ pVERSIGHT EXT-18-248-B-000182 On Mar 22, 2018, at 6:02 PM, Lloyd, Scott (ACF) wrote: Hi Lisa, In the morning after 10:30 is best, on my cell (below). Thank you, Scott /\MERICAi\ pVERSIGHT EXT-18-248-B-000183 *** E. Scott Lloyd Director Office of Refugee Resettlement U.S. Department of Health and Human Serv ices (202) 401 -7269 (202) !(b)(6) I(cell) scott.lloyd @acf.hh s.gov /\MERICAi\ pVERSIGHT EXT-18-248-B-000184 From: Lisa Correnti [mailto:lisa @c-fam.org l Sent: Thursday , March 22, 2018 5:58 PM To: Huber , Valerie (HHS/OASH) Cc: Lloyd, Scott (ACF) Subject: Re: Scott Lloyd Thank you, Valerie. Scott, would there be a good time to call you tomorrow or Monday? Many thanks Lisa /\MERICAi\ pVERSIGHT EXT-18-248-B-000185 On Mar 22, 2018 , at 5:54 PM , Huber, Valerie (HHS/OASH) wrote: Lisa, I've cc'd Scott to this email, so you can both converse about the invitation. Best, Valerie /\MERICAi\ pVERSIGHT EXT-18-248-B-000186 From: Lisa Con-enti [mailto:lisa@c-fam .org] Sent: Thursday , March 22, 2018 3:42 PM To: Huber, Valerie (HHS/OASH) Subject: Scott Lloyd Dear Valerie, We are organi zing a UN event on migration and we would like to extend an invitation to Scott Lloyd who heads up Office of Refugee Resettlement (ORR) . Would you have an email for hi? /\MERICAi\ pVERSIGHT EXT-18-248-B-000187 Thank you , Lisa Lisa Correnti Execu tive Vice Pres ident /\MERICAi\ pVERSIGHT EXT-18-248-B-000188 Center for Family and Human Rights (C-Fam) lisa@c-fa m.org NY : (212) 754-5948 DC: (202) 393-7002 /\MERICAi\ pVERSIGHT EXT-18-248-B-000189 Sender: Lisa Correnti Recipient: "Lloyd, Scott (ACF) " Sent Date: 2018/03/30 14:17:23 Delivered Date: 2018/03/30 14:17: 36 /\MERICAi\ pVERSIGHT EXT-18-248-B-000190 Pilato, Anna (ACF) To: "Lloyd, Scott (ACF) " "Dukes, Amanda (ACF) "; "Marriott, Brian (ACF) " Subject: FW: Scott Lloyd Dat e : 2018/04/06 17:41:14 Priority: Normal Type: Note Scott, My clearance is for ACF purposes, I don't know OGA or Global Affairs perspective of this event . Do you have a contact in those offices you could do a quick check in? In the email below, you said you were going to send for their clearance . From: Pilato, Anna (ACF) Sent: Wednesday, March 28, 2018 5:25 PM To : Lloyd, Scott (ACF) Cc: Dukes, Amanda (ACF) ; Marriott, Brian (ACF) (Brian.Marriott@acf.hhs.gov) Subject : RE:Scott Lloyd Hi Scott, I approve on my end. As you said in the email chain below, I am confirming that you are sending to OGA and Global Affairs. I'm not sure about the Mission to the UN, do you have a specific contact name? If you feel that's necessary then feel free, but I'm not requiring that. Please keep me posted and we wi ll look for submission of your remarks . Thanks. Best, Anna From: Lloyd, Scott (ACF) Sent: Monday , March 26, 2018 10:19 AM To: Pilato, Anna (ACF) Subject: FW: Scott Lloyd Importance: High Anna, /\MERICAi\ pVERSIGHT EXT-18-248-B-000191 I'm just putting this at the top of your inbox-we'd like approval to speak at this event on the 10th in NYC,(will send planned comments through clearance) and then to attend a refugee consultation on the 12th in Philadelphia, which we submitted separate ly. Thank you, Scott From: Lloyd, Scott (ACF) Sent: Friday, March 23, 2018 12:38 PM To : Holt, Lydia (ACF); Pilato, Anna (ACF) Cc: Dukes, Amanda (ACF); Wagner, Steven (ACF) Subject: FW: Scott Lloyd Anna, I've been invited to participate at a UN roundtable on April 10. I do not see anything preventing my attendance at this point, but we do need to run this through OGA, maybe Global Affairs, and also run it by the Mission to the UN. Please let me know how we should proceed-what you need us to do. Thank you, Scott From: Lisa Correnti [mailto: lisa@c-fam.org 1 Sent: Friday, March 23, 2018 12:28 PM To : Lloyd, Scott (ACF) Subject: Re: Scott Lloyd Dear Scott, It was a pleasure speaking with you today. Attached please find an invitation to speak at the April 10 side event at UN headquarters. Also attached is a draft concept note . Many thanks for your consideration. Best, Lisa Lisa Correnti Executive Vice Pres ident Center for Fam ily and Human Rights (C-Fam) lisa@c-fam.org NY: (212) 754-5948 DC : (202) 393-7002 /\MERICAi\ pVERSIGHT EXT-18-248-B-000192 On Mar 22, 2018 , at 6:02 PM, Lloyd , Scott (ACF) wrote: Hi Lisa, In the morning after 10:30 is best, on my cell (below). Thank you, Scott *** E. Scott Lloyd Director Office of Refugee Resettlement U.S. Department of Health and Human Services (202) 401-7269 (202) !wrote: Lisa, I've cc'd Scott to this email, so you can both converse about the invitation. Best, Valerie From : Lisa Correnti (mailto:lisa@c-fam.org) Sent : Thursday, March 22, 2018 3:42 PM To : Huber, Valerie (HHS/OASH) Subjec t: Scott Lloyd /\MERICAi\ pVERSIGHT EXT-18-248-B-000193 Dear Valerie, We are organ izing a UN event on migrat ion and we wou ld like to extend an invitation to Scott Lloyd who heads up Office of Refugee Resett lement (ORR). Would you have an email for hi ? Thank you, Lisa Lisa Corrent i Exec utive Vice President Center for Family and Human Rights (C-Fam) lisa@c-fam.org NY: (212) 754-5948 DC : (202) 393-7002 Sender: Pilato, Anna (ACF) "Lloyd, Scott (ACF) "; "Dukes, Amanda (ACF) "; "Marriott, Brian (ACF) " Sent Date : 2018/04/06 17:41:13 Delivered Date : 2018/04/06 17:41:14 /\MERICAi\ pVERSIGHT EXT-18-248-B-000194 Date: 20 18/04/06 19:09:23 Priority: Normal Type: Contact Display Name: Susan Email Display Name: Susan Email Address: susan@c-fam.org I Sent Date: !2018/04/06 19:09:23 /\MERICAi\ pVERSIGHT EXT-18-248-B-000195 Lloyd, Scott (ACF) To: "Lisa Correnti " Subject: Re: Scott Lloyd Date: 2018/04/09 19:10: 18 Priority : Normal Type : Note Hi Lisa, No power point. I'll see you there! Scott On: 09 April 2018 08:07, "Lisa Correnti" wrote: Good morning Scott, Looking forward to your participation tomorrow. Should you have a PPT please send to us today as we run all from one laptop . To access the UN we have a pass for you. Please meet us outside the UN tomorrow morning at 9:30am at the 1st and 46th Street entrance. Here ' s my cell ... just text me when you arrive: (619) lw rote: Lisa, I can make it. As part of the panel, should I have specific remarks prepared (if so, how long should they be), or is it more of a Q&A format? Thank you, Scott From: Lisa Correnti [ mailto:lisa@c-fam .org 1 Sen t: Friday , March 23, 2018 12:28 PM To: Lloyd, Scott (ACF) Subject: Re: Scott Lloyd /\MERICAi\ pVERSIGHT EXT-18-248-B-000197 Dear Scott, It was a pleasure speaking with you today. Attached please find an invitation to speak at the April 10 side event at UN headquarters. Also attached is a draft concept note. Many thanks for your consideration. Best, Lisa Lisa Correnti /\MERICAi\ pVERSIGHT EXT-18-248-B-000198 Executive Vice President Center for Family and Human Right s (C-Fam) lisa@c-fam .org NY: (212) 754-5948 DC: (202) 393-7002 /\MERICAi\ pVERSIGHT EXT-18-248-B-000199 On Mar 22, 2018 , at 6:02 PM, Lloyd , Scott (ACF) wrote: Hi Lisa, In the morning after 10:30 is best, on my cell (below). T hank you , Scott *** E. Scott Lloyd /\MERICAi\ pVERSIGHT EXT-18-248-B-000200 Director Office of Refugee Resettlement U.S. Department of Health and Human Services (202) 40 I -7269 (202) !{b l(6l I(cell) scott. lloyd@acf.h hs .gov From : Lisa Correnti [mailto:lisa@c-fam.org] Sent: Thursday, March 22, 2018 5:58 PM /\MERICAi\ pVERSIGHT EXT-18-248-B-000201 To: Huber, Valerie (HHS/OASH) Cc: Lloyd, Scott (ACF) Subject: Re: Scott Lloyd Thank you, Valerie . Scott , would there be a good time to call you tomorrow or Monday ? Many thank s Lisa On Mar 22, 2018, at 5:54 PM, Huber , Valerie (HHS/OASH) wrote: /\MERICAi\ pVERSIGHT EXT-18-248-B-000202 Lisa, I've cc'd Scott to this email, so you can both converse about the invitation. Best, Valerie From: Lisa Correnti [mailto:lisa@c-fam.org] Sent: Thursday, March 22, 2018 3:42 PM To: Huber , Valerie (HHS/OASH) Subject: Scott Lloyd /\MERICAi\ pVERSIGHT EXT-18-248-B-000203 Dear Valerie , We are organizing a UN event on migration and we would like to extend an invitation to Scott Lloyd who heads up Office of Refugee Resettlement (ORR) . Would you have an email for hi? Thank you, /\MERICAi\ pVERSIGHT EXT-18-248-B-000204 Lisa Lisa Correnti Execut ive Vice President Center for Family and Human Rights (C-Fam) lisa@c-fam .org /\MERICAi\ pVERSIGHT EXT-18-248-B-000205 NY: (212) 754-5948 DC: (202) 393-7002 Lloyd, Scott (ACF) Recipient : " Lisa Correnti " Sent Date: 2018/04/09 19:10: 17 Delivered Date: 2018/04/09 19:10:18 /\MERICAi\ pVERSIGHT EXT-18-248-B-000206 Lloyd, Scott (ACF) To: "Susan Yoshihara " Subject : Re: Meeting with Sisters of Life Date : 2018/04/09 19:13:00 Priority : Normal Type : Note Hi Susan, That sounds great. I will taxi up and meet you there. I will be staying across from the UN at the Hilton. See you tomorrow, Scott On: 08 April 20 18 17: 10, "Susan Yoshihara " wrote: /\MERICAi\ pVERSIGHT EXT-18-248-B-000207 Scott, They've invited us to the convent or breakfast at 8am which will give us time to get to the UN by 9:30. The address is 320 E. 66th. Where will you be staying? I will be coming from the West Side via tax i so may be able to pick you up on the way . Othe rwise we can meet there. Mother Agnes said she will definitely try to get there. We will meet with Sr. Benedicta and Sr. Magda lene from the 66th St. Convent. My cell is 40 l i,_(b-)(6_) _ _. Best, Susan On Fri, Apr 6, 20 18 at 11:50 AM, Susan wrote: /\MERICAi\ pVERSIGHT EXT-18-248-B-000208 Scott That's great. I let them know and also that you need to be at the UN by 0930. Will get back to you on the time and place. Susan On Apr 6, 2018 at 11:35, wrote: Hi Susan, I'd love to meet with Mother Agnes . I will be there before the event, so that should be no problem. I am pretty flexible with place and time as I will be arriving in the city the night before. /\MERICAi\ pVERSIGHT EXT-18-248-B-000209 Just let me know! God bless, Scott From: Susan [mailto:susan @c-fam.org 1 Sent: Thursday, April 05, 2018 10:10 PM To: Lloyd , Scott (ACF) Subject: Meeting with Sisters of Life Scott, /\MERICAi\ pVERSIGHT EXT-18-248-B-000210 Mother Agnes would like to meet with you when you come Tuesday. I don't know your travel schedule but are you able to meet before the event - at their convent or at Holy Family across the street from the UN? Thanks, Susan Yoshihara /\MERICAi\ pVERSIGHT EXT-18-248-B-000211 Lloyd, Scott (ACF) Recipient: "Susan Yoshihara " Sent Date: 2018/04/09 19:13:00 /\MERICAi\ pVERSIGHT EXT-18-248-B-000212 From: Lisa Correnti To: "Lloyd, Scott (ACF) " Subject: Re: Speaker Inv ite Date: 2018/0 4/20 12:33 :36 Priority: Normal Type: Note Thank you, Scott. On Apr 20, 2018 , at 11:00 AM , Lloyd , Scott (ACF) wrote: Hi Lisa, Thank you for the invite . I will see if this is possible and get back to you. Scott From: Lisa Corrent i [mailto :lisa@c-fam .org1 Sent: Thursday , Apri l 19, 20 18 10:48 AM To: Lloyd, Scott (ACF) Subj ect : S eaker Invite /\MERICAi\ pVERSIGHT EXT-18-248-B-000213 Dear Scott, Attached please find an invite letter and draft agenda for an anti-trafficking briefing on May 17 in Washington DC at the Russell Senate bldg. We invite you to presen t on the vulnerability of unaccompanied minors in falling prey to traffickers and U.S. government programs that protect these children whi le waiting to be united with family. Your panel will begin at 3pm . Please see attached for more information. Happy to discuss by phone . Best regards, Lisa Lisa Correnti Exec utive Vice President Center for Family and Human Rights (C-Fam) lisa@c-fam.org NY: (212) 754-5948 /\MERICAi\ pVERSIGHT EXT-18-248-B-000214 DC: (202) 393-7002 Sender: Lisa Correnti Recipient: "Lloyd, Scott (ACF) " Sent Date: 2018/04/20 12:32 :43 Delivered Date: 2018/04/20 12:33 :36 /\MERICAi\ pVERSIGHT EXT-18-248-B-000215 To: " Pilato, Anna (ACF) " Subject: Fwd: Event f lyer Date: 20 18/05/01 09:06 : 13 Priority: Norma l Type: Note Anna Any objections in principle? Thank you, Scott From: "Lisa Corrent i" Subject: Event flyer Date : 26 April 20 18 08:20 To: "Lloyd, Scott (ACF)" Recipient: " Pilato, Anna (ACF) " Sent Date: 2018/05/01 09:06 : 12 Delivered Date: 20 18/05/01 09:06:13 Message Flags: Unsent /\MERICAi\ pVERSIGHT EXT-18-248-B-000216 Pilato, Anna (ACF) "Lloyd, Scott (ACF) "; To: "Marriott, Brian (ACF) " Subject : Fwd: Event flyer Date : 2018/05/01 09:22:56 Priority: Normal Type: Note No, but who else is participating in the panel with you? Can you send the original invitation? Since it' s on the Hill we may want to loop in OLAB. Brian, any input on this? From: "Lloyd, Scott (ACF)" Subject: Fwd: Event flyer Date: 01 May 2018 09:06 To: "Pilato, Anna (ACF)" /\MERICAi\ pVERSIGHT EXT-18-248-B-000217 Anna Any object ions in principle? Thank you, Scott From: "Lisa Correnti" Subject: Event flyer Date : 26 Apr il 20 18 08:20 To: "Lloyd, Scott (ACF)" Scott , Attached is the event flyer. Since all govt reps are pend ing they are not listed. As well we are hoping Sen . Lankford will make opening remarks. It is a half day event but of cou rse we would /\MERICAi\ pVERSIGHT EXT-18-248-B-000218 only expect you for your panel which is scheduled for 3pm. Best regards , Lisa Pilato, Anna (ACF) " Lloyd, Scott (ACF) "; Recipient: "Mar riott, Brian (ACF) " Sent Date: 20 18/05/01 09:22:53 Delivered Date: 20 18/05/01 09:22:56 /\MERICAi\ pVERSIGHT EXT-18-248-B-000219 Marriott, Brian (ACF) "Pilato, Anna (ACF) "; To: " Lloyd, Scott (ACF) " Subject: RE: Event flyer Date : 2018/05/01 11:43: 19 Priority: Normal Type : Note (b)(5) From: Pilato, Anna (ACF) Sent: Tuesday, May 01, 2018 9:23 AM To: Lloyd, Scott (ACF) ; Marriott, Brian (ACF) Subject: Fwd: Event flyer No, but who else is participating in the panel with you? Can you send the original invitat ion? Since it's on the Hill we may want to loop in OLAB. Brian, any input on this? From: "Lloyd, Scott (ACF)" Subject: Fwd: Eve nt flyer Date : 01 May 20 18 09 :06 To : "Pilato, Anna (ACF)" Anna Any object ions in principle? Thank you, Scott From: "Lisa Corre nti" Subject: Event flyer /\MERICAi\ pVERSIGHT EXT-18-248-B-000220 Date : 26 April 2018 08:20 To: "Lloyd, Scott (ACF)" Scott, Attached is the event flyer. Since all govt reps are pending they are not listed. As well we are hoping Sen . Lankford will make openi ng remarks. It is a half day event but of course we would only expect you for your panel which is scheduled for 3pm. Best regards , Lisa Marriott, Brian (ACF) " Pilato, Anna (ACF) "; Recipient: "Lloyd, Scott (ACF) " Sent Date: 2018/05/0111:43:18 Delivered Date: 2018/05/01 11:43:19 /\MERICAi\ pVERSIGHT EXT-18-248-B-000221 TraHickinR IJldwomen's andChildren's Health: Interven ion,, Recovery andPrevention Trafficking and sexual exploitation is a gross violation of human rights inflicting great harm to women and girls. Experts will examine the health impact as well as treatment and prevention programs to safeguard at risk women and children. SPEAKERS: Tanya Street, Survivor, Member, President's National Advisory Council on Trafficking Box lunch served at 12 PM ORGANIZERS: Dr. Donna Harrison, Ob-Gyn, President, AAPLOG Global Centurion Foundation Center for Family and Human Rights (C-Fam) Dr. Yaro Garcia, Clinical Psychologist, Florida Gulf Coast University CO-SPONSORED BY: Hope Green, Survivor and Service Provider American Association of Pro-Life Ob -Gyns (MPLOG ) Speaking Hope The Justice Center Center Against Forced Abortion Operation Outcry The Charles and Mary Crossed Foundat ion Feminists Choos ing Life of New York Identifiable Me Rahab's Hideaway Civil Rights for the Unborn Frederick Douglass Leadership Institute Human Coalition Dean Nelson, Pastor, National Outreach Director, Human Coalition Cynthia Collins, Founder, Speak Hope Chuck Donovan, President, Charlotte Lozier Institute Betty McDowell, Heartbeat International, TIP Training Pregnancy Resource Centers Marlene Carlson, Survivor and Service Provider Laura Lederer, J.D., President, Global Centurion Foundation EXT-18-248-B-000222 (c-Fam -Fam CENTER FOR FAMILY & HUMAN RIGHTS NEW YORK· WASH I NGTON. DC E. Scott Lloyd Director Office of Refugee Resettlement U.S. Department of Health and Human Services 200 Independence Avenue, S.W. Washington, D.C. 20201 April 19, 2018 Dear Scott, Together with the anti-trafficking organization Global Centurion we extend an invitation to you to participate in a briefing that examines the health consequences of women and girls who are victims of trafficking and prostitution. Additionally, panelists will present on best practices to arm and protect women and girls from being vulnerable to trafficking. The briefing is scheduled from 12:00pm to 4:00pm on May 17, 2018 in Room 485 of the Russell Senate Office building. We are grateful to Sen. Lankford for making this event possible where we hope to educate staffers and advocates. Several anti-trafficking organizations will participate both as panelists and as co-sponsoring organizations. We have reserved the fourth panel to hear from experts from the Trump administration to inform on policy and programs that assist women and girls both domestically and internationally. We invite you to present on the vulnerability of unaccompanied minors in falling prey to traffickers and U.S. government programs that protect these children while waiting to be united with family. More information on the event can be found in the accompanying draft agenda. We hope you will accept this invitation. We look forward to a fruitful discussion. Best regards, Lisa Correnti Executive Vice President /\MERICAi\ pVERSIGHT EXT-18-248-B-000223 HALF-DAV EVENT ON THE HI LL- DRAFT May 17, 2018 12 :00 - 4 :00 pm Russell Senate Bldg - Room 485 Welcome and Introduction - LUNCH OFFERED Opening Remarks - Senator James Lankford and Rep. Chris Smith Panel 1 - The Problem - Moderated by Laura Lederer, J.D. -What Does the Research Tell Us - CONFIRMED Tanya Street- Survivor, member President's Natl Advisory Council on Trafficking)- CONFIRMED Dr. Donna Harrison {Ob-Gyn, President, AAPLOG) - CONFIRMED Dr. Yara Garcia {Florida Gulf Coast University clinical psychologist) - CONFIRMED Panel 2 - Provider Perspective/Case Studies - Moderated by Hilary Chester, USCCB,{INVITED) Hope Green, Survivor and Service Provider - CONFIRMED Dean Nelson, Pastor, and Consultant, Human Coalition - CONFIRMED Cynthia Collins, Speaking Hope - CONFIRMED Panel 3 -The Way Forward: Double Panel - Moderated by Chuck Donovan, President, Charlotte Lozier Institute {INVITED) Bette McDowell, Heartbeat International, TIP Training Pregnancy Resource Centers CONFIRMED Clydette Powell, Board member, CMDA - CONFIMRED Marlene Carlson, Survivor and Service Provider- CONFIRMED Panel 3 Part 2 - Government Panel - Moderated by Valerie Huber, HHS- Preventing Trafficking by Training Teens to Avoid Sexually Risky Behavior and Predatory Relationships {INVITED) Scott Lloyd, ORR, HHS - Programs to Address Abortion and Trafficking on the Border {INVITED) William Wubbenhorst - Integrating Anti-Trafficking Programming into FYSB(Family Youth Service Bureau Programs) {INVITED) Michele Bekkering, - Bureau of Economic Growth, Education, and Environment (E3) {INVITED) Closing Remarks /\MERICAi\ pVERSIGHT EXT-18-248-B-000224 Date: May 17th Time of Day: 12:00 - 4:00 pm Name of Event: Human Trafficking and Women's and Children's Health Issues Point of ContacUEmail/Phone: Laura J. Lederer 703 919 6828 Type of event: Briefing Food or drink: Lunch, Coffee , Tea and Dessert Number of Attendees: 100 Full Event Description: Human trafficking impacts all aspects of the victim's health, but especially reproductive, procreative, and other women's health issues . In one study , 71.2% of females got pregnant at least once while being trafficking; 21.2% reported five or more pregnancies while being trafficked. Of those, 54.7% had at least one miscarriage; 29.7% had multiple miscarriages . Similarly, 55.2% had at least one abortion while 29.2% reported multiple abortions while being trafficked. 67.3% contracted an STD; 63.8% reported gynecological problems such as pelvic inflammatory disease (PID), infertility, and other serious gynecological problems. In addition, many serious communicable diseases affect women being trafficking, including hepatitis, and tuberculosis. In one recent case, out of 125 women and children apprehended in a raid on 13 brothels owned by the same trafficker, over 75% of them tested positive for TB. Finally , studies indicate that thousands of children are born into trafficking in the U.S. today. While there is little research on this problem, the negative physical, mental and emotional repercussions for such children are considerable and deserve further attention. Co-Sponsors - All Co-Sponsors are Pro-Life , Anti Trafficking NGOs (Confirmed): Global Centurion C-FAM American Association of Pro -Lif e Ob-Gyns {AAPLOG) Speaking Hope The Justice Center Center Against Forced Abortion Op eration Outcry The Charles and Mary Crossed Foundation Feminists Choosing Life of New York Identifiable Me Rahab 's Hideaway Civil Rights for the Unborn Co-Sponsors (Awaiting Confirmation) Char lotte Lozier Institute Christian Medica l and Dental Associat ion (CMDA) Heartbeat Internat ional Human Coalition USCCB Catholic Char ities /\MERICAi\ pVERSIGHT EXT-18-248-B-000225 Dukes,Amanda (ACF) To: "Lloyd, Scott (ACF) " Subj ect: Re: Speaker Invite Date: 2018/05/0114:11:53 Priority: Normal Type: Note Will do! On: 01 May 2018 12:38, "Lloyd, Scott (ACF)" wrote : Amanda, /\MERICAi\ pVERSIGHT EXT-18-248-B-000227 I'm not sure wha t thi s form is ...could you track it down and fill it out ? I can help with any que stion s if they ari se. Thank you , Scott From: "Marriott , Bri an (ACF)" Subject: FW: Speaker Invite Date: 01May201811:44 To: "Pilato, Anna (ACF)" , "Llo yd, Scott (ACF)" Scott, Be sure to have your staff send in a public speaking request form fo r this. /\MERICAi\ pVERSIGHT EXT-18-248-B-000228 Brian From: Pilato, Anna (ACF) Sent: Tue sday, May 01, 2018 9:37 AM To: Marriott , Brian (ACF ) Subject : Fwd : Speak er Invite FYI From: "Lloyd, Scott (ACF)" Subject: Fwd: Speaker Invite Date: 01 May 2018 09:29 To: "Pilato, Anna (ACF)" /\MERICAi\ pVERSIGHT EXT-18-248-B-000229 Begin Fotwarded Message : From : "Lisa Correnti" Subject: Speaker Invite Date: 19 April 2018 10:50 To: "Lloyd, Scott (ACF)" Dear Scott, Attached please find an invite letter and draft agenda for an anti-trafficking briefing on May 17 in Wash ington DC at the Russell Senate bldg. We invite you to pre sent on the vulnerability of unaccompanied minors in falling prey to traffick ers and U.S. government programs that protect these children while waiting to be united with fami ly. Your pane l w ill begin at 3pm. /\MERICAi\ pVERSIGHT EXT-18-248-B-000230 Please see attached for more infom1ation. Happy to discuss by phone. Best regards , Lisa Lisa Corre nti Executive Vice President Center for Fam ily and Hum an Rights (C-Fam) lisa@c-fam .org NY: (212) 754-5948 DC: (202) 393-7002 Dukes, Amanda (ACF) /\MERICAi\ pVERSIGHT EXT-18-248-B-000231 R . . t· "Lloyd, Scott (ACF) " Sent Date: 2018/05/0114:11 :53 /\MERICAi\ pVERSIGHT EXT-18-248-B-000232 Wynne, Maggie (HHS/IOS) "Wagner, Steven (ACF) "; "Lloyd, Scott (ACF) " Subject: FW: Speaker Invite Date: 2018/05/07 09:13:23 Import ance: High Priority: Urgent Type: Note (b)(5) -Maggie Deliberative and pre-decisional communication From: Lloyd, Scott (ACF) Sent: Monday, May 7, 2018 7:59 AM To : Wagner, Steven (ACF) ; Wynne, Maggie (HHS/IOS) Subject : FW: Speaker Invite Import ance : High Steve and Maggie, This is an invite from cfam for a panel on trafficking on May 12.I (b)(5) I (b)(5) Scott /\MERICAi\ pVERSIGHT EXT-18-248-B-000233 From: Marriott, Brian (ACF) Sent: Tuesday, May 01, 2018 11:44 AM To: Pilato, Anna (ACF); Lloyd, Scott (ACF) Subject: FW: Speaker Invite Scott, Be sure to have your staff send in a public speaking request form for this. Brian From: Pilato , Anna (ACF) Sent: Tuesday, May 01, 2018 9:37 AM To : Marriott, Brian (ACF) Subject: Fwd: Speaker Invite FYI From: "Lloy d, Scott (ACF)" Subject: Fwd: Speaker Invite Date: 01 May 2018 09:29 To: "Pilato , Anna (ACF)" Begin Forwarded Message: From: "Lisa Correnti" Subject: Spea ker Invite Date: 19 Apr il 2018 10:50 To: "Lloyd, Scott (ACF)" Dear Scott, Attached p lease find an invite letter and draft agenda for an anti-trafficki ng briefing on May 17 in Washington DC at the Russell Senate bldg. We invite you to pre sent on the vulnerab ility of unaccompanied minor s in falling prey to trafficker s and U.S. gove rnment program s that protect these children while waiting to be united with family. Your panel will begin at 3pm. /\MERICAi\ pVERSIGHT EXT-18-248-B-000234 Please see attached for more infom1ation. Happy to discuss by phone. Best regards, Lisa Lisa Corrent i Execut ive Vice Pres ident Center for Family and Human Rights (C-Fam) lisa@c-fam.org NY: (212) 754-5948 DC : (202) 393-7002 Wynne, Maggie (HHS/IOS) "Wagner, Steven (ACF) " ; " Lloyd, Scott (ACF) " Sent Date: 2018/05/07 09:13:21 Delivered Date: 2018/05/07 09:13:23 /\MERICAi\ pVERSIGHT EXT-18-248-B-000235 Hayes, Sean (HHS/ASL) "Lloyd, Scott (ACF) "; To: " Logan, Scott (ACF) " Subject: RE: Speaker Inv ite Date: 2018/05/07 13:42:34 Priority: Normal Type: Note Hang tight we may have a hearing that day From: Lloyd, Scott (ACF) Sent: Monday, May 07, 2018 1:42 PM To: Logan, Scott (ACF); Lawrence, Courtney (HHS/ASL); Hayes, Sean (HHS/ASL) Subject: RE: Speaker Invite No, I haven't . From: Logan, Scott (ACF) Sent: Monday, May 07, 2018 1:41 PM To: Lloyd, Scott (ACF); Lawrence, Courtney (HHS/ASL); Hayes, Sean (HHS/ASL) Subject: RE: Speaker In vite Have you accepted the speaking request yet? Scott Logan Director Div ision of Legislative and Regulatory Affairs Office of Legislative Affairs and Budget Administration for Children and Families U.S. Department of Health and Human Services 330 CST , SW Suite 50200 Washington, D.C. 20201 202.401.4529 From: Lloyd, Scott (ACF) Sent: Monday, May 07, 2018 9:47 AM To: Logan, Scott (ACF) ; Lawrence, Courtney (HHS/ASL) ; Hayes, Sean (HHS/ASL) Subject: FW: Speaker Invite Importance : High Scott and Sean, Attached is a speaker invite from C-fam. Magg ie thought I should bring it to your attention since it is in the Senate office building and could include Senate staffers. /\MERICAi\ pVERSIGHT EXT-18-248-B-000236 Please let me know if you have any concerns or feedback. Thank you, Scott From: Marriott, Brian (ACF) Sent: Tuesday, May 01, 2018 11:44 AM To: Pilato, Anna (ACF); Lloyd, Scott (ACF) Subject: FW: Speaker Invite Scott , Be sure to have your staff send in a public speaking request form for this. Brian From: Pilato, Anna (ACF) Sent: Tuesday, May 01, 2018 9:37 AM To: Marriott, Brian (ACF) Subject: Fwd: Speaker Invite FYI From: "Lloyd, Scott (ACF)" Subject: Fwd: Speaker Invite Date : 01 May 2018 09:29 To: "Pilato, Anna (ACF)" Begin Fo1warded Message: From: "Lisa Correnti" Subject: Spea ker Invite Date: 19 Ap ril 2018 10:50 To: "Lloyd, Scott (ACF)" Dear Scott , Attached please find an invite letter and draft agenda for an anti-trafficking briefing on May 17 in Washington DC at the Russell Senate bldg. /\MERICAi\ pVERSIGHT EXT-18-248-B-000237 We invite you to present on the vulnerability of unaccompanied minors in falling prey to traffickers and U.S. gove rnment programs that protect these children while waiting to be united with family. Your panel w ill begin at 3pm. Please see attac hed for more information. Happy to discuss by phone. Best regards , Lisa Lisa Correnti Executive Vice President Center for Family and Human Rights (C-Fam) lisa@c- fam.or g NY: (212) 754-5948 DC: (202) 393-7002 Hayes, Sean (HHS/ASL) Recipient: "Lloyd, Scott (ACF) "; " Logan, Scott (ACF) " Sent Date: 2018/05/07 13:42:33 Delivered Date: 2018/05/07 13:42:34 /\MERICAi\ pVERSIGHT EXT-18-248-B-000238 Wagner, Steven (ACF) "Lloyd, Scott (ACF) "; "Wynne, Maggie (HHS/IOS) "; "Marriott, Brian (ACF) " Subject: RE: Speaker Invite Date: 2018/05/08 08:57:47 Priority: Normal Type: Note Scott, please decline this invitation . Maggie or I can cover . Thank you. From: Lloyd, Scott (ACF) Sent: Monday, May 07, 2018 7:59 AM To: Wagner, Steven (ACF); Wynne, Maggie (HHS/IOS) Subject: FW: Speaker Invite Importance: High Steve and Maggie, This is an invite from dam for a panel on trafficking on May 12] (b)(5) I (b)(5) Scott From: Marriott, Brian (ACF) Sent: Tuesday, May 01, 2018 11:44 AM To: Pilato, Anna (ACF); Lloyd, Scott (ACF) Subject: FW: Speaker Invite Scott, Be sure to have your staff send in a public speaking request form for this. Brian From: Pilato, Anna (ACF) Sent : Tuesday, May 01, 2018 9:37 AM To : Marriott, Brian (ACF) Subject : Fwd: Speaker Invite /\MERICAi\ pVERSIGHT EXT-18-248-B-000239 FYI From: "Lloyd, Scott (ACF)" Subject: Fwd: Speaker Invite Date : 01 May 2018 09:29 To: "Pilato , Anna (ACF)" Begin Fo1warded Message: From : "Lisa Correnti" Subject: Speaker Invite Date: 19 April 2018 10:50 To: "Lloyd, Scott (ACF)" Dear Scott, Attached please find an invite letter and draft agenda for an anti-trafficking briefing on May 17 in Wash ington DC at the Russell Senate bldg. We invite you to present on the vulnerability of unaccompanied minors in falling prey to traffickers and U.S. government programs that protect these children while waiting to be united with fami ly. Your panel w ill begin at 3pm. Please see attached for more information. Happy to discuss by phone. Best regards, Lisa Lisa Corrent i Execut ive Vice Pres ident Center for Family and Human Rights (C-Fam) lisa@c-fam.org NY: (212) 754-5948 DC: (202) 393-7002 Wagner, Steven (ACF) Recipient: " Lloyd, Scott (ACF) "; "Wynne, Maggie (HHS/1O5) "; " Marriott, Brian (ACF) " Sent Date: 2018/05/08 08:57:46 Delivered Date: 2018/05/08 08:57:47 /\MERICAi\ pVERSIGHT EXT-18-248-B-000241 From: Lisa Correnti To: "Lloyd, Scott (ACF) " Subject: Re: Event flyer Date: 20 18/05/08 10:24 :58 Priority: Normal Type: Note Scott, Thanks so much for passing it on. I appreciate your help with this. Wish you all the best with the important work you are doing. Blessings, Lisa On May 8, 2018, at 6:15 AM, Lloyd, Scott (ACF) wrote : Lisa, I will not be able to attend . I have forwarded the invite to others who are a bit closer to the traffick ing issue- they will reach out to you if they are able to attend. Thank you for thinking of me. God bless, Scott From: Lisa Correnti [m ailto:lisa@c-fam.org1 Sent: Thursday, April 26, 2018 8:20 AM To: Lloyd, Scott (ACF) Subject: Event flyer Scott, Attached is the event flyer. Since all govt reps are pending they are not listed. As well we are hoping Sen. Lankford will make opening remarks. It is a half day event but of course we would only expect you for your panel which is scheduled for 3pm. Best regards, Lisa /\MERICAi\ pVERSIGHT EXT-18-248-B-000242 Sender: Lisa Correnti Recipient: " Lloyd, Scott (ACF) " Sent Date: 20 18/05/08 10:24 :30 Delivered Date: 20 18/05/08 10:24 :58 /\MERICAi\ pVERSIGHT EXT-18-248-B-000243 Chien, Nina (O5/ASPE) "Chien, Nina (O5/ASPE)"; "OS - ASPE"; "Shannon Mok (Shannon.Mok@cbo.gov)"; "Angela.Rachidi@AEI.org"; "romich@u.washington.edu"; "ocass@manhattan-institute.org"; "Wagner, Steven (ACF) "; "Powers, Mary (ACF) 11 ; "Negri, Warren A. (ACF) "; "Carter, Clarence (ACF) "; "Goldstein, Naomi (ACF) "; "Lekan, Scott (ACF) "; "Christian, Shannon (ACF) "; "Clark, Barbara (HHS/ASL)"; "Keckler, Charles (HHS/IOS) "; "Wynne, Maggie (HHS/IOS) "; "Smith, Andrew (ACF) "; "Townsend, Kara (HHS/ASPE)"; "Kevin.C.Corinth@cea.eop.gov "; "Jeffrey.L.Schlagenhauf@omb .eop.gov"; "Lloyd, Scott (ACF) "; "Duran, Mishaela (ACF) "; "Milner, Jerry (ACF) " ; "Wubbenhorst, William (ACF) "; "Barlow, Amanda (ACF) "; "George, Jolleen Janelle (ACF) "; " Linehan,Ann (ACF) "; "Kelley, Curtis (HHS/ASFR)"; "Curtis, Jillian (HHS/ASFR) "; "McMillen, Cheryl (HHS/ASFR) "; " Horn, Wade (HHS/IOS) (CTR) "; "O'Brien, John (HHS/ASPE)"; "Stevenson, Sarah-Lloyd(HHS/IO5) "; "Ecoffey, Stacey (HHS/IEA) "; "Kavanagh, Laura (HRSA) "; "Coulouris, Natasha (HRSA) "; "Willis, David (HRSA) "; "Pilato, Anna (ACF) "; "Donato, Ingrid (SAMHSA/CMHS)"; "Kleinschmidt, Arthur (SAMHSA/CSAT) "; " Erwin.Molly.E@do l.gov"; "Ja'Ron.K.Smith@who.eop.gov"; "Laura.cunliffe@who.eop.gov"; "Balderston, Deirdre (HHS/OGC)"; "brian.neale@cms.hhs.gov"; "Moughalian, Jen (HHS/ASFR) "; " Lynch, Calder (CMS/OA) "; "Bowman, Matthew (HHS/OGC)"; "Lawrence, Courtney (HHS/ASL)"; "O'Dell, Ben (OS/CFBNP)"; "Trueman, Laura (HHS/IEA) "; "Stevenson, Marquita (ACL) (CTR) "; "Robertson, Lance (ACL) "; "Wheatley PhD., Ellen (ACF) "; "Logan, Scott (ACF) "; "Wolfe, Kenneth (ACF) "; "Jones, Molly (ACF) "; "Fisher, Patrick (ACF) "; "Golonka, Susan (ACF) "; "McDonald, Robin (ACF) "; "Brodowski, Melissa(ACF) " ; "Joyner, Deric (ACF) (CTR) "; "Fucello, Mark (ACF) "; "Webb, Mary Bruce (ACF) "; "Brown, Brett (ACF) "; /\MERICAi\ pVERSIGHT EXT-18-248-B-000245 " Rathgeb, Colleen (ACF) "; "Chon, Katherine (ACF) "; "Zukowski, Amy (ACF) "; "Henderson, Sharon (ACF) "; " Powell, Debbie A. (ACF) "; "Martin, Vernae (ACF) "; "Sorensen, Elaine (ACF) "; "Lacina, Barbara (ACF) "; "Nerenberg, Laura (ACF) "; "Mueggenborg, Mary (ACF) "; "Illangasekare, Samantha (ACF) "; "McCormack,Tiffany (ACF) "; " Forster, Hilary (ACF) "; "Jain, Kriti (ACF)(CTR) "; "Schmitt, Emily (ACF) "; "Constance, Nicole (ACF) "; " Popham,Amelia (ACF) "; "Reid, Megan (ACF)(CTR) "; "Kabak, Victoria (ACF) "; "Clum, Kimberly (ACF) "; "Wulff, Carli (ACF) "; "Clopet, Tracy (ACF)(CTR) "; "Blandon, Alysia (ACF) (CTR) "; "Newell, Gabrielle (ACF) (CTR) "; " DiSalvo, Clare (ACF) (CTR) "; "Frohlich, Lauren (ACF) "; "Germanis, Peter (ACF) "; "List, Deborah (ACF) "; "Woolverton, Maria (ACF) "; "Martinez-Beck,Ivelisse (ACF) "; "Le, Minh (ACF) "; "Demma, Rachel (ACF) "; "Williams, Andrew (ACF) "; "Campbell, Megan (ACF) "; "Abdi, Abdihakin (ACF) "; " Beltangady, Moushumi (ACF) "; "Wiseman, Michael (ACF)(CTR) "; "Johnson, Melissa (ACF) "; "Hayes, Michael (ACF) "; " Fairley, Kenya (ACF) "; "Orsinger, Rachel (ACF) "; "White, LeBretia (ACF) "; "Kelvington, Areon (ACF) "; " Baldwin PhD., Melinda (ACF) "; "Simcox, Edwin (OS/IOS) "; "Koyani, Sanjay (OS/IOS) "; "Morris, Genevieve(OS/ONC/IO) "; " Rancourt, John H. Jr. (OS/ONC)"; "Novak, Thomas (OS/ONC) "; "Traver, Christopher (ACF) "; "Henriksen, Maureen (ACF) "; " Morse, Jonathan D. (CMS/CPI) "; "Washington-Thomas, Lisa (ACF) "; "Murray, James (ACF) "; "Jones, David (ACF) "; " Macrae,Jim (HRSA) "; "Burbank, Nick (HHS/ASFR)"; "O'Keefe, Erin (HHS\ASFR) "; "Lewandoski, Mona (OS/ASFR) "; "Williams, cameron (HHS/ASFR) "; "Simms, Jeffrey (HHS/ASFR)"; "Donley, Katherine (HHS/ASFR)"; "Weber, Mark (HHS/ASPA)"; "Scala-Foley, Marisa(ACL) "; "Melissa_Benton_Bomberger @omb.eop.gov"; "Kira_R_Fatherree@omb.eop.gov"; "Jacob_H._Kaplan@omb.eop.gov"; "Jennifer_L_Hanson@omb.eop.gov"; "Catherine_E_White2@omb.eop.gov"; "James_C._Hurban@omb.eop.gov"; "jhoef@omb.eop.gov"; "Mariarosaria_Sciannameo@omb.eop.gov"; "John_T_Tambornino@omb.eop.gov"; "Mary_E._Wiggins@omb.eop.gov"; "Brian_A_Widuch@omb.eop.gov"; "Diana_F_Epstein@omb.eop.gov"; "neil_b._danberg@omb.eop.gov"; "Janet.McCubbin@treasury.gov "; "Deena.Ackerman@treasury.gov"; "barbara.murphy@fns.usda.gov"; "Richard.Lucas@fns.usda.gov"; "Melissa.Abelev@fns.usda.gov "; "Susan.Wilschke@ssa.gov "; "alex.f.coccia@gmail.com"; "mzaslow@srcd.org"; "NBlain@nas.edu"; ''asaph.glosser@mefassociates.com"; "Aditommaso@cns.gov"; "mhyde@cns.gov"; "mgish@crs.loc.gov"; "JTOLLESTRUP @crs.loc.gov"; "AFERNANDES @crs.loc.gov"; "ESTOLTZFUS@crs.loc.gov"; "KLYNCH@crs .loc.gov"; "GFALK@crs .loc.gov"; "MCRANDALLHOLLICK@crs.loc.gov"; "Yancey.Christina.L@DOL.GOV"; "Simonetta.Jon.A@dol.gov"; "rachel.m.shattuck@census.gov"; "rebecca.schwei@wisc.edu"; "lmberger@wisc.edu"; "palanders@wisc.edu "; "mcabbott@wisc.edu"; "info.clerkweb@mail.house.gov"; "povertystudies@aei.org"; "events@aei.org"; "ryan.streeter@aei.org"; "jerry .mande@aei.org"; "craig.gunderson@aei.org"; "Robert.doar@aei.org"; "w. Bradford.wilcox@aei.org"; "tamar.jacoby@aei.org"; "spenser.moore@ae i.org"; "Cecilia.gallogly@aei.org"; "amathur@aei.org"; "besharov@umd.edu"; "policyservices@heritage.org"; "info@heritage.org"; "robert. rector@heritage.org"; "katherine.bradley@heritage.org"; "romina.boccia@heritage .org"; "events@brookings.edu"; "communications@brookings.edu"; "cgraham@brookings.edu"; "wgale@brookings.edu"; "mkearney@brookings.edu"; "lpescatore@thehatchergroup.com"; /\MERICAi\ pVERSIGHT EXT-18-248-B-000248 "devin@thehatchergroup.com"; "nick@thehatchergroup.com"; "Michael@thehatchergroup.com"; "cole@taxfoundation.org"; "pomerleau@taxfoundation.org"; "abby@mccloskeypolicy.com"; "Burkhauser, Richard V. EOP/CEA"; " Ball Jabbour, Emily (ACF) "; "Barofsky, Meryl (ACF) "; "Barry, Melissa(ACF) "; "Blankenship, Sarah (ACF) (CTR) "; " Blitz, Caryn (ACF) "; "Braithwaite, Kezia (ACF)(CTR) "; "Butler, Valeria (ACF) "; "Cannon, Erin (ACF)(CTR) "; "Carpenter, Elaine (ACF) (CTR) "; "Celentano, Sheila (ACF) "; "Chamberlain, Seth (ACF) "; "Cheatham, Dionna (ACF) (CTR) "; "Clifford, Maria (ACF) "; "Coleman, Amanda (ACF) "; "Dant, Christi (ACF) "; "Decourcey, Wendy (ACF) "; " Denmark, Nicole (ACF) "; "Deterding, Nicole (ACF) (CTR) "; "Deutsch, Lauren (ACF) (CTR) "; "Dwyer, Kathleen (ACF) "; "Fortunato, Christine (ACF) "; "Gattin, Kathy (ACF) (CTR) "; "Gupta, Pooja (ACF) " ; "Hetzner, Nina (ACF)(CTR) "; "Hoard, Laura (ACF) "; "Houston, Elizabeth (ACF) "; "Madigan, Amy (ACF) "; "Malin, Jenessa(ACF) (CTR) "; "Margie, Nancy (ACF) "; "Mccoy, Kathleen (ACF) (CTR) "; "McKinney, Katherine (ACF)(CTR) "; "Meyer, Aleta (ACF) "; " Miller, Thomas (ACF) "; "Moore, Kathleen (ACF) (CTR) "; "Rivera, Ann (ACF) "; "Sargis, Robert A (ACF) "; "Solmeyer, Anna (ACF) "; "Walker, Allison (ACF) (CTR) "; "Williams, Connor (ACF)(CTR) "; "Workmeister, Catherine (ACF)(CTR) "; "Wright, Girley (ACF) "; "Zeno, Tia (ACF) " " Malliou, Ekaterini (OS/IOS) "; "Sassi,Aliya (HHS/ASPE) "; " Lawver, Daniel A. (OS/ASPE)"; "Cravens, catherine (OS/ASPE)"; " Martinez, Sofi (OS/ASPE)"; "Potter, Sarah (HHS/ASPE)"; "Burnszynski,Jennifer (OS/ASPE)"; "Destro, Brenda (HHS/ASPE)"; "Taplin, caroline (HHS/ASPE)"; "Woody, Iara (OS/ASPE)"; "romich@uw.edu"; "Antelo, Lauren (HHS/ASPE)"; "Waters, Annette (HHS/HSP)"; " Lazare, Mary (ACL) " ; " Kennedy, Gavin (HHS/ASPE)"; "BurkeBebee,Suzie (HHS/ASPE)"; "Duplantier, Daniel (OS/ASPE)"; "Graham, John (HHS/IEA) "; "Winston, Pamela (OS/ASPE)"; "Chan, Stephanie (HHS/ASPE)"; /\MERICAi\ pVERSIGHT EXT-18-248-B-000250 "Jones, Kaitlyn (HHS/ASPE) "; "Boyd, Michelle (OS/ASPE)"; "Jackson, ChazemanS. (OS/ASPE)"; "Hannan, Marylee (FDA/OC) "; "Hayes, Andrea (HHS/ONC) "; "Blake, Stephanie (SAMHSNCSAP)"; "Raymond, Meredith (ACL) "; "Lukens, Gideon F. EOP/OMB"; "Barbour-Rawlings,Angela (OS/ASPE)"; "Marks, caryn (HHS/IEA) "; "EI-Kilani, Zeid (HHS/ASPE) "; "Dube, Timothy (OS/ASPE)"; "Branham, Keith (OS/ASPE)"; "Jones, John Travis HQ ORDP"; "Potter, D.E.B. (OS/ASPE)"; "Filion, Kai "; "Macartney, Suzanne (OS/ASPE)"; "Lamont, Helen (HHS/ASPE)"; "Jones Parkinson,Amica (OS/ASPE)(CTR) "; "Delew, Nancy (HHS/ASPE) "; "Bathon, David (ACF)(CTR) "; "Johnson, Charisse(ACF) "; "Le Menestrel, Suzanne "; "Radel, Laura (HHS/ASPE)"; "McCurdy, Matthew (HHS/ASPE)"; "Hauan, Susan (HHS/ASPE)"; "Stalbaum, Lori A. (ACL) "; '"Lohmann, Jessica - ASP' " Subj ect : ASPE-IRPPop Up Panel I Marginal Tax Rates/ProgramCliffs I June 26, 2018 Date: 2018/05/08 17:07:23 Start Date: 2018/06/26 13:30:00 End Date : 2018/06/26 16:30:00 Priority: Normal Type: Appointment Location: Hubert H. Humphrey Building, Room 705A (200 Independence Ave. SW, Washington, DC) /\MERICAi\ pVERSIGHT EXT-18-248-B-000251 OS - ASPE;Shannon Mok; Angela.Rachidi@AEl.org; romich@u.washington.edu; ocass@manhattan-institute.org;Wagner, Steven (ACF); Powers, Mary (ACF); Negri, Warren A. (ACF); Carter, Clarence (ACF); Goldstein, Naomi (ACF); Lekan, Scott (ACF); Christian, Shannon (ACF); Clark, Barbara (HHS/ASL); Keckler, Charles (HHS/IOS); Wynne, Maggie (HHS/IOS); Smith, Andrew (ACF); Townsend, Kara (HHS/ASPE);Kevin.C.Corinth@cea.eop.gov; Jeffrey.L.Schlagenhauf@omb.eop.gov; Lloyd, Scott (ACF); Duran, Mishaela (ACF); Milner, Jerry (ACF); Wubbenhorst, William (ACF); Barlow, Amanda (ACF); George, Jolleen Janelle (ACF); Linehan, Ann (ACF); Kelley, Curtis (HHS/ASFR);Curtis, Jillian (HHS/ASFR);McMillen, Cheryl (HHS/ASFR);Horn, Wade (HHS/IOS) (CTR); O'Brien, John (HHS/ASPE);Stevenson, Sarah-Lloyd (HHS/IOS); Ecoffey, Stacey (HHS/IEA); Kavanagh,Laura (HRSA); NCoulouris.hrsa@mail.nih.gov; Willis, David (HRSA); Pilato, Anna (ACF); Donato, Ingrid (SAMHSA/CMHS);Kleinschmidt, Arthur (SAMHSNCSAT);Erwin.Molly.E@dol.gov; Ja'Ron.K.Smith@who.eop.gov; Laura.cunliffe@who.eop.gov;Balderston, Deirdre (HHS/OGC); brian.neale@cms.hhs.gov; Moughalian,Jen (HHS/ASFR); Lynch, Calder (CMS/OA);Bowman, Matthew (HHS/OGC);Lawrence, Courtney (HHS/ASL); O'Dell, Ben (OS/CFBNP);Trueman, Laura (HHS/IEA); Stevenson, Marquita (ACL) (CTR); Robertson, Lance (ACL); Wheatley PhD., Ellen (ACF); Logan, Scott (ACF); Wolfe, Kenneth (ACF); Jones, Molly (ACF); Fisher, Patrick (ACF); Golonka, Susan (ACF); McDonald, Robin (ACF); Brodowski, Melissa(ACF); Joyner, Deric (ACF)(CTR); Fucello, Mark (ACF); Webb, Mary Bruce (ACF); Brown, Brett (ACF); Rathgeb, Colleen (ACF); Chon, Katherine (ACF); Zukowski, Amy (ACF); Henderson, Sharon (ACF); Powell, Debbie A. (ACF); Martin, Vernae (ACF); Sorensen, Elaine (ACF); Lacina, Barbara (ACF); Nerenberg, Laura (ACF); Mueggenborg, Mary (ACF); Illangasekare, Samantha (ACF); McCormack, Tiffany (ACF); Forster, Hilary (ACF); Jain, Kriti (ACF) (CTR); Schmitt, Emily (ACF); Constance, Nicole (ACF); Popham, Amelia (ACF); Reid, Megan (ACF)(CTR); Kabak, Victoria (ACF); Clum, Kimberly (ACF); Wulff, Carli (ACF); Clopet, Tracy (ACF) (CTR); Blandon, Alysia (ACF) (CTR); Newell, Gabrielle (ACF) (CTR); DiSalvo,Clare (ACF) (CTR); Frohlich, Lauren (ACF); Germanis, Peter (ACF); List, Deborah (ACF); Woolverton, Maria (ACF); Martinez-Beck, Ivelisse (ACF); Le, Minh (ACF) (Minh.Le@acf.hhs.gov);Demma, Rachel (ACF); Williams, Andrew (ACF); Campbell, Megan (ACF); Abdi, Abdihakin (ACF); Beltangady, Moushumi(ACF); Wiseman, Michael (ACF)(CTR); Johnson, Melissa (ACF); Hayes, Michael (ACF); Fairley, Kenya (ACF); Orsinger, Rachel (ACF); White, LeBretia(ACF); Kelvington, Areon (ACF); Baldwin PhD., Melinda (ACF); Simcox, Edwin (OS/IOS); Koyani, Sanjay (OS/IOS); Morris, Genevieve(OS/ONC/IO); Att d . Rancourt, John H. Jr. (OS/ONC); Novak, Thomas (OS/ONC);Traver, Christopher (ACF); en ees. Henriksen, Maureen (ACF); Morse, Jonathan D. (CMS/CPI); Washington-Thomas,Lisa (ACF); Murray, James (ACF); Jones, David (ACF); Macrae,Jim (HRSA);Burbank, Nick (HHS/ASFR); O'Keefe, Erin (HHS\ASFR);Lewandoski,Mona (OS/ASFR);Williams, Cameron (HHS/ASFR); Simms, Jeffrey (HHS/ASFR); Donley, Katherine (HHS/ASFR);Weber, Mark (HHS/ASPA);ScalaFoley, Marisa (ACL); Melissa_Benton_Bomberger@omb.eop.gov; Kira_R_Fatherree@omb.eop.gov; Jacob_H._Kaplan@omb.eop.gov; Jennifer_L_Hanson@omb.eop.gov; Catherine_E_White2@omb.eop.gov; James_C._ Hurban@omb.eop.gov; jhoef@omb.eop.gov; Mariarosaria_Sciannameo@omb.eop.gov; John_T_ Tambornino@omb.eop.gov; Mary_E._Wiggins@omb.eop.gov;Brian_A_Widuch@omb.eop.gov; Diana_F_Epstein@omb.eop.gov; neil_b._danberg@omb.eop.gov; Janet.McCubbin@treasury.gov;Deena.Ackerman@treasury.gov; barbara.murphy@fns.usda.gov; Richard.Lucas@fns.usda.gov;Melissa.Abelev@fns.usda.gov; Susan.Wilschke@ssa.gov;alex.f.coccia@gmail.com; mzaslow@srcd.org; NBlain@nas.edu; asaph.glosser@mefassociates.com; Aditommaso@cns.gov;mhyde@cns.gov; mgish@crs.loc.gov; JTOLLESTRUP@crs.loc .gov; AFERNANDES@crs.loc .gov; ESTOL TZFUS@crs.loc.gov;KLYNCH@crs.loc.gov; GFALK@crs .loc.gov; MCRANDALLHOLLICK@crs .loc.gov; Yancey.Christina.L@DOL.GOV;Simonetta.Jon.A@do l.gov; rachel.m.shattuck@census.gov;rebecca.schwei@wisc.edu; lmberger@wisc.edu; palanders@wisc.edu; mcabbott@wisc.edu; info.clerkweb@mail.house.gov; povertystudies@aei.org;events@aei.org; ryan.streeter@aei.org;jerry.mande@aei.org; craig.gunderson@aei.org;Robert.doar@aei.org;w.Bradford.wilcox@aei.org; tamar.j acoby@aei.org;spenser.moore@aei.org; Cecilia.gallogly@aei.org; amathur@aei.org; besharov@umd.edu; policyservices@heritage.org; info@heritage.org; robert.rector@heritage.org; katherine.bradley@heritage.org; romina.boccia@heritage.org; events@brookings.edu; communications@brookings.edu; cgraham@brookings.edu; wgale@brookings.edu;mkearney@brookings.edu;lpescatore@thehatchergroup.com; devin@thehatchergroup.com;nick@thehatchergroup.com; Michael@thehatchergroup.com; cole@taxfoundation.org; pomerleau@taxfoundation.org; abby@mccloskeypolicy.com; Malliou, Ekaterini (OS/IOS); Sassi,Aliya (HHS/ASPE);Lawver, Daniel A. (OS/ASPE);Cravens, Catherine (OS/ASPE);Martinez, Safi (OS/ASPE);Potter, Sarah (HHS/ASPE);Burnszynski,Jennifer (OS/ASPE);Destro, Brenda (HHS/ASPE);Taplin, Caroline (HHS/ASPE);Woody, Iara (OS/ASPE); romich@uw.edu; Antelo, Lauren (HHS/ASPE);Waters, Annette (HHS/HSP);Lazare, Mary (ACL); /\MERICAi\ pVERSIGHT EXT-18-248-B-000252 Kennedy, Gavin (HHS/ASPE); BurkeBebee, Suzie (HHS/ASPE); Duplantier, Daniel (OS/ASPE); Graham, John (HHS/IEA); Winston, Pamela (OS/ASPE); Chan, Stephanie (HHS/ASPE); Jones, Kaitlyn (HHS/ASPE); Boyd, Michelle (OS/ASPE); Burkhauser, Richard V . EOP/CEA; Jackson, Chazeman S. (OS/ASPE); Hannan, Marylee (FDNOC); Hayes, Andrea (HHS/ONC); Blake, Stephanie (SAMHSA/CSAP); Raymond, Meredith (ACL); Lukens, Gideon F. EOP/OMB; Barbour Rawlings, Angela (OS/ASPE); Marks, Caryn (HHS/IEA); EI-Kilani, Zeid (HHS/ASPE); Dube , Timothy (OS/ASPE); Branham, Keith (OS/ASPE); Jones, John Trav is HQ ORDP; Potter, D.E.B. (OS/ASPE); Filion, Kai; Macartney, Suzanne (OS/ASPE); Lamont, Helen (HHS/ASPE); Jones Parkinson, Amica (OS/ASPE) (CTR); Delew, Nancy (HHS/ASPE); Bathon, David (ACF) (CTR); Johnson, Charisse (ACF); Le Menestrel, Suzanne; Radel, Laura (HHS/ASPE); Mccurdy, Matthew (HHS/ASPE); Hauan, Susan (HHS/ASPE); Stalbaum, Lori A. (ACL); Ball Jabbour, Emily (ACF); Barofsky, Meryl (ACF); Barry, Melissa (ACF); Blankensh ip, Sarah (ACF) (CTR); Blitz, Caryn (ACF); Braithwa ite, Kezia (ACF) (CTR); Butler, Valeria (ACF); Cannon, Erin (ACF) (CTR); Carpent er, Elaine (ACF) (CTR); Celentano, Sheila (ACF); Chamberlain, Seth (ACF); Cheatham, Dionna (ACF) (CTR); Clifford, Maria (ACF); Coleman, Amanda (ACF); Dant, Christi (ACF); DeCourcey, Wendy (ACF); Denmark, Nicole (ACF); Deterd ing, Nicole (ACF) (CTR); Deutsch, Lauren (ACF) (CTR); Dwyer, Kathleen (ACF); Fortunato, Christine (ACF); Gattin, Kathy (ACF) (CTR); Gupta, Pooja (ACF); Hetzner, Nina (ACF) (CTR); Hoard, Laura (ACF); Houston, Elizabeth (ACF); Madigan, Amy (ACF); Malin, Jenessa (ACF) (CTR); Margie, Nancy (ACF); Mccoy, Kathleen (ACF) (CTR); McKinney, Katherine (ACF) (CTR); Meyer, Aleta (ACF); Miller, Thomas (ACF); Moore, Kathleen (ACF) (CTR); Rivera, Ann (ACF); Sargis, Robert A (ACF); Solmeyer , Anna (ACF); Walker, Allison (ACF) (CTR); Williams, Connor (ACF) (CTR); Werkmeister, Catherine (ACF) (CTR); Wr ight, Girley (ACF); Zeno, Tia (ACF); 'Lohmann, Jessica - ASP' If you are non HHS: Please allow an extra 15 minutes to go through security. Also, please make sure you've "accepted" the invitation so that you can be placed on the guest list for building entry. Dear Colleagues, We are pleased to invite you to a Pop Up Panel on Marginal Tax Rates/Pro gram Cliffs and how understanding them can be beneficial for policy development and program implementation. The panel will take place Tuesday, June 26, 2018, from 1:30 to 4:30 p.m., and is hosted by HHS/ASPEand the Institute for Research on Poverty at t he Universi ty of Wisconsin. Please forward t his invitation to interested colleagues. No video or conference lines will be available. If you would like to attend , plea se accept the invitation and send a response to : nina.chien@hhs.gov Pop Up Panel on Marginal Tax Rates/Program Cliffs June 26, 2018 1:30 p.m. to 4:30 p.m. Event: When: Location : Hubert H. Humphrey Building, Room 705A 200 Indep endence Avenue S.W . Washington, D.C. Overview Employment and social networks are central to helping fam ilies achieve and maintain independence. Yet, for low- income individuals and families who receive government benefits, high effective marginal tax rates may discourage work and marriage as earnings rise. Of particular concern are "benefit cliffs" occurring when effective marginal tax rates exceed 100 percent. In such cases, due to the loss of benefits, workers wit h earnings increases do not retain any of their new earnings. The panel will assessand present current analyses on marginal tax rates and their relationship to work effort among program recipients and other populations /\MERICAi\ pVERSIGHT EXT-18-248-B-000253 includ ing married families. The panel w ill close w ith a discussion of policy options for addressing potential work and marriage disincentives associated with the fede ral safety net. Expert s Contribut ing to th is Event • • • • • Angela Rachidi, Amer ican Enterpri se Insti t ute Oren Cass, M anhatt an Institut e Shannon Mok, Congressional Budget Office Jennifer Romich, University of W ashingto n Suzanne Macartney & Nina Chien, Offic e of the Assistant Secretary for Planning and Evaluation Wh at is a Pop Up Pane l? A Pop Up Panel is a panel designed and implemented quickly and flexibly with the intent of informing new and emerging policy questions and providing federal policy makers with timely and critical information and resources needed to advance policy ideas. Please contact nina.chien@hhs .gov for more information or with any questions. We hope you can join us! Nina Chien Chien, Nina (OS/ASPE) "Chien, Nina (OS/ASPE)"; "OS - ASPE"; "Shannon Mok (Shannon.Mok@cbo.gov)"; "Angela.Rachidi@AEI.org"; "romich@u.washington.edu"; "ocass@manhattan-institute.org"; "Wagner, Steven (ACF) "Powers, Mary (ACF) "; "Negri, Warren A. (ACF) "; Recipient: "Carter, Clarence (ACF) "; "Goldstein, Naomi (ACF) "; "Lekan, Scott (ACF) "; "Christian, Shannon (ACF) "; "Clark, Barbara (HHS/ASL) "; "Keckler, Charles (HHS/IOS) "; "Wynne, Maggie (HHS/IOS) "; "Smith, Andrew (ACF) "; "Townsend, Kara (HHS/ASPE)"; "Kevin.C.Corinth@cea.eop.gov"; "Jeffrey.L.Schlagenhauf@omb.eop.gov"; "Lloyd, Scott (ACF) "; "Duran, Mishaela (ACF) "; " Milner, Jerry (ACF) "; "Wubbenhorst, William (ACF) "; "Barlow, Amanda (ACF) "; "George, Jolleen Janelle (ACF) "; "Linehan, Ann (ACF) "; "Kelley, Curtis (HHS/ASFR)" ; "Curtis, Jillian (HHS/ASFR)"; " McMillen,Cheryl (HHS/ASFR) "; "Horn, Wade (HHS/IOS) (CTR) "; "O'Brien, John (HHS/ASPE)"; "Stevenson, Sarah-Lloyd(HHS/IOS) "; "Ecoffey, Stacey (HHS/IEA) " ; "Kavanagh, Laura (HRSA) "; "Coulouris, Natasha (HRSA) "; "Willis, David (HRSA) "; "Pilato, Anna (ACF) "; "Donato, Ingrid (SAMHSA/CMHS)"; " Kleinschmidt,Arthur (SAMHSA/CSAT) "; "Erwin.Molly.E@dol.gov"; "Ja'Ron.K.Smith@who.eop.gov"; "Laura.cunliffe@who.eop.gov"; "Balderston, Deirdre (HHS/OGC)"; "brian.neale@cms.hhs.gov"; " Moughalian, Jen (HHS/ASFR) "; "Lynch, Calder (CMS/OA) "; "Bowman, Matthew (HHS/OGC)"; "Lawrence, Courtney (HHS/ASL)"; "O'Dell, Ben (OS/CFBNP)"; "Trueman, Laura (HHS/IEA) "; "Stevenson, Marquita (ACL) (CTR) "; "Robertson, Lance (ACL) "; "Wheatley PhD., Ellen (ACF) "; "Logan, Scott (ACF) "; "Wolfe, Kenneth (ACF) "; "Jones, Molly (ACF) "; "Fisher, Patrick (ACF) "; "Golonka, Susan (ACF) "; "McDonald, Robin (ACF) "; "Brodowsk.i,Melissa(ACF) "; "Joyner, Deric (ACF) (CTR) "; "Fucello, Mark (ACF) "; "Webb, Mary Bruce (ACF) "; "Brown, Brett (ACF) "; "Rathgeb, Colleen (ACF) "; "Chon, Katherine (ACF) "; "Zukowski, Amy (ACF) "; " Henderson,Sharon (ACF) "; "Powell, Debbie A. (ACF) "; "Martin, Vernae (ACF) "; "Sorensen, Elaine (ACF) "; " Lacina, Barbara(ACF) "; "Nerenberg, Laura (ACF) "; "Mueggenborg, Mary (ACF) "; "Illangasekare, Samantha (ACF) "; " McCormack,Tiffany (ACF) "; "Forster, Hilary (ACF) "; "Jain, Kriti (ACF)(CTR) "; "Schmitt, Emily (ACF) "; "Constance,Nicole (ACF) "; "Popham, Amelia (ACF) "; "Reid, Megan (ACF)(CTR) "; /\MERICAi\ pVERSIGHT EXT-18-248-B-000256 " Kabak,Victoria (ACF) "; "Clum, Kimberly (ACF) "; "Wulff, Carli (ACF) "; "Clopet, Tracy (ACF)(CTR) "; "Blandon, Alysia (ACF) (CTR) "; "Newell, Gabrielle (ACF) (CTR) "; "DiSalvo, Clare (ACF) (CTR) "; "Frohlich, Lauren (ACF) "; "Germanis, Peter (ACF) "; "List, Deborah (ACF) "; "Woolverton, Maria (ACF) "; "Martinez-Beck, Ivelisse (ACF) "; "Le, Minh (ACF) "; "Demma, Rachel (ACF) "; "Williams, Andrew (ACF) "; "Campbell, Megan (ACF) "; "Abdi, Abdihakin (ACF) "; "Beltangady, Moushumi (ACF) "; "Wiseman, Michael (ACF)(CTR) 11 ; "Johnson, Melissa(ACF) "; "Hayes, Michael (ACF) "; "Fairley, Kenya (ACF) "; "Orsinger, Rachel (ACF) "; "White, LeBretia (ACF) "; "Kelvington, Areon (ACF) "; "Baldwin PhD., Melinda (ACF) "; "Simcox, Edwin (OS/IOS) "; "Koyani, Sanjay (OS/IOS) "; "Morris, Genevieve(OS/ONC/IO) "; "Rancourt, John H. Jr. (OS/ONC)"; "Novak, Thomas (OS/ONC) "; /\MERICAi\ pVERSIGHT EXT-18-248-B-000257 "Traver, Christopher (ACF) "; "Henriksen, Maureen (ACF) "; " Morse, Jonathan D. (CMS/CPI) "; "Washington-Thomas, Lisa (ACF) 11 ; "Murray, James (ACF) "; "Jones, David (ACF) "; "Macrae, Jim (HRSA) "; "Burbank, Nick (HHS/ASFR)"; "O'Keefe, Erin (HHS\ASFR)"; "Lewandoski, Mona (OS/ASFR) "; "Williams, Cameron (HHS/ASFR) "; "Simms, Jeffrey (HHS/ASFR)"; " Donley, Katherine (HHS/ASFR)"; "Weber, Mark (HHS/ASPA)"; "Scala-Foley,Marisa (ACL) "; "Melissa_Benton_Bomberger@omb.eop.gov"; " Kira_R_Fatherree@omb.eop.gov"; "Jacob_H._Kaplan@omb.eop.gov"; "Jennifer_L_Hanson@omb.eop.gov"; "Catherine_E_White2@omb.eop.gov"; "James_C._Hurban@omb.eop.gov"; "jhoef@omb.eop.gov"; "Mariarosaria_Sciannameo @omb.eop.gov"; "John_T_Tambornino@omb.eop.gov"; "Mary_E._Wiggins@omb.eop.gov"; " Brian_A_Widuch@omb.eop.gov"; " Diana_F_Epstein@omb.eop.gov"; "neil_b._danberg@omb.eop.gov"; "Janet.McCubbin@treasury.gov"; "Deena.Ackerman@treasury.gov "; "barbara.murphy@fns.usda.gov"; "Richard.Lucas@fns.usda.gov"; "Melissa.Abelev@fns.usda.gov"; "Susan.Wilschke@ssa.gov"; "alex.f.coccia@gmail.com"; "mzaslow@srcd.org"; "NBlain@nas.edu"; ''asaph.glosser@mefassociates.com"; "Aditommaso@cns.gov"; "mhyde@cns.gov"; "mgish@crs.loc.gov"; "JTOLLESTRUP @crs.loc.gov"; "AFERNANDES@crs.loc .gov"; " ESTOLTZFUS@crs.loc .gov"; "KLYNCH@crs .loc.gov"; "GFALK@crs.loc.gov"; "MCRANDALLHOLLICK @crs.loc.gov"; "Yancey.Christina.L@DOL.GO V"; "Simonetta.Jon.A@dol.gov"; "rachel.m.shattuck@census.gov "; /\MERICAi\ pVERSIGHT EXT-18-248-B-000258 "rebecca.schwei@wisc.edu"; "lmberger@wisc.edu"; "palanders@wisc.edu"; "mcabbott@wisc.edu"; "info.clerkweb@maii. house.gov"; "povertystudies@aei.org"; "events@aei.org"; "ryan.streeter@aei.org"; "jerry.mande@aei.org"; "craig.gunderson@aei.org"; "Robert.doar@aei.org"; "w. Bradford.wilcox@aei.org"; "tamar.jacoby@aei.org"; "spenser.moore@aei.org"; "Cecilia.gallogly@aei.org"; "amathur@aei.org"; "besharov@umd.edu"; "policyservices@heritage.org"; "info@heritage.org"; "robert. rector@heritage.org"; "katherine.bradley@heritage.org"; "romina.boccia@heritage.org"; "events@brookings.edu"; "communications@brookings.edu"; "cgraham@brookings.edu"; "wgale@brookings.edu"; "mkearney@brookings.edu"; "lpescatore@thehatchergroup.com"; "devin@thehatchergroup.com"; "nick@thehatchergroup.com"; " Michael@thehatchergroup.com"; "cole@taxfoundation.org"; "pomerleau@taxfoundation.org"; "abby@mccloskeypolicy.com "; " Burkhauser, Richard V. EOP/CEA"; "Ball Jabbour, Emily (ACF) "; "Barofsky, Meryl (ACF) "; "Barry, Melissa(ACF) "; " Blankenship,Sarah (ACF) (CTR) "; " Blitz, Caryn (ACF) "; "Braithwaite, Kezia (ACF)(CTR) "; "Butler, Valeria (ACF) "; "Cannon, Erin (ACF)(CTR) "; "Carpenter, Elaine (ACF) (CTR) "; "Celentano,Sheila (ACF) "; "Chamberlain, Seth (ACF) "; "Cheatham, Dionna (ACF) (CTR) "; "Clifford, Maria (ACF) "; "Coleman, Amanda (ACF) "; "Dant, Christi (ACF) "; "Decourcey, Wendy (ACF) "; (FYDIBOHF23SPDL T)/cn =Recipients/cn=0aee8a1fOf9c4b3da56058e4d528c5e3-DeCourcey "Denmark, Nicole (ACF) "; "Deterding, Nicole (ACF) (CTR) "; " Deutsch, Lauren (ACF) (CTR) "; " Dwyer, Kathleen (ACF) "; "Fortunato, Christine (ACF) "; "Gattin, Kathy (ACF) (CTR) "; "Gupta, Pooja (ACF) " ; "Hetzner, Nina (ACF)(CTR) "; "Hoard, Laura (ACF) "; " Houston, Elizabeth(ACF) "; "Madigan, Amy (ACF) "; " Malin, Jenessa(ACF) (CTR) "; "Margie, Nancy (ACF) "; "Mccoy, Kathleen (ACF) (CTR) "; "McKinney, Katherine (ACF)(CTR) "; " Meyer, Aleta (ACF) "; " Miller, Thomas (ACF) "; "Moore, Kathleen (ACF) (CTR) "; "Rivera, Ann (ACF) "; "Sargis, Robert A (ACF) "; "Solmeyer, Anna (ACF) "; "Walker, Allison (ACF) (CTR) "; "Williams, Connor (ACF)(CTR) "; "Workmeister, Catherine (ACF) (CTR) "; "Wright, Girley (ACF) "; "Zeno, Tia (ACF) "; "Malliou, Ekaterini (OS/IOS) "; "Sassi,Aliya (HHS/ASPE) "; " Lawver, Daniel A. (O5/ASPE)"; "Cravens, Catherine (O5/ASPE)"; "Martinez, Sofi (OS/ASPE)"; "Potter, Sarah (HHS/ASPE)"; "Burnszynski, Jennifer (OS/ASPE)"; "Destro, Brenda (HHS/ASPE)"; "Taplin, caroline (HHS/ASPE) "; "Woody, Iara (OS/ASPE)"; "romich@uw.edu"; "Antelo, Lauren (HHS/ASPE)"; "Waters, Annette (HHS/HSP)"; "Lazare, Mary (ACL) "; " Kennedy, Gavin (HHS/ASPE) "; "BurkeBebee,Suzie (HHS/ASPE)"; "Duplantier, Daniel (OS/ASPE)"; "Graham, John (HHS/IEA) "; "Winston, Pamela (OS/ASPE)"; "Chan, Stephanie (HHS/ASPE)"; "Jones, Kaitlyn (HHS/ASPE)"; " Boyd, Michelle (OS/ASPE)"; "Jackson, Chazeman S. (OS/ASPE)"; " Hannan, Marylee (FDA/OC) "; "Hayes, Andrea (HHS/ONC) "; "Blake, Stephanie (SAMHSNCSAP) "; "Raymond, Meredith (ACL) ..; "Lukens, Gideon F. EOP/OMB"; "Barbour-Rawlings, Angela (OS/ASPE)"; "Marks, caryn (HHS/IEA) "; "EI-Kilani, Zeid (HHS/ASPE) "; " Dube, Timothy (OS/ASPE)" i "Branham, Keith (OS/ASPE)"; "Jones, John Travis HQ ORDP"; "Potter, D.E.B. (OS/ASPE)"; " Filion, Kai "; "Macartney, Suzanne (OS/ASPE)"; "Lamont, Helen (HHS/ASPE)"; "Jones Parkinson,Amica (OS/ASPE)(CTR) "; "Delew, Nancy (HHS/ASPE) "; " Bathon, David (ACF)(CTR) "; "Johnson, Charisse(ACF) "; " Le Menestrel, Suzanne "; " Radel, Laura (HHS/ASPE)"; "McCurdy, Matthew (HHS/ASPE)"; "Hauan, Susan (HHS/ASPE)"; "Stalbaum, Lori A. (ACL) "; "'Lohmann, Jessica - ASP' " Sent Date: 2018/05/08 17:07:23 /\MERICAi\ pVERSIGHT EXT-18-248-B-000262 Institute for Researchon Poverty UNIVERSITY OF WISCONSIN - MADISON ' Pop-Up Panel: Marginal Tax Rates Benefit Cliffs June 26, 2018 I 1:30 p.m. - 4:30 p.m. U.S. Department of Health and Human Services The Hubert H. Humphrey Building Room 705A 200 Independence Avenue S.W. Washington, D.C. Convened by the Institute for Research on Poverty at the University of Wisconsin-Madison in conjunction with the Office of Human Services Policy, Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services Overview: Employment and social networks are cent ral to helping families achieve and maintain independence. Yet, for low-income individuals and fami li es who receive government benefits, high effective marginal tax rates may discourage work and marriage as earn ings rise. Of particular concern are "be nefit cliffs" occurring when effective marginal tax rates exceed 100 percent . In such cases, due to the loss of benefits , workers with earnings increases do not retain any of their new earnings. The panel will assessand present current analyses on marginal tax rates and t heir relationship to work effort among program recipients and other populations including married families. The panel will close with a discussion of policy options for addressing potentia l work and marr iage disincentives associated with the federal safety net. Agenda 1:30 p.m. /\ML Welcome 1:40 p.m. Opening remarks Charles Keckler, Associate Deputy Secretary, HHS 1:45 p.m. Overview and introduction to marginal t ax rates and benefit cliffs Angela Rachidi, American Enterprise Institute 1:50 p.m. HHS programs and populations Suzanne Macartney, HHS Office of the Assistant Secretary for Planning and Evaluation Nina Chen, HHS Office of the Assistant Secretary for Planning and Evaluation 2:20 p.m. Analysis from the Congressional Budget Office Shannon Mok, Congressional Budget Office 2:55 p.m. Break 3:10 p.m. How do families experience and respond to marginal tax rates and benefit cliffs? Jennie Romich, University of Washington 3:45 p.m. Commentators Angela Rachidi, American Enterprise Institute Oren Cass, Manhattan Institute 4:25 p.m. Wrap up and thank you 4:30 p.m. Adjourn pVERSIGHT EXT-18-248-B-000263 Wynne, Maggie (HHS/IOS) "Lloyd, Scott (ACF) "; To: "Wagner, Steven (ACF) " Subject: Re: Event flyer Date : 2018/05/11 14:42:22 Priority: Normal Type : Note l(b)(5) Magg ie Wynne HHS On: 11 May 2018 14:30, "Lloyd, Scott (ACF)" wro te : FYI, in case eit her of you would like to attend the dam event From: Lisa Correnti [mailto: lisa@c-fam.org] /\MERICAi\ pVERSIGHT EXT-18-248-B-000264 Sent: Friday, May 11, 2018 2:16 PM To: Lloyd , Scott (ACF) Subject: Re: Event flyer Hi Scott, Just checking back in on whether you have a colleague available to participate. We would really welcome someone's participation and can extend until Monday confirmation . Best regards, Lisa On May 8, 2018 , at 6: 15 AM, Lloyd, Scott (ACF) wrote: /\MERICAi\ pVERSIGHT EXT-18-248-B-000265 Lisa, I will not be able to attend . I have forwarded the invite to others who are a bit closer to the trafficking issue-t hey will reach out to you if they are able to attend. Thank you for thinking of me. God bless, Scott From: Lisa Correnti [mailto:lis a@c-fam .org1 Sent: Thursday, Apr il 26, 2018 8:20 AM To: Lloyd, Scott (ACF) Subject: Event flyer Scott, Attached is the event flyer. Since all govt reps are pending they are not listed. As well we are hoping Sen. Lankford will make opening remarks. It is a half day event but of course we would only expect you for your panel /\MERICAi\ pVERSIGHT EXT-18-248-B-000266 which is scheduled for 3pm. Best regards , Lisa Wynne, Maggie (HHS/IOS) Recipient: "Lloyd, Scott (ACF) "; "Wagner, Steven (ACF) " Sent Date: 2018/05/11 14:42:22 /\MERICAi\ pVERSIGHT EXT-18-248-B-000267 Kalavritinos, Jack (OS/IEA) "Harrison, Brian (HHS/IOS) "; "Stecker, Judy (OS/ASPA) "; "Urbanowicz, Peter (HHS/IOS) "; "Charrow, Robert (HHS/OGC)"; "Kadlec, Robert (OS/ASPR/IO) "; "Meekins, Chris (OS/ASPR/IO) " ; "Lloyd, Scott (ACF) "; "Wagner, Steven (ACF) "; "Lloyd, Scott (ACF) "; "Brady, Will (HHS/IOS) "; "Bassett, Matthew (HHS/ASL) " "Trueman, Laura (HHS/IEA) "; " Heck, Mia (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; "Johnston, Darcie (HHS/IEA) "; "Beck, Gary (OS/IEA) "; " Reilly, Erin (OS/IEA) " Subject: FW: Invite for Call @ 2pm ESTToday Date: 2018/07/13 11:05:43 Importance: High Priority: Urgent Type: Note Here you go - pis see the email below to thought leaders for an update on the UAC situation , how HHS is executing on its mission and how to better amplify our message and help to set the record straight. Thank s to Team Hargan for helping to make the time while on the road and Laura for getting this call quickly together with the right peopl e. The run of show is: /\MERICAi\ pVERSIGHT EXT-18-248-B-000268 Laura Trueman to open and introduce HHS participants and introduce the Deputy Secretary EDH to give comments at the top with an update and perspective Q and A with Steve Wagner/Scott Lloyd and Chris Meekins and if EDH is available for some or all. The list of participants: Hispanic Leadership Fund FRC Heritage david. inserra@heri tage. org Mario H. Lopez Tony Perkins arp@frc.org David Christensen David Inserra (scholar) dxc@frc.org Hans von Spakovsky (Scholar) John Cooper (Director of Comms) AEI Robert Doar John Cusey john.cusey @awi.org. Karlyn Bowman Focus on the Family Tim Goeglein tim.goeglein@fotf.org American Conservative Union Dan Schneider dschneider@conservative.org Ethics and Policy Center Travis Wussow Faith and Freedom Coalition Ralph Reed ralph@centstrat.com Patrick Purtill, patrick@ffcoalition.com Americans for Prosperity ATR Grover Norquist and Alex Hendrie Foundation for Research on Equal Opportunity' Avik Roy John Fund Peter Roff Yuval Levin Matt Schlapp Ma1y Katherine Hamm would like to send to her - need email Mollie Hemingway Kelsey Harkness would like to send to her - need email Judy - do you want to share with your WH contacts? All - if you have a few others you want to invite pls send to me and Laura T asap. Thank you, Jack Jack Kalavritinos Director , Office of Intergovernmental and External Affairs /\MERICAi\ pVERSIGHT EXT-18-248-B-000269 U.S. Department of Health and Human Services (202) 690-6060 From: Trueman , Laura (HHS/IEA) Sent: Friday, July 13, 2018 10:52 AM To: Trueman, Laura (HHS/IEA) Subject: Invite for Call @ 2pm EST Today Importance: High Dear Colleague You are invited to join a call with HHS Deputy Secretary Eric Hargan at 2pm EST today. He will be discussing HHS's care and reunification of the minors in the Unaccompanied Alien Children (UAC) program, particularly those affected by the court order for reunification. As you know, there has been intense focus on this in the media. As key opinion leaders who speak to important audiences for our Administration, we believe it is important that you know what is fact and what is fiction. While this may not be directly in your organization's day-to-da y wheelhouse, we know that your being knowledgeable on an issue where unfair characterizations are being made can be helpful. Call in # Participant Cod e 1~)(6) Please let me know if you plan to join. I know our Deputy Secretary will appreciate the opportunity to connect with you. By the way, while this is invitation only, if you are not able to join today and want to have a colleague on the call, that is fine - just let me know about the substitute. Below please find our latest report on reunification efforts, in graphic and text. Laura Laura Clay Trueman Principal Deputy Director , Office oflntergovernmental and External Affairs U.S. Department of Health and Human Services 200 Independence Ave SW, Washington D.C. 20201 /\MERICAi\ pVERSIGHT EXT-18-248-B-000270 Reunification by the numbers. As of 7 am, July 12, 2018, 57 children reunified with parents, 24 not eligible due to adult's circumstances, 22 not eligible due to safety concerns FOR IMMEDIATE RELEASE July 12, 2018 Contact: HHS Press Office 202-690-6343 media@hhs.gov TrumpAdministrationCompletes Reunification for Eligible ChildrenUnder Age 5 Under order of the U.S . District Court for the Southern District of California, the departments of Health and Human Services (HHS), Homeland Security (OHS), and Justice (DOJ) have been reunifying alien minors under 5 years old who are currently in the custody of HHS with adults who have been in the custody of OHS. /\MERICAi\ pVERSIGHT EXT-18-248-B-000271 HHS Secretary Alex Azar, DHS Secretary Kirstjen Nielsen, and Attorney General Jeff Sessions made the following joint statement regarding reunification efforts for children under age 5: "Dedicated teams at the Departments of Health and Human Services, Homeland Security, and Justice have worked tirelessly to ensure the safety of Ms. L class members. As of this morning , the initial reunifications were completed. Throughout the reunification process our goal has been the well-being of the children and return ing them to a safe environment. Our agencies ' careful vetting procedures helped prevent the reunification of children with an alleged murderer, an adult convicted of child cruelty, and adults determined not to be the parent of the child . Of course, there remains a tremendous amount of hard work and similar obstacles facing our teams in reuniting the remaining families . The Trump administration does not approach this mission lightly, and we intend to continue our good faith efforts to reunify families. "Certain facts remain : The American people gave this administration a mandate to end the lawlessness at the border , and President Trump is keeping his promise to do exactly that. Our message has been clear all along: Do not risk your own life or the life of your child by attempting to enter the United States illegally. Apply lawfully and wait your turn. "The American immigration system is the most generous in the world , but we are a nation of laws and we intend to continue enforcing those laws. Establishing the immigration system demanded of our political leaders by the American people for more than 30 years-one that serves the national interest-w ill allow our nation to further realize the foundation of freedom, safety, and prosperity we inherited from our Founders." There are 103 children under age 5 covered by the court case. Of the 103 children : • • • 57 children have been reunified as of 7 a.m. EST on July 12. • 46 children were acknowledged by the court to be ineligible for reunification or determined by HHS, DHS, and DOJ to be ineligible under court-approved criteria. Of these 46: • • • 22 children have been found ineligible due to safety concerns posed by the adults in question: o • 11 adults have a serious criminal history (charges or convictions for child cruelty, kidnapping, murder, human smugg ling, domestic violence, etc.). o • 7 adults were determined not to be a parent. o • 1 adult had a falsified birth certificate (parentage is being examined). o • 1 adult was alleged to have abused the child. o • 1 adult planned to house the child with an adult charged with sexually abusing a child. o • 1 adult is being treated for a communicable disease. • 24 children are not currently eligible for reunification due to circumstances of the adults in question: o • 12 adults have been deported and are now being contacted. o • 9 adults are in custody of the U.S. Marshals Service for other offenses. o • 2 adults are in custody of state jails for other offenses. 1 adult's locat ion has been unknown for over a year. /\MERICAi\ pVERSIGHT EXT-18-248-B-000272 Laura Clay Trueman Principal Deputy Directo r Office of Intergovernmen tal and External Affairs Office of the Secretaiy U.S. Department of Health and Human Services 200 Independence Ave SW Wash ington D.C. 20201 (202) 260-6349 Office Laura .Trueman@h hs.gov Kalavritinos, Jack (OS/IEA) "Harrison, Brian (HHS/IOS) "; "Stecker, Judy (OS/ASPA) "; "Urbanowicz, Peter (HHS/IOS) "; "Charrow, Robert (HHS/OGC)"; " Kadlec, Robert (OS/ASPR/IO) "; " Meekins,Chris (OS/ASPR/IO) " ; " Lloyd, Scott (ACF) "; "Wagner, Steven (ACF) " ; " Lloyd, Scott (ACF) "; " Brady, Will (HHS/IOS) "; " Bassett, Matthew (HHS/ ASL) "; "Trueman, Laura (HHS/IEA) "; " Heck, Mia (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; "Johnston, Darcie (HHS/I EA) "; "Beck, Gary (OS/IEA) "; " Reilly, Erin (OS/IEA) " Sent Date: 2018/07/ 13 11:05:40 Delivered Date: 2018/07/ 13 11:05:43 /\MERICAi\ pVERSIGHT EXT-18-248-B-000273 Trueman, Laura (HHS/IEA) Kalavritinos, Jack (OS/IEA) "Wagner, Steven (ACF) "; "Murphy, Ryan (OS/ASPA)"; "Stecker, Judy (OS/ASPA)"; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Callahan, Kenneth (HHS/IOS) "; " Brady, Will (HHS/IOS) "; "Caliguiri, Laura (HHS/IOS) "; " Dareshori,Zack (HHS/IOS) "; "Harrison, Brian {HHS/IOS) " Subject: FW: Call on UAC with Dep Sec Date: 2018/07/13 12:01:18 Start Date: 2018/07/13 14:00:00 End Dat e : 2018/07/13 14:30:00 Priority: Normal Type: Schedule.Meeting.Request -----Original Appointment----From: Tru eman, Laura (HHS/IEA) Sent: Friday, July 13, 2018 11:09 AM To: Trueman, Laura (HHS/IEA); Callahan, Kenneth (HHS/IOS); Brady, W ill (HHS/IOS); Kalavritinos, Jack (OS/IEA); Beck, Gary (OS/IEA); Johnston, Darcie (HHS/I EA); Reilly, Erin (OS/IEA) Subject : Call on UAC with Dep Sec When: Friday, July 13, 2018 2:00 PM-2:30 PM (UTC-05:00) Eastern Time (US & Canada). Where: l(b) (6 ) Participant Code LeaderCode l(b )( l._ Subject: Invite for Call @ 2pm ESTToday Importance: High Dear Colleague You are invited to join a call with HHS Deputy Secretary Eric Hargan at 2pm ESTtoday. He will be discussing HHS's care and reunification of the minors in the Unaccompanied Alien Children (UAC) program, particularly those affected by the court order for reunification. As you know, there has been intense focus on this in the media. As key opinion leaders who speak to important audiences for our Administration, we believe it is im portant that you know what is fact and what is fiction. While this may not be directly in your organization's day-to -day whee lhouse, we know that your being knowledgeable on an issue where unfair character izations are being made can be helpful. Call in# Participant Code Please let me know if you plan to join. I know our Deputy Secretary will appreciate the opportunity to connect w ith you. By the way, while this is invitation only, if you are not able to join today and want to have a colleague on the call, that is fine - just let me know about the substitute. Below please find our latest report on reunification efforts, in graphic and text . Laura The run of show is: Laura Trueman to open and introduce HHS participants and introduce the Deputy Secretary EDH to give comments at the top with an update and perspective Q and A with Steve Wagner/Scott Lloyd and Chris Meekins and if EDH is available for some or all. The list of participants: Hispanic Leadership Fund FRC Heritage AEI /\MERICAi\ pVERSIGHT Mario H. Lopez Tony Perkins arp@frc.org dxc@frc.org David Christensen David Inserra (scholar) david.inserra@heritage.org Hans von Spakovsky (Scholar) John Cooper (Director of Comms) Robert Doar John Cusey john.cusey@awi.org, Karlyn Bowman EXT-18-248-B-000275 Focus on the Family Tim Goeglein tim.goeglein@fotf.org American Conservative Union Dan Schneider dschneider@conservative.org Ethics and Policy Center Travis Wussow Faith and Freedom Coalition Ralph Reed ralph@centstrat.com Patrick Purtill, patrick@ffcoalition.com Americans for Prosperity ATR Grover Norquist and Alex Hendrie Foundation for Research on Equal Opportunity' Avik Roy John Fund Peter Roff Yuval Levin Matt Schlapp Mary Katherine Hamm would like to send to her- need email Mollie Hemingway Kelsey Harkness would like to send to her - need email Trueman, Laura (HHS/IEA) ; Kalavritinos,Jack (OS/IEA) "Wagner, Steven (ACF) "; " Murphy, Ryan (OS/ASPA)"; "Stecker, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "; " Pilato, Anna (ACF) "; "Callahan, Kenneth (HHS/IOS) "; " Brady, Will (HHS/IOS) "; "Caliguiri, Laura (HHS/IOS) " ; "Dareshori, Zack (HHS/IOS) "; "Harrison, Brian (HHS/IOS) " Sent Date: 2018/07/13 12:01:14 Delivered Date: 2018/07/13 12:01:18 /\MERICAi\ pVERSIGHT EXT-18-248-B-000276 From: Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; To: "Brady, Will (HHS/IOS) "; "Kalavr itinos, Jack (OS/IEA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; " Reilly, Erin (OS/IEA) " "Wagner, Steven (ACF) "; "Murphy, Ryan (OS/ASPA) "; "Stecke r, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "i CC: "Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; "Dareshori, Zack (HHS/IOS) "; " Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA) "; "Hayes, Jonathan (ACF) " Subject: Call on UAC with Dep Sec Date: 20 18/07/13 12:01 : 17 Start Date: 20 18/07/13 14:00:00 End Date: 20 18/07/13 14:30:00 Priority: Norma l Type: Appointment Location: I EA Conference room Trueman, Laura (HHS/IEA); Callahan, Kenneth (HHS/IOS); Brady, Will (HHS/IOS); Kalavrit inos, Jack (OS/I EA); Beck, Gary (OS/I EA); Johnston, Darcie (HHS/IEA); Reilly, Erin (OS/IEA); Wagner, Steven (ACF); Murphy, Ryan (OS/ASPA); Stecker, Judy (O5/ASPA); Lloyd, Scott (ACF); Attendees: Pilato, Anna (ACF); Caliguiri, Laura (HHS/IOS); Dareshori, Zack (HHS/IOS); Harrison, Brian (HHS/IOS); Riley Althouse (Riley.Althouse@hhs.gov); Hayes, Jonathan (ACF); HHS !EA (OS/IEA) !(b)(6) Participant Code LeaderCode !(b)(6) I l= Subject: Invite for Call@ 2pm ESTToday Importance : High Dear Colleague You are invited to join a call wi t h HHS Deputy Secretary Eric Hargan at 2pm ESTtoday . He will be discussing HHS's care and reunification of the minors in the Unaccompanied Alien Children (UAC) program , particularly those affected by the court order for reunification . /\MERICAi\ pVERSIGHT EXT-18-248-B-000277 As you know , there has been intense focus on this in the media . As key opinion leaders who speak to important audiences for our Administration, we believe it is important that you know what is fact and what is fiction . While this may not be directly in your organization' s day-to -day whee lhouse, we know that your being knowledgeable on an issue where unfair characterizat ions are being made can be helpful. Call in# Participant Code ..,!{ b.... )(...,6 )_____ _, l= {b,..} {6""'} _...., Please let me know if you plan to join . I know our Deputy Secretary will appreciate the opportunity to connect with you . By the way, while this is invitation only, if you are not able to join today and want to have a colleague on the call, that is fine - just let me know about the subst itute . Below please find our latest report on reunification efforts, in graphic and text. Laura The run of show is: Laura Trueman to open and introduce HHS participants and introduce the Deputy Secretary EDH to give comments at the top with an update and perspective Q and A with Steve Wagner/Scott Lloyd and Chris Meekins and if EDH is available for some or all. The list of participants: Hispanic Leadership Fund FRC Mario H. Lopez Tony Perkins arp@frc.org dxc@frc.org David Christensen David Inserra (scholar) david.inserra@heritage.org Heritage Hans von Spakovsky (Scholar) John Cooper (Director of Comms) AEI Robert Doar John Cusey john.cusey@awi.org, Karlyn Bowman Focus on the Family Tim Goeglein tim.goeglein@fotf.org American Conservative Union Dan Schneider dschneider@conservative.org Ethics and Policy Center Travis Wussow Faith and Freedom Coalition Ralph Reed ralph@centstrat.com Patrick Purtill, patrick@ffcoalition.com Americans for Prosperity ATR Grover Norquist and Alex Hendrie Foundation for Research on Equal Opportunity' Avik Roy John Fund Peter Roff /\MERICAi\ pVERSIGHT EXT-18-248-B-000278 Yuval Levin Matt Schlapp Mary Katherine Hamm would like to send to her - need email Mollie Hemingway Kelsey Harkness would like to send to her - need email Sender: Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; "Brady, Will (HHS/IOS) "; "Kalavritinos, Jack (OS/IEA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Reilly, Erin (OS/IEA) "; "Wagner, Steven (ACF) "; Recipient: " Murphy, Ryan (OS/ASPA) "; "Stecker, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "; "Caliguiri , Laura (HHS/IOS) "; "Dareshor i, Zack (HHS/IOS) "; "Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA) "; "Hayes, Jonathan (ACF) " -Lloyd, Edwa> "i Sent Date : 20 18/07/13 12:01 :17 /\MERICAi\ pVERSIGHT EXT-18-248-B-000279 Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) "; "Wagner, Steven (ACF) "; " Murphy, Ryan (OS/ASPA)"; "Stecker, Judy (OS/ASPA) "i " Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Callahan, Kenneth (HHS/IOS) "i "Brady, Will (HHS/IOS) "; "Caliguiri, Laura (HHS/IOS) "i "Dareshori, Zack (HHS/IOS) "; " Harrison, Brian (HHS/IOS) "; "Callahan, Kenneth (HHS/IOS) "; "Brady, Will (HHS/IOS) "; "Kalavritinos, Jack (OS/IEA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; " Reilly, Erin (OS/IEA) " Subject: FW: Call on UACwith Dep Sec Date: 2018/07/13 12:01:17 Start Date: 2018/07/13 14:00:00 End Date: 2018/07/13 14:30:00 Priority: Normal Type: Appointment -----Original Appointment----From: Trueman, Laura (HHS/IEA) Sent : Friday, July 13, 2018 11:09 AM To: Trueman, Laura (HHS/IEA); Callahan, Kennet h (HHS/IOS); Brady, W ill (HHS/IOS); Kalavritinos, Jack (OS/IEA); Beck, Gary (OS/IEA); Johnston, Darcie (HHS/I EA); Reilly, Erin (OS/IEA) Subject : Call on UAC with Dep Sec When: Friday, July 13, 2018 2:00 PM-2:30 PM (UTC-05:00) Eastern Time (US & Canada). Where : !(b)(6) Participant Code /\MERICAi\ pVERSIGHT kbl{6l EXT-18-248-B-000280 LeaderCo de l~ (b~)(6 ~)_ _. From: Trueman, Laura (HHS/IEA) Sent: Friday, July 13, 2018 10:52 AM To: Trueman, Laura (HHS/IEA) Subject : Invite for Call @ 2pm ESTToday Importance : High Dear Colleague You are invited to join a call with HHS Deputy Secretary Eric Hargan at 2pm ESTtoday. He w ill be discussing HHS's care and reunification of the minors in the Unaccompanied Alien Children (UAC) program, particularly those affected by the court order for reunification . As you know, there has been inte nse focus on this in the media. As key opinion leaders who speak to important audiences for our Administration, we believe it is impor t ant that you know what is fact and what is fiction. While th is may not be directly in your organization's day-to-day wheelhouse, we know that your being knowledgeable on an issue where unfair character izations are being made can be helpful. Call in# Parti cipant Code ..._ !(b....,)( ..... 6)'--- __ != (b...,.l(6 ""l _ _. _. Please let me know if you plan to join. I know our Deputy Secretary will appreciate the opportunity to connect with you. By the way, while this is invitation only, if you are not able to join today and want to have a colleague on the call, t hat is fine - j ust let me know about the substitute . Below please find our latest report on reunif icat ion efforts , in graphic and t ext. Laura The run of show is: Laura Trueman to open and introduce HHS participants and introduce the Deputy Secretary EDH to give comments at the top with an update and perspective Q and A with Steve Wagner/Scott Lloyd and Chris Meekins and if EDH is available for some or all. The list of participants: Hispanic Leadership Fund FRC Heritage /\MERICAi\ pVERSIGHT Mario H. Lopez Tony Perkins arp@frc.org dxc@frc.org David Christensen David Inserra (scholar) david.inserra@heritage.org Hans von Spakovsky (Scholar) EXT-18-248-B-000281 John Cooper (Director of Comms) AEI Robert Doar John Cusey john.cusey@awi.org, Karlyn Bowman Focus on the Family Tim Goeglein tim.goeglein@fotf.org American Conservative Union Dan Schneider dschneider@conservative.org Ethics and Policy Center Travis Wussow Faith and Freedom Coalition Ralph Reed ralph@centstrat.com Patrick Purtill, patrick@ffcoalition.com Americans for Prosperity ATR Grover Norquist and Alex Hendrie Foundation for Research on Equal Opportunity' Avik Roy John Fund Peter Roff Yuval Levin Matt Schlapp Mary Katherine Hamm would like to send to her- need email Mollie Hemingway Kelsey Harkness would like to send to her - need email Trueman, Laura (HHS/I EA) "Trueman, Laura (HHS/IEA) "; "Wagner, Steven (ACF) "; "Murphy, Ryan (OS/ASPA)"; "Stecker, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "; " Pilato, Anna (ACF) "; Recipient: "Callahan, Kenneth (HHS/IOS) "; "Brady, Will (HHS/IOS) "; "Caliguiri, Laura (HHS/IOS) "; "Dareshori, Zack (HHS/IOS) "; "Harrison, Brian (HHS/IOS) "; "Callahan, Kenneth (HHS/IOS) "; "Brady, Will (HHS/IOS) "; " Kalavritinos, Jack (OS/IEA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; /\MERICAi\ pVERSIGHT EXT-18-248-B-000282 " Reilly, Erin (05/IEA) " Sent Date: 20 18/07/13 12:01: 17 /\MERICAi\ pVERSIGHT EXT-18-248-B-000283 Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; To: "Brady, Will (HHS/IOS) "; "Kalavr itinos, Jack (OS/IEA) "; " Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Reilly, Erin (OS/IEA) " "Wagner, Steven (ACF) "; "Murphy, Ryan (OS/ASPA) "; "Stecker, Judy (OS/ASPA) "; " Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; " Dareshori, Zack (HHS/IOS) "; " Harrison, Brian (HHS/IOS) " Subject: FW: Call on UAC with Dep Sec Date: 20 18/07/13 12:01:17 Start Date: 2018/07/13 14:00:00 End Date: 20 18/07/13 14:30:00 Priority: Norma l Type: Appointment Trueman, Laura (HHS/IEA); Callahan, Kenneth (HHS/IOS); Brady, Wil l (HHS/IOS); Kalavrit inos, Jack (OS/I EA); Beck, Gary (OS/I EA); Johnst on, Darcie (HHS/IEA); Reilly, Erin (OS/IEA); Attendees: Wagne r, Steven (ACF); Murphy, Ryan (OS/ASPA); Stecker, Judy (O5/ASPA); Lloyd, Scott (ACF); Pilato, Anna (ACF); Caliguiri, Laura (HHS/IOS); Dareshori, Zack (HHS/IOS); Harrison, Brian (HHS/IOS) ----- Original Appointment ----From: Trueman, Laura (HHS/IEA) Sent: Friday, July 13, 2018 11:09 AM To: Trueman, Laura (HHS/IEA); Callahan, Kenneth (HHS/I OS); Brady, Will (HHS/IOS); Kalavrit inos, Jack (OS/IEA); Beck, Gary (OS/IEA); Johnston , Darcie {HHS/I EA); Reilly, Erin (OS/IEA) Subject : Call on UAC with Dep Sec When: Fri day, July 13, 2018 2:00 PM-2:30 PM (UTC-05 :00) Eastern Time (US & Canada). Where : !(b)(6) i{bl{6l l= {b=l{6=l -~I Participant Code LeaderCode From: Trueman, Laura (HHS/IEA) Sent: Friday, July 13, 2018 10:5 2 AM To: Trueman, Laura (HHS/IEA) /\MERICAi\ pVERSIGHT EXT-18-248-B-000284 Subje ct: Invite for Call @ 2pm ESTToday Importanc e: High Dear Colleague You are invited to j oin a call w ith HHS Deputy Secret ary Eric Hargan at 2pm ESTtod ay. He will be discussing HHS' s care and reunificat ion of the mino rs in the Unaccompanied Alien Children (UAC) program, particularly those affected by the court order for reunification. As you know , there has been intense focus on this in the media . As key opinion leaders who speak to important audiences for our Adm inistration, we believe it is impor t ant that you know what is fact and what is fiction. While this may not be directly in your organization ' s day-to -day whee lhouse, we know that your being knowledgeable on an issue where unfair characterizat ions are being made can be helpful. Ca ll in # l< ...,b"-') (""'6 )._ Parti cipant Code l= {b.,,l {6=l _ _. __ _. Please let me know if you plan to join. I know our Deputy Secretary wi ll appreciate the opportunity to connect w ith you. By the way, wh ile th is is invit ation only, if yo u are not able to join today and want to have a colleague on the call, that is fine - just let me know about the substitute. Below please find our latest report on reunification efforts, in graphic and text. Laura The run of show is: Laura Trueman to open and introduce HHS participants and introduce the Deputy Secretary EDH to give comments at the top with an update and perspective Q and A with Steve Wagner/Scott Lloyd and Chris Meekins and if EDH is available for some or all. The list of participants: Hispanic Leadership Fund FRC Heritage AEI Focus on the Family /\MERICAi\ pVERSIGHT Mario H. Lopez Tony Perkins arp@frc.org dxc@frc.org David Christensen David Inserra (scholar) david.inserra@heritage.org Hans von Spakovsky (Scholar) John Cooper (Director of Comms) Robert Doar John Cusey john.cusey@awi.org, Karlyn Bowman Tim Goeglein tim.goeglein@fotf.org EXT-18-248-B-000285 American Conservative Union Dan Schneider dschneider@conservative .org Ethics and Policy Center Travis Wussow Faith and Freedom Coalition Ralph Reed ralph@centstrat.com Patrick Purtill, patrick@ffcoalition.com Americans for Prosperity ATR Grover Norquist and Alex Hendrie Foundation for Research on Equal Opportunity' Avik Roy John Fund Peter Roff Yuval Levin Matt Schlapp Mary Katherine Hamm would like to send to her- need email Mollie Hemingway Kelsey Harkness would like to send to her - need email Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) "Callahan, Kenneth (HHS/IOS) "; "Brady, Will (HHS/IOS) "; "Kalavritinos, Jack (OS/IEA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Reilly, Erin (OS/IEA) "; Recipient: "Wagner, Steven (ACF) "; "Murphy, Ryan (OS/ASPA) "; "Stecker, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; "Dareshor i, Zack (HHS/IOS) "; "Harrison , Brian (HHS/IOS) " 11 ; Sent Date: 2018/07/13 12:01:17 /\MERICAi\ pVERSIGHT EXT-18-248-B-000286 Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; To: "Brady, Will (HHS/IOS) "; "Kalavr itinos, Jack (OS/IEA) "; " Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Reilly, Erin (OS/IEA) " "Wagner, Steven (ACF) "; "Stecke r, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; CC: "Caliguiri, Laura (HHS/IOS) "; "Dareshor i, Zack (HHS/IOS) < Zachary.Dareshori@hhs.gov>"; " Harrison, Brian (HHS/IOS) "; " Murphy, Ryan (OS/ASPA) " Subject: FW: Call on UAC with Dep Sec Date: 20 18/07/13 12:01 : 17 Start Date: 20 18/07/13 14:00:00 End Date: 20 18/07/13 14:30:00 Priority: Normal Type: Appointment Trueman, Laura (HHS/IEA); Callahan, Kenneth (HHS/IOS); Brady, Wil l (HHS/IOS); Kalavritinos, Jack (OS/IEA); Beck, Gary (OS/IEA); Johnst on, Darcie (HHS/IEA); Reilly, Erin (OS/IEA); Att endees: Wagner, Steven (ACF); Murphy, Ryan (OS/ASPA); Stecker, Judy (OS/ASPA); Lloyd, Scott (ACF); Pilato, Anna (ACF); Caliguiri, Laura (HHS/IOS); Dareshori, Zack (HHS/IOS); Harrison, Brian (HHS/IOS) ----- Original Appointment ----From: Trueman, Laura {HHS/IEA) Sent: Friday, July 13, 2018 11:09 AM To: Trueman, Laura (HHS/IEA); Callahan, Kenneth (HHS/IOS); Brady, Will (HHS/IOS); Kalavrit inos, Jack (OS/IEA); Beck, Gary (OS/IEA); Johnston, Darcie (HHS/I EA); Reilly, Erin (OS/IEA) Subject : Call on UAC with Dep Sec When: Friday, July 13, 2018 2:00 PM-2:30 PM (UTC-05:00) Eastern Time (US & Canada). Where : !{b)(6) Participant Code LeaderCode !(b)(6) l= /\MERICAi\ pVERSIGHT EXT-18-248-B-000287 Subje ct: Invite for Call @ 2pm ESTToday Importanc e: High Dear Colleague You are invited to j oin a call w ith HHS Deputy Secret ary Eric Hargan at 2pm ESTtod ay. He will be discussing HHS' s care and reunificat ion of the mino rs in the Unaccompanied Alien Children (UAC) program, particularly those affected by the court order for reunification. As you know , there has been intense focus on this in the media . As key opinion leaders who speak to important audiences for our Adm inistration, we believe it is impor t ant that you know what is fact and what is fiction. While this may not be directly in your organization ' s day-to -day whee lhouse, we know that your being knowledgeable on an issue where unfair characterizat ions are being made can be helpful. Ca ll in # l< ...,b"-') (""'6 )._ Parti cipant Code l= {b.,,l {6=l _ _. __ _. Please let me know if you plan to join. I know our Deputy Secretary wi ll appreciate the opportunity to connect w ith you. By the way, wh ile th is is invit ation only, if yo u are not able to join today and want to have a colleague on the call, that is fine - just let me know about the substitute. Below please find our latest report on reunification efforts, in graphic and text. Laura The run of show is: Laura Trueman to open and introduce HHS participants and introduce the Deputy Secretary EDH to give comments at the top with an update and perspective Q and A with Steve Wagner/Scott Lloyd and Chris Meekins and if EDH is available for some or all. The list of participants: Hispanic Leadership Fund FRC Heritage AEI Focus on the Family /\MERICAi\ pVERSIGHT Mario H. Lopez Tony Perkins arp@frc.org dxc@frc.org David Christensen David Inserra (scholar) david.inserra@heritage.org Hans von Spakovsky (Scholar) John Cooper (Director of Comms) Robert Doar John Cusey john.cusey@awi.org, Karlyn Bowman Tim Goeglein tim.goeglein@fotf.org EXT-18-248-B-000288 American Conservative Union Dan Schneider dschneider@conservative .org Ethics and Policy Center Travis Wussow Faith and Freedom Coalition Ralph Reed ralph@centstrat.com Patrick Purtill, patrick@ffcoalition.com Americans for Prosperity ATR Grover Norquist and Alex Hendrie Foundation for Research on Equal Opportunity' Avik Roy John Fund Peter Roff Yuval Levin Matt Schlapp Mary Katherine Hamm would like to send to her- need email Mollie Hemingway Kelsey Harkness would like to send to her - need email Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) 11 ; "Callahan, Kenneth (HHS/IOS) "; "Brady, Will (HHS/IOS) "; "Kalavritinos, Jack (OS/IEA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Reilly, Erin (OS/IEA) "; Recipient: "Wagner, Steven (ACF) "; "Stecker, Judy (OS/ASPA)"; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; " Dareshori, Zack (HHS/IOS) "; "Harrison, Brian (HHS/IOS) "; "Murphy, Ryan (OS/ASPA)" Sent Date: 2018/07/13 12:01:17 /\MERICAi\ pVERSIGHT EXT-18-248-B-000289 Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; "Brady, Will (HHS/IOS) "; To: " Kalavritinos, Jack (OS/IEA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Reilly, Erin (OS/IEA) " "Wagner, Steven (ACF) "; "Stecker, Judy (OS/ASPA)"; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; CC: "Caliguiri, Laura (HHS/IOS) "; " Dareshori, Zack (HHS/IOS) "; "Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA)"; "Murphy, Ryan (OS/ASPA)" Subject: FW: Call on UAC with Dep Sec Date: 2018/07/13 12:01: 17 Start Date: 2018/07/13 14:00:00 End Date: 2018/07/13 14:30:00 Priority: Normal Type: Appointment Trueman, Laura (HHS/IEA); Callahan, Kenneth (HHS/IOS); Brady, Will (HHS/IOS); Kalavritinos, Jack (OS/IEA); Beck, Gary (OS/IEA); Johnston, Darcie (HHS/IEA); Reilly, Erin (OS/IEA); Attendees: Wagner, Steven (ACF); Murphy, Ryan (OS/ASPA);Stecker, Judy (O5/ASPA); Lloyd, Scott (ACF); Pilato, Anna (ACF); Caliguiri, Laura (HHS/IOS); Dareshori, Zack (HHS/IOS); Harrison, Brian (HHS/IOS); Riley Althouse (Riley.Althouse@hhs.gov) ----- Original A ppointment ----From: Truema n, Laura (HHS/IEA) Sent: Friday, July 13, 2018 11:09 AM To: Trueman, Laura (HHS/ IEA); Callahan, Kenneth (HHS/10S); Brady, Will (HHS/ 10S); Kalavrit inos, Jack (OS/IEA); Beck, Gary (OS/IEA); Johnston , Darcie (HHS/I EA); Reilly, Erin (OS/IEA) Subject : Call on UAC with Dep Sec /\MERICAi\ pVERSIGHT EXT-18-248-B-000290 When : Friday, July 13, 2018 2:00 PM-2:30 PM (UTC-05:00) Eastern Time (US & Canada). Wh ere: !(b)(6) Participant Code !{bl{6l LeaderCode l= Subject: Invite for Call@ 2pm ESTToday Importance: High Dear Colleague You are invited to join a call with HHS Deputy Secretary Eric Hargan at 2pm ESTtoday . He will be discussing HHS's care and reunification of the minors in the Unaccompanied Alien Children (UAC) program, particularly those affected by the court order for reunification. As you know, there has been intense focus on this in the media. As key opinion leaders who speak to important audiences for our Administration, we believe it is impor tant that you know what is fact and what is fiction. While this may not be directly in your organization's day-to-day wheelhouse, we know that your being knowledgeable on an issue where unfair characterizations are being made can be helpful. Call in# ""'!{b"'-')(-"'6 )..____ ~ Participant Code l... {b....,,l {6 ,...l _ _, Please let me know if you plan to join. I know our Deputy Secretary will appreciate the opportunity to connect with you. By the way, while this is invitation only, if you are not able to join today and want to have a colleague on the call, that is fine - just let me know about the substitute . Below please find our latest report on reunification efforts, in graphic and text . Laura The run of show is: Laura Trueman to open and introduce HHS participants and introduce the Deputy Secretary EDH to give commen t s at the top wit h an update and perspective Q and A with Steve Wagner/Scott Lloyd and Chris Meekins and if EDH is available for some or all. The list of participants: /\MERICAi\ pVERSIGHT EXT-18-248-B-000291 Hispanic Leadership Fund FRC Mario H. Lopez Tony Perkins arp@frc.org dxc@frc.org David Christensen Heritage David Inserra (scholar) david.inserra@heritage.org Hans von Spakovsky (Scholar) John Cooper (Director of Comms) AEI Robert Doar John Cusey john.cusey@awi.org, Karlyn Bowman Focus on the Family Tim Goeglein tim.goeglein@fotf.org American Conservative Union Dan Schneider dschneider@conservative.org Ethics and Policy Center Travis Wussow Faith and Freedom Coalition Ralph Reed ralph@centstrat.com Patrick Purtill, patrick@ffcoalition.com Americans for Prosperity ATR Grover Norquist and Alex Hendrie Foundation for Research on Equal Opportunity' Avik Roy John Fund Peter Roff Yuval Levin Matt Schlapp Mary Katherine Hamm would like to send to her - need email Mollie Hemingway Kelsey Harkness would like to send to her - need email Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; "Brady, Will (HHS/IOS) "; " Kalavritinos, Jack (OS/IEA) "; "Beck, Gary (OS/IEA) "; Recipient : "Johnston, Darcie (HHS/IEA) "; " Reilly, Erin (OS/IEA) "; "Wagner, Steven (ACF) "; "Stecker, Judy (OS/ASPA) "; " Lloyd, Scott (ACF) "; /\MERICAi\ pVERSIGHT EXT-18-248-B-000292 " Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; "Dareshori, Zack (HHS/IOS) "; "Harrison, Brian (HHS/ IOS) "; "Althouse, Riley (OS/ASPA)"; "Murphy, Ryan (OS/ASPA)" Sent Date: 2018/07/ 13 12:01:17 /\MERICAi\ pVERSIGHT EXT-18-248-B-000293 Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; To: "Brady, Will (HHS/IOS) "; "Kalavr itinos, Jack (OS/IEA) "; " Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Reilly, Erin (OS/IEA) " "Wagner, Steven (ACF) "; "Stecke r, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; CC: "Dareshor i, Zack (HHS/IOS) < Zachary.Dareshori@hhs.gov>"; " Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA) "; "Hayes, Jonathan (ACF) "; "Murphy, Ryan (OS/ASPA) " Subject: FW: Call on UAC with Dep Sec Dat e: 2018/07/13 12:01:17 Start Date: 2018/07/13 14:00:00 End Dat e: 2018/07/13 14:30:00 Priority: Norma l Type: Appointment Trueman, Laura (HHS/IEA); Callahan, Kenneth (HHS/IOS); Brady, Wil l (HHS/IOS); Kalavrit inos, Jack (OS/IEA); Beck, Gary (OS/IEA); Johnston, Darcie (HHS/IEA); Reilly, Erin (OS/IEA); Attendees: Wagner, Steven (ACF); Murphy, Ryan (OS/ASPA); Stecker, Judy (OS/ASPA); Lloyd, Scott (ACF); Pilato, Anna (ACF); Caliguiri, Laura (HHS/IOS); Dareshori, Zack (HHS/IOS); Harrison, Brian (HHS/IOS); Riley Althouse (Riley.Althouse@hhs.gov); Hayes, Jonathan (ACF) -----Origi nal Appointment----From: Tru eman, Laura (HHS/IEA) Sent: Friday, July 13, 2018 11:09 AM To: Trueman, Laura (HHS/IEA); Callahan, Kenneth (HHS/IOS); Brady, Will (HHS/IOS); Kalavritinos, Jack (OS/IEA); Beck, Gary (OS/IEA); Johnston, Darcie (HHS/I EA); Reilly, Erin (OS/IEA) Subject: Call on UAC with Dep Sec When: Friday, July 13, 2018 2:00 PM-2:30 PM (UTC-05:00) Eastern Time (US & Canada). Where : !(b)(6) !(b){6l l= {b=l{6=l -~I Participant Code LeaderCode /\MERICAi\ pVERSIGHT EXT-18-248-B-000294 From : Trueman, Laura (HHS/IEA) Sent : Friday, July 13, 2018 10:52 AM To: Trueman, Laura (HHS/IEA) Subject: Invite for Call @ 2pm ESTToday Import ance: High Dear Colleague You are invited to join a call with HHS Deputy Secret ary Eric Hargan at 2pm ESTtoday. He will be discussing HHS's care and reunification of the minors in the Unaccompanied Alien Children (UAC) program, particularly those affected by the court order for reunification. As you know, there has been intense focus on this in the media . As key opinion leaders who speak to important audiences for our Adm inistration, we believe it is impor t ant that you know what is fact and what is fiction . While this may not be directly in your organization's day-to -day whee lhouse, we know that your being knowledgeable on an issue where unfair characterizations are being made can be helpful. Ca ll in # Participant Code l< -b~H ~6~ l __ _, l={b..,.) (6""') _ _, Please let me know if you plan to join . I know our Deputy Secretary wi ll appreciate the opportunity to connect w ith you . By the way, wh ile th is is invit at ion only, if yo u are not able to join today and want to have a colleague on the call, t hat is fine - just let me know about the substitute. Below please find our latest report on reunification efforts, in graphic and text . Laura The run of show is: Laura Trueman to open and introduce HHS participants and introduce the Deputy Secretary EDH to give comments at the top with an update and perspective Q and A with Steve Wagner/Scott Lloyd and Chris Meekins and if EDH is available for some or all. The list of participants: Hispanic Leadership Fund FRC Heritage AEI /\MERICAi\ pVERSIGHT Mario H. Lopez Tony Perkins arp@frc.org dxc@frc.org David Christensen David Inserra (scholar) david.inserra@heritage.org Hans van Spakovsky (Scholar) John Cooper (Director of Comms) Robert Doar EXT-18-248-B-000295 John Cusey john.cusey@awi.org, Karlyn Bowman Focus on the Family Tim Goeglein tim.goeglein@fotf.org American Conservative Union Dan Schneider dschneider@conservative.org Ethics and Policy Center Travis Wussow Faith and Freedom Coalition Ralph Reed ralph@centstrat.com Patrick Purtill, patrick@ffcoalition.com Americans for Prosperity ATR Grover Norquist and Alex Hendrie Foundation for Research on Equal Opportunity' Avik Roy John Fund Peter Roff Yuval Levin Matt Schlapp Mary Katherine Hamm would like to send to her- need email Mollie Hemingway Kelsey Harkness would like to send to her - need email Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; " Brady, Will (HHS/IOS) "; "Kalavritinos, Jack (OS/IEA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Reilly, Erin (OS/IEA) "; "Wagner, Steven (ACF) "; Recipient: "Stecker, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "; " Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; " Dareshori, Zack (HHS/IOS) "; "Harrison, Brian (HHS/IOS) < Brian.Harrison@hhs.gov>"; "Althouse, Riley (OS/ASPA) "; " Hayes, Jonathan (ACF) "; "Murphy, Ryan (OS/ASPA) " Sent Date : 2018/07/13 12:01:17 /\MERICAi\ pVERSIGHT EXT-18-248-B-000296 Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; To: "Brady, Will (HHS/IOS) "; "Kalavr itinos, Jack (OS/IEA) "; " Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Reilly, Erin (OS/IEA) " "Wagner, Steven (ACF) "; "Stecker, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; CC: "Dareshori, Zack (HHS/IOS) < Zachary.Dareshori@hhs.gov>"; " Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA) "; "Hayes, Jonathan (ACF) "; "HHS IEA (OS/IEA) "; "Murphy, Ryan (OS/ASPA) " Subject: FW: Call on UAC with Dep Sec Date : 2018/07/ 13 12:01:17 Start Date: 2018/07/13 14:00 :00 End Date : 2018/07/13 14:30 :00 Priority: Normal Ty pe: Appointment Trueman, Laura (HHS/IEA); Callahan, Kenneth (HHS/IOS); Brady, Wil l (HHS/IOS); Kalavrit inos, Jack (OS/IEA); Beck, Gary (OS/IEA); Johnston, Darcie (HHS/IEA); Reilly, Erin (OS/I EA); Wagner, Steven (ACF); Murphy, Ryan (OS/ASPA); Stecker, Judy (OS/ASPA); Lloyd, Scott (ACF); Attendees: Pilato, Anna (ACF); Caliguiri, Laura (HHS/IOS); Dareshori, Zack (HHS/IOS); Harrison, Brian (HHS/IOS); Riley Althouse (Riley.Althouse@hhs .gov); Hayes, Jonathan (ACF); HHS IEA (OS/IEA) -----Original Appointment----From: Trueman, Laura (HHS/IEA) Sent: Friday, July 13, 2018 11:09 AM To: Trueman, Laura (HHS/IEA); Callahan, Kenneth (HHS/I OS); Brady, W ill (HHS/IOS); Kalavritinos, Jack (OS/IEA); Beck, Gary (OS/IEA); Johnston, Darcie (HHS/I EA); Reilly, Erin (OS/IEA) Subject : Call on UAC with Dep Sec When: Friday, July 13, 2018 2:00 PM-2:30 PM (UTC-05:00) Eastern Time (US & Canada). Where: !(b)(6) !{bl(6l LeaderCo de l= Subject: Invite for Call @ 2pm ESTToday Import ance: High Dear Colleague You are invited to join a call with HHS Deputy Secret ary Eric Hargan at 2pm ESTtoday. He will be discussing HHS's care and reunification of the minors in the Unaccompanied Alien Children (UAC) program, particularly those affected by the court order for reunification. As you know, there has been intense focus on this in the media . As key opinion leaders who speak to important audiences for our Adm inistration, we believe it is impor t ant that you know what is fact and what is fiction . While this may not be directly in your organization's day-to -day whee lhouse, we know that your being knowledgeable on an issue where unfair characterizations are being made can be helpful. Ca ll in # Participant Code l< -b~H ~6~ l __ _, l={b..,.) (6""') _ _, Please let me know if you plan to join . I know our Deputy Secretary wi ll appreciate the opportunity to connect w ith you . By the way, wh ile th is is invit at ion only, if yo u are not able to join today and want to have a colleague on the call, t hat is fine - just let me know about the substitute. Below please find our latest report on reunification efforts, in graphic and text . Laura The run of show is: Laura Trueman to open and introduce HHS participants and introduce the Deputy Secretary EDH to give comments at the top with an update and perspective Q and A with Steve Wagner/Scott Lloyd and Chris Meekins and if EDH is available for some or all. The list of participants: Hispanic Leadership Fund FRC Heritage AEI /\MERICAi\ pVERSIGHT Mario H. Lopez Tony Perkins arp@frc.org dxc@frc.org David Christensen David Inserra (scholar) david.inserra@heritage.org Hans van Spakovsky (Scholar) John Cooper (Director of Comms) Robert Doar EXT-18-248-B-000298 John Cusey john.cusey@awi.org, Karlyn Bowman Focus on the Family Tim Goeglein tim.goeglein@fotf.org American Conservative Union Dan Schneider dschneider@conservative.org Ethics and Policy Center Travis Wussow Faith and Freedom Coalition Ralph Reed ralph@centstrat.com Patrick Purtill, patrick@ffcoalition.com Americans for Prosperity ATR Grover Norquist and Alex Hendrie Foundation for Research on Equal Opportunity' Avik Roy John Fund Peter Roff Yuval Levin Matt Schlapp Mary Katherine Hamm would like to send to her- need email Mollie Hemingway Kelsey Harkness would like to send to her - need email Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; " Brady, Will (HHS/IOS) "; "Kalavritinos, Jack (OS/IEA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Reilly, Erin (OS/IEA) "; "Wagner, Steven (ACF) "; "Stecker, Judy (OS/ASPA) "; Recipient: "Lloyd, Scott (ACF) "; " Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; " Dareshori, Zack (HHS/IOS) "; "Harrison, Brian (HHS/IOS) < Brian.Harrison@hhs.gov>"; "Althouse, Riley (OS/ASPA) "; " Hayes, Jonathan (ACF) "; "HHS IEA (OS/IEA) "; "Murphy, Ryan (OS/ASPA) " Sent Date: 2018/07/13 12:01:17 /\MERICAi\ pVERSIGHT EXT-18-248-B-000299 Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; "Brady, Will (HHS/IOS) "; To: " Kalavritinos, Jack (OS/IEA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Reilly, Erin (OS/IEA) " "Wagner, Steven (ACF) "; "Murphy, Ryan (OS/ASPA)"; "Stecker, Judy (OS/ASPA) "; " Lloyd, Scott (ACF) "; " Pilato, Anna (ACF) "; CC: "Caliguiri, Laura (HHS/IOS) " ; "Dareshori, Zack (HHS/IOS) "; "Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA)"; "Hayes, Jonathan (ACF) " ; "HHS IEA (OS/IEA) " Subject: Call on UACwith Dep Sec Date: 2018/07/13 12:01:17 Start Date: 2018/07/ 13 14:00:00 End Date: 2018/07/ 13 14:30:00 Priority: Normal Type: Appointment Location: IEA Conference room Callahan, Kenneth (HHS/IOS); Brady, Will (HHS/IOS); Kalavritinos,Jack (OS/IEA); Beck, Gary (OS/IEA); Johnston, Darcie (HHS/IEA); Reilly, Erin (OS/IEA); Wagner, Steven (ACF); Murphy, Attendees: Ryan (OS/ASPA);Stecker, Judy (OS/ASPA);Lloyd, Scott (ACF); Pilato, Anna (ACF); Caliguiri, Laura (HHS/IOS); Dareshori, Zack (HHS/IOS); Harrison, Brian (HHS/IOS); Riley Althouse (Riley.Althouse@hhs.gov); Hayes,Jonathan (ACF); HHSIEA (OS/IEA) !(b)/6) Participant Code Leader Code /\MERICAi\ pVERSIGHT !ibl/6) !(b}(6) I EXT-18-248-B-000300 From: Trueman, Laura (HHS/IEA) Sent: Friday, July 13, 2018 10:52 AM To: Trueman, Laura (HHS/IEA) Subject: Invite for Call @ 2pm ESTToday Importance: High Dear Colleague You are invited to join a call with HHS Deputy Secretary Eric Hargan at 2pm ESTtoday. He will be discussing HHS' s care and reunification of the minors in the Unaccompanied Alien Children (UAC) program, particularly those affected by the court order for reunification. As you know, there has been intense focus on this in the media. As key opinion leaders who speak to important audiences for our Administration, we believe it is impor tant that you know what is fact and what is fiction. While this may not be directly in your organization's day-to-day wheelhouse, we know that your being knowledgeable on an issue where unfair characterizations are being made can be helpful. Call in # l< ~b~ )(~6)~ Participant Code ~lr b_...)( __.6) _ _. __ _. Please let me know if you plan to join . I know our Deputy Secretary will appreciate the opportunity to connect with you. By the way, while this is invitation only, if you are not able to join today and want to have a colleague on the call, that is fine - just let me know about the substitute. Below please find our latest report on reunification efforts, in graphic and text. Laura The run of show is: Laura Trueman to open and introduce HHS participants and introduce the Deputy Secretary EDH to give comments at the top with an update and perspective Q and A with Steve Wagner/Scott Lloyd and Chris Meekins and if EDH is available for some or all. The list of participants: Hispanic Leadership Fund FRC Heritage /\MERICAi\ pVERSIGHT Mario H. Lopez Tony Perkins arp@frc.org dxc@frc.org David Christensen David Inserra (scholar) david.inserra@heritage.org Hans van Spakovsky (Scholar) John Cooper (Director of Comms) EXT-18-248-B-000301 AEI Robert Doar John Cusey john.cusey@awi.org, Karlyn Bowman Focus on the Family Tim Goeglein tim.goeglein@fotf.org American Conservative Union Dan Schneider dschneider@conservative .org Ethics and Policy Center Travis Wussow Faith and Freedom Coalition Ralph Reed ralph@centstrat.com Patrick Purtill, patrick@ffcoalition.com Americans for Prosperity ATR Grover Norquist and Alex Hendrie Foundation for Research on Equal Opportunity' Avik Roy John Fund Peter Roff Yuval Levin Matt Schlapp Mary Katherine Hamm would like to send to her - need email Mollie Hemingway Kelsey Harkness would like to send to her - need email Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) 11 ; "Callahan, Kenneth (HHS/IOS) "; " Brady, Will (HHS/IOS) "; "Kalavritinos, Jack (OS/IEA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; " Reilly, Erin (OS/IEA) "; "Wagner, Steven (ACF) "; "Murphy, Ryan (OS/ASPA)"; "Stecker, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; "Dareshori, Zack (HHS/IOS) "; " Harrison, Brian (HHS/IOS) "; "Althouse, Riley (O5/ASPA)"; "Hayes, Jonathan (ACF) "; "HHS IEA (O5/IEA) " Se nt Date : 2018/07/13 12:01:17 /\MERICAi\ pVERSIGHT EXT-18-248-B-000303 Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; To: "Brady, Will (HHS/IOS) "; "Kalavr itinos, Jack (OS/IEA) "; " Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Reilly, Erin (OS/IEA) " "Wagner, Steven (ACF) "; "Stecker, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; CC: "Dareshori, Zack (HHS/IOS) < Zachary.Dareshori@hhs.gov>"; " Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA) "; "Hayes, Jonathan (ACF) "; "Murphy, Ryan (OS/ASPA) " Subject: Call on UAC with Dep Sec Date: 2018/07/ 13 12:01:17 Start Date: 2018/07/ 13 14:00 :00 End Date: 2018/07/13 14:30 :00 Priority: Norma l Type: Appointment Location : IEA Conference room Trueman, Laura (HHS/IEA); Callahan, Kenneth (HHS/IOS); Brady, Will (HHS/IOS); Kalavrit inos, Jack (OS/I EA); Beck, Gary (OS/IEA); Johnston, Darcie (HHS/IEA); Reilly, Erin (OS/IEA); Wagne r, Steven (ACF); Murphy, Ryan (OS/ASPA); Stecker, Judy (O5/ASPA); Lloyd, Scott (ACF); Attendees: Pilato, Anna (ACF); Caliguiri, Laura (HHS/IOS); Dareshori, Zack (HHS/IOS); Harrison, Brian (HHS/ I OS); Riley Althouse (Riley.Althouse@hhs.gov); Hayes, Jonathan (ACF); HHS !EA (OS/IEA) !{b)(6) Participant Code LeaderCode !{b)(6l l= {b=)(6 =l_ _.l From : Trueman, Laura (HHS/IEA) Sent: Friday, July 13, 2018 10:52 AM To: Trueman, Laura (HHS/IEA) Subject : Invite for Call @ 2pm ESTToday Importance: High Dear Colleague You are invited to joi n a call with HHS Deputy Secretary Eric Hargan at 2pm ESTtoday. He will be discussing HHS's care and reunification of the minors in the Unaccompanied Alien Children (UAC) program, particularly those affected by the court order for reunification. /\MERICAi\ pVERSIGHT EXT-18-248-B-000304 As you know, there has been intense focus on this in the media. As key opinion leaders who speak to important audiences for our Administration, we believe it is important that you know what is fact and what is fiction. While this may not be directly in your organization's day-to-day wheelhouse, we know that your being knowledgeable on an issue where unfair characterizations are being made can be helpful. Call in# Participant Code ""!(b""'l(.a..6l _____ _. l= "T rueman, Laura (HHS/IEA) ; "Callahan, Kennet h (HHS/IOS) < Kenneth. Callahan@hhs.gov>"; " Brady, Will (HHS/l05) "; " Kalavritinos, Jack (05/IEA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/I EA) "; "Reilly, Erin (0S/IEA) "; "Wagner, Steven (ACF) "; Recipient: "Stecker, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "; " Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; "Dareshori, Zack (HHS/IOS) "; "Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA) "; " Hayes, Jonathan (ACF) "; "Murphy, Ryan (OS/ASPA) " Sent Date: 2018/07/13 12:01:17 /\MERICAi\ pVERSIGHT EXT-18-248-B-000306 Trueman, Laura (HHS/IEA) "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; To: "Brady, Will (HHS/IOS) "; "Kalavr itinos, Jack (OS/IEA) "; " Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Reilly, Erin (OS/IEA) " "Wagner, Steven (ACF) "; "Stecker, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; CC: "Caliguiri, Laura (HHS/IOS) "; "Dareshori, Zack (HHS/IOS) < Zachary.Dareshori@hhs.gov>"; " Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA) "; "Murphy, Ryan (OS/ASPA) " Subject: FW: Call on UAC with Dep Sec Date: 2018/07/ 13 12:01 : 17 Start Date: 20 18/07/13 14:00 :00 End Date: 20 18/07/13 14:30 :00 Priority: Norma l Type: Appointment Trueman, Laura (HHS/I EA); Callahan, Kenneth (HHS/IOS); Brady, Wil l (HHS/IOS); Kalavrit inos, Jack (OS/IEA); Beck, Gary (OS/IEA); Johnston, Darcie (HHS/IEA); Reilly, Erin (OS/IEA); Attendee s: Wagne r, Steven (ACF); Murphy, Ryan (OS/ASPA); Stecker, Judy (O5/ASPA); Lloyd, Scott (ACF); Pilato, Anna (ACF); Caliguiri, Laura (HHS/IOS); Dareshori, Zack (HHS/1O5); Harrison, Brian (HHS/ I OS); Riley Althouse (Riley.Althouse@hhs.gov) -----Original Appointment----From : Tru eman, Laura (HHS/IEA) Sent: Friday, July 13, 2018 11:09 AM To: Trueman, Laura (HHS/IEA); Callahan, Kenneth (HHS/IOS); Brady, Will (HHS/IOS); Kalavritinos, Jack {OS/IEA); Beck, Gary {OS/IEA); Johnston, Darcie {HHS/I EA); Reilly, Erin {OS/IEA) Subject: Call on UAC with Dep Sec Wh en: Friday, July 13, 2018 2:00 PM-2:30 PM {UTC-05 :00) Eastern Time {US & Canada). Where : !(b)(6) Participant Code LeaderCode !(b)(6) 1(b_}(6 _}_~1 From : Trueman, Laura (HHS/IEA) Sent: Friday, July 13, 2018 10:52 AM /\MERICAi\ pVERSIGHT EXT-18-248-B-000307 To: Trueman, Laura (HHS/IEA) Subject: Invite for Call @ 2pm ESTToday Importance: High Dear Colleague You are invited to join a call with HHS Deputy Secretary Eric Hargan at 2pm ESTtoday. He will be discussing HHS's care and reunification of the minors in the Unaccompanied Alien Children (UAC) program, particularly those affected by the court order for reunification. As you know, there has been intense focus on this in the media. As key opinion leaders who speak to important audiences for our Administration, we believe it is im portant that you know what is fact and what is fiction. While this may not be directly in your organization's day-to -day whee lhouse, we know that your being knowledgeable on an issue where unfair character izations are being made can be helpful. Call in # l< _b_) (6 ~)--~ Partici pant Code l= "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; " Brady, Will (HHS/IOS) "; "Kalavritinos, Jack (OS/IEA) "; " Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Reilly, Erin (OS/IEA) "; "Wagner, Steven (ACF) "; Recipient: "Stecker, Judy (OS/ASPA)"; "Lloyd, Scott (ACF) "; " Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; " Dareshori,Zack (HHS/IOS) "; "Harrison, Brian (HHS/IOS) < Brian.Harrison@hhs.gov>"; "Althouse, Riley (OS/ASPA)"; " Murphy, Ryan (OS/ASPA)" Sent Date: 2018/07/13 12:01:17 /\MERICAi\ pVERSIGHT EXT-18-248-B-000309 Trueman, Laura (HHS/IEA) "Callahan, Kenneth (HHS/IOS) "; " Brady, Will (HHS/IOS) "; "Kalavritinos, Jack (OS/IEA) "; To: " Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/I EA) "; "Reilly, Erin (OS/IEA) " "Wagner, Steven (ACF) "; "Murphy, Ryan (OS/ASPA)"; "Stecker, Judy (OS/ASPA)"; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; CC: "Caliguiri, Laura (HHS/IOS) "; " Dareshori, Zack (HHS/IOS) "; "Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA)"; "Hayes, Jonathan (ACF) "; "HHS IEA (OS/IEA) " Subject: Call on UACwith Dep Sec Date: 2018/07/13 13:54:22 Start Date: 2018/07/13 14:00:00 End Date : 2018/07/13 14:30:00 Priority: Normal Type: Schedule.Meeting.Request Location: IEA Conference room Callahan, Kenneth (HHS/IOS); Brady, Will (HHS/IOS); Kalavritinos,Jack (OS/IEA); Beck, Gary (OS/IEA); Johnston, Darcie (HHS/IEA); Reilly, Erin (OS/IEA); Wagner, Steven (ACF); Murphy, Attendees: Ryan (OS/ASPA);Stecker, Judy (OS/ASPA);Lloyd, Scott (ACF); Pilato, Anna (ACF); Caliguiri, Laura (HHS/IOS); Dareshori, Zack (HHS/IOS); Harrison, Brian (HHS/IOS); Riley Althouse (Riley.Althouse@hhs.gov);Hayes,Jonathan (ACF); HHSIEA (OS/IEA) !(b)/6) Participant Code LeaderCode /\MERICAi\ pVERSIGHT !-~I EXT-18-248-B-000310 From : Trueman, Laura (HHS/IEA) Sent : Friday, July 13, 2018 10:52 AM To: Trueman, Laura (HHS/IEA) Subject: Invite for Call @ 2pm ESTToday Import ance: High Dear Colleague You are invited to join a call with HHS Deputy Secret ary Eric Hargan at 2pm ESTtoday. He will be discussing HHS's care and reunification of the minors in the Unaccompanied Alien Children (UAC) program, particularly those affected by the court order for reunification. As you know, there has been intense focus on this in the media . As key opinion leaders who speak to important audiences for our Adm inistration, we believe it is impor t ant that you know what is fact and what is fiction . While this may not be directly in your organization's day-to -day whee lhouse, we know that your being knowledgeable on an issue where unfair characterizations are being made can be helpful. Ca ll in # Participant Code l< -b~H ~6~ l __ _, l={b..,.) (6""') _ _, Please let me know if you plan to join . I know our Deputy Secretary wi ll appreciate the opportunity to connect w ith you . By the way, wh ile th is is invit at ion only, if yo u are not able to join today and want to have a colleague on the call, t hat is fine - just let me know about the substitute. Below please find our latest report on reunification efforts, in graphic and text . Laura The run of show is: Laura Trueman to open and introduce HHS participants and introduce the Deputy Secretary EDH to give comments at the top with an update and perspective Q and A with Steve Wagner/Scott Lloyd and Chris Meekins and if EDH is available for some or all. The list of participants: Hispanic Leadership Fund FRC Heritage AEI /\MERICAi\ pVERSIGHT Mario H. Lopez Tony Perkins arp@frc.org dxc@frc.org David Christensen David Inserra (scholar) david.inserra@heritage.org Hans van Spakovsky (Scholar) John Cooper (Director of Comms) Robert Doar EXT-18-248-B-000311 John Cusey john.cusey@awi.org, Karlyn Bowman Focus on the Family Tim Goeglein tim.goeglein@fotf.org American Conservative Union Dan Schneider dschneider@conservative.org Ethics and Policy Center Travis Wussow Faith and Freedom Coalition Ralph Reed ralph@centstrat.com Patrick Purtill, patrick@ffcoalition.com Americans for Prosperity ATR Grover Norquist and Alex Hendrie Foundation for Research on Equal Opportunity' Avik Roy John Fund Peter Roff Yuval Levin Matt Schlapp Mary Katherine Hamm would like to send to her- need email Mollie Hemingway Kelsey Harkness would like to send to her - need email Trueman, Laura (HHS/I EA) "Callahan, Kenneth (HHS/IOS) "; "Brady, Will (HHS/IOS) "; " Kalavritinos, Jack (OS/IEA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; " Reilly, Erin (OS/IEA) "; "Wagner, Steven (ACF) "; " Murphy, Ryan (OS/ASPA)"; "Stecker, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "; " Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; " Dareshori, Zack (HHS/IOS) "; "Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA)"; "Hayes, Jonathan (ACF) "; /\MERICAi\ pVERSIGHT EXT-18-248-B-000312 " HHS I EA (O5/IEA) " Sent Date: 2018/07/13 13:54 :20 Delivered Date: 20 18/07/13 13:54 :22 /\MERICAi\ pVERSIGHT EXT-18-248-B-000313 Reilly, Erin (OS/IEA) "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; "Brady, Will (HHS/IOS) "; " Kalavritinos,Jack (OS/IEA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) " "Wagner, Steven (ACF) "Stecker, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; "Dareshori, Zack (HHS/IOS) "; " Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA)"; "Hayes, Jonathan (ACF) "; "Murphy, Ryan (OS/ASPA)" 11 ; Subject : RE: Call on UACwith Dep Sec Date: 2018/07/13 14:01:58 Imp orta nce: High Priority : Urgent Type: Note The passcode is: ""! Subject: Invit e fo r Call@ 2pm ESTToday Importance : High Dear Colleague You are inv ited to jo in a call with HHS Deputy Secretary Eric Hargan at 2pm ESTtoday . He w ill be discussing HHS's care and reun ification of the minors in the Unaccompan ied Alien Children (UAC) prog ram, part icularly those affect ed by the court order fo r reunification . As you know, there has been inte nse focus on this in the media. As key opinion leaders who speak to important audiences for our Administration, we believe it is impor t ant that you know what is fact and what is fiction. While this may not be directly in your organization's day-to -day wheelhouse, we know that your being knowledgeable on an issue where unfair characterizations are being made can be helpful. Ca ll in# Participant Code ""!( b""'l( -=.. 6l'----' ~lt b~l<~ 6>_~ Please let me know if you plan to join. I know our Deputy Secretary will apprec iate the opportunity to connect with you. By the way, while this is invitation only, if you are not able to join today and want to have a colleague on the call, t hat is fine - just let me know about the subst itute . Below please find our latest report on reunification efforts, in graphic and text. laura The run of show is: Laura Trueman to open and introduce HHS participants and introduce the Deputy Secret ary EDH to give comments at the top with an update and perspective Q and A with Steve Wagner/Scott Lloyd and Chris Meekins and if EDH is available for some or all. The list of participants: /\MERICAi\ pVERSIGHT EXT-18-248-B-000315 Hispanic Leadership Fund FRC Mario H. Lopez Tony Perkins arp@frc.org dxc@frc.org David Christensen Heritage David Inserra (scholar) david.inserra@heritage.org Hans van Spakovsky (Scholar) John Cooper (Director of Comms) AEI Robert Doar John Cusey john.cusey@awi.org. Karlyn Bowman Focus on the Family Tim Goeglein tim.goeglein@fotf.org American Conservative Union Dan Schneider dschneider@conservative.org Ethics and Policy Center Travis Wussow Faith and Freedom Coalition Ralph Reed ralph@centstrat.com Patrick Purtill. patrick@ffcoalition.com Americans for Prosperity ATR Grover Norquist and Alex Hendrie Foundation for Research on Equal Opportunity· Avik Roy John Fund Peter Roff Yuval Levin Matt Schlapp Mary Katherine Hamm would like to send to her- need email Mollie Hemingway Kelsey Harkness would like to send to her - need email Reilly, Erin (OS/IEA) "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; " Brady, Will (HHS/IOS) "; "Kalavritinos, Jack (OS/IEA) "; "Beck, Gary (OS/IEA) "; Recipient: "Johnston, Darcie (HHS/IEA) "; "Wagner, Steven (ACF) "; "Stecker, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) " ; "Dareshori, Zack (HHS/1O5) "; "Harrison, Brian (HHS/1O5) "; "Althouse, Riley (O5/ASPA)"; "Hayes, Jonathan (ACF) "; "Murphy, Ryan (O5/ASPA)" Sent Date : 2018/07/ 13 14:01:56 Delivered Date: 2018/07/13 14:01:58 /\MERICAi\ pVERSIGHT EXT-18-248-B-000317 Pilato, Anna (ACF) "Reilly, Erin (OS/IEA) "; "Trueman, Laura (HHS/IEA) 11 ; "Callahan, Kenneth (HHS/IOS) "; To: " Brady, Will (HHS/IOS) "; "Kalavritinos, Jack (O5/I EA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) " "Wagner, Steven (ACF) "; "Stecker, Judy (OS/ASPA)"; "Lloyd, Scott (ACF) "; "Caliguiri, Laura (HHS/IOS) "; CC: "Dareshori, Zack (HHS/IOS) "; " Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA)"; "Hayes, Jonathan (ACF) "; "Murphy, Ryan (O5/ASPA)" Subject : RE: Call on UACwith Dep Sec Date : 2018/07/13 14:02:58 Priority : Normal Ty pe : Note Ok, I was able to join now. From : Reilly, Er in (OS/IEA) Sent : Friday, July 13, 2018 2:02 PM To: Trueman, Laura (HHS/IEA) ; Callahan, Kenneth (HHS/IOS) ; Brady, Will (HHS/IOS) ; Kalavritinos, Jack (OS/IEA) ; Beck, Gary (OS/IEA) ; Johnston, Darcie (HHS/I EA) Cc: Wagner, Steven (ACF) ; Stecker, Judy (OS/ ASPA) ; Lloyd, Scott (ACF) ; Pilato, Anna (ACF) ; Caliguiri, Laura (HHS/IOS) ; Dareshori, Zack (HHS/IOS) ; Harrison, Brian (HHS/IOS) /\MERICAi\ pVERSIGHT EXT-18-248-B-000318 ; Althouse, Riley (OS/ASPA) ; Hayes, Jonathan (ACF) ; Murphy, Ryan (OS/ASPA) Subject: RE: Call on UAC with Dep Sec Import ance: High The passcode is: = kb~}C6 =}_ _, -----Ori ginal Appointment----From: Trueman, Laura (HHS/IEA) Sent: Friday, July 13, 2018 11:09 AM To: Trueman, Laura (HHS/IEA); Callahan, Kenneth (HHS/IOS); Brady, Will (HHS/IOS); Kalavritinos, Jack (OS/IEA); Beck, Gary (OS/IEA); Johnston, Darcie (HHS/IEA); Reilly, Erin (OS/IEA) Cc : Wagner, Steven (ACF); Stecker, Judy (OS/ASPA); Lloyd, Scott (ACF); Pilato, Anna (ACF); Caliguiri, Laura (HHS/IOS); Dareshori, Zack (HHS/IOS); Harrison, Brian ( HHS/IOS); Althouse, Riley (OS/ASPA); Hayes, Jonathan (ACF); Murphy, Ryan (OS/ASPA) Subject: Call on UAC with Dep Sec When: Friday, July 13, 2018 2:00 PM-2:30 PM (UTC-05:00) Eastern Time (US & Canada). Where: IEA Conference room !(b}(6} Participant Code Leader Code !(b)(6) !(b}(6l I From : Trueman, Laura (HHS/IEA) Sent : Friday, July 13, 2018 10:52 AM To: Trueman, Laura (HHS/IEA) Subject : Invite for Call @ 2pm ESTToday Import ance: High Dear Colleague You are invited to join a call w ith HHS Deputy Secret ary Eric Hargan at 2pm ESTtoday . He will be discussing HHS's care and reunification of the minors in the Unaccompanied Alien Children (UAC) program, particularly those affected by the court order for reunification . As you know, there has been intense focus on this in the media. As key opinion leaders who speak to important audiences for our Administration, we believe it is important that you know what is fact and what is fiction. While this may not be directly in your organization's day-to-day wheelhouse, we know that your being knowledgeable on an issue where unfair characterizations are being made can be helpful. Call in# kb...,)(6...,l .... __ Participant Code l.... "Reilly, Erin (OS/IEA) " ; "Trueman, Laura (HHS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; " Brady, Will (HHS/IOS) "; "Kalavritinos, Jack (OS/I EA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Wagner, Steven (ACF) "; "Stecker, Judy (OS/ASPA) "; "Lloyd, Scott (ACF) "; "Caliguiri, Laura (HHS/IOS) "; " Dareshori, Zack (HHS/IOS) "; " Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA)"; "Hayes, Jonathan (ACF) "; " Murphy, Ryan (OS/ASPA) " Sent Date: 2018/07/13 14:02:57 Delivered Date: 2018/07/13 14:02:58 /\MERICAi\ pVERSIGHT EXT-18-248-B-000321 Trueman, Laura (HHS/IEA) "Brady, Will (HHS/IOS) "; "Stecker, Judy (OS/ASPA) "; "Reilly, Erin (OS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; "Kalavritinos, Jack (OS/I EA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) " "Wagner, Steven (ACF) "; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; CC: " Dareshori,Zack (HHS/IOS) "; " Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA)"; "Hayes, Jonathan (ACF) "; "Murphy, Ryan (OS/ASPA)" Subject: Re: Call on UACwith Dep Sec Date: 2018/07/15 09:21:06 Priority: Normal Type: Note We did not use the upgraded call line that includes a moderator or provided a list of who called in as this was not a massive call list. /\MERICAi\ pVERSIGHT EXT-18-248-B-000322 We did not do a roll call on who was on, but 17 dialed in, which includes some interna ls. Invitees Hispanic Leadership Fund , Mario Lope z FRC , Tony Perkins ,David Christensen Heritage, David Inserra, Hans von Spakovsky AEI Robert Doar , John Cusey, Karlyn Bowman On: 15 July 2018 09:09, "Brady, Will (HHS/IOS)" wrote : Jack ,Laura- Can we let Judy know who attended ? /\MERICAi\ pVERSIGHT EXT-18-248-B-000323 Thanks On: 14 July 2018 22 :54, "Stecker, Judy (OS/ASPA)" wrote: Do we have a list of all those who join ed? On: 13 July 2018 14 :01, "Reilly, Erin (OS/IEA)" wro te: The passcode is· l/b\/6\ -- ---O riginal Appointment----- From: Trueman, Laura (HHS/IEA) Sent: Friday, July 13, 2018 11:09 AM /\MERICAi\ pVERSIGHT EXT-18-248-B-000324 To: Trueman, Laura (HHS/IEA); Callahan, Kenneth (HHS/IOS); Brady, Will (HHS/IOS); Kalavritinos, Jack (OS/IEA); Beck, Gary (OS/IEA); Johnston, Darcie (HHS/IEA); Reilly, Erin (OS/IEA) Cc: Wagner, Steven (ACF); Stecker, Judy (OS/ASPA); Lloyd, Scott (ACF); Pilato, Anna (ACF); caliguiri, Laura (HHS/IOS); Dareshori, Zack (HHS/IOS); Harrison, Brian (HHS/IOS); Althouse, Riley (OS/ASPA); Hayes, Jonathan (ACF); Murphy, Ryan (OS/ASPA) Subject: Call on UAC with Dep Sec When: Friday, July 13, 2018 2:00 PM-2:30 PM (UTC-05:00) Eastern Time (US &canada). Where: IEA Conference room !rb}/6} Participant Code Leader Code !(b)/6) l Subject: Invite for Call @ 2pm ESTToday Importance: High Dear Colleague You are invited to join a call with HHS Deputy Secretary Eric Hargan at 2pm EST today . He wil l be discussing HHS's care and reunification of the minors in the Unaccompanied Alien Children (UAC) program, particu larly those affected by the court order for reunification . As you know, there has been intense focus on this in the media. As key opinion leaders who speak to important audiences for our Administration, we believe it is important that you know what is fact and what is fiction. While this /\MERICAi\ pVERSIGHT EXT-18-248-B-000325 may not be direct ly in your organization's day-to -day whee l house, we know that your being knowledgeab le on an issue where unfair character izations are being made can be helpfu l. l/b\(6) Call in# Participant Code icb}/6} Please let me know if you plan to jo in. I know our Deputy Secretary will appreciate the opportunity to connect with you. By the way, while this is invitation only, if you are not able to join today and want to have a colleague on the call, that is fine - just let me know about the substitute. Below please find our latest report on reunification efforts, in graph ic and text. Laura The run of show is: Laura Trueman to open and introduce HHS partic ipants and introd uce the Deputy Secretary EDH to give comments at the top with an update and perspective Q and A with Steve Wagner/Scott Lloyd and Chris Meekins and if EDH is available for some or all. The list of participants: Hispanic Leadership Fund FRC arp@frc.org dxc@frc.org Mario H. Lopez Tony Perkins _ David Christensen Heritage david.inserra@heritage.org /\MERICAi\ pVERSIGHT David Inserra (scholar) EXT-18-248-B-000326 Hans von Spakovsky (Scholar) John Cooper (Director of Comms) AEI Robert Doar John Cusey john.cusey@awi.org , Karlyn Bowman Focus on the Family tim.goeg lein@fotf.org Tim Goeglein American Conservative Union Dan Schneider dschneider@conservative.org Ethics and Policy Center Faith and Freedom Coalition ralph@centstrat.com Travis Wussow Ralph Reed Patrick Purtill, patrick@ffcoalition.com Americans for Prosperity ATR Grover Norquist and Alex Hendrie Foundation for Research on Equal Opportunity' Avik Roy John Fund Peter Roff Yuval Levin Matt Schla pp Mary Katherine Hamm wou ld like to send to her - need email Mollie Hemingway Kelsey Harkness would like to send to her - need email /\MERICAi\ pVERSIGHT EXT-18-248-B-000327 Trueman, Laura (HHS/IEA) " Brady, Will (HHS/IOS) "; "Stecker, Judy (OS/ASPA)"; "Reilly, Erin (OS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; " Kalavritinos,Jack (OS/IEA) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Wagner, Steven (ACF) "; " Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; "Dareshori, Zack (HHS/IOS) "; "Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA)"; "Hayes, Jonathan (ACF) "; "Murphy, Ryan (OS/ASPA)" Sent Date: 2018/07/15 09:21:05 Delivered Date: 2018/07/15 09:21:06 Message Flags: Unread /\MERICAi\ pVERSIGHT EXT-18-248-B-000328 Trueman, Laura (HHS/IEA) "Stecker, Judy (OS/ASPA)"; "Kalavritinos, Jack (OS/I EA) "; "Brady, Will (HHS/IOS) "; "Reilly, Erin (OS/IEA) "; "Callahan, Kenneth (HHS/IOS) "; "Beck, Gary (OS/IEA) "; "Johnston, Darcie (HHS/IEA) "; "Wagner, Steven (ACF) "; " Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Caliguiri, Laura (HHS/IOS) "; "Dareshori, Zack (HHS/ IOS) "; " Harrison, Brian (HHS/IOS) "; "Althouse, Riley (OS/ASPA)"; "Hayes, Jonathan (ACF) "; "Murphy, Ryan (OS/ASPA)" Sent Date: 2018/07/15 10:13:30 Delivered Date: 2018/07/ 15 10:13:31 Message Flags: Unread /\MERICAi\ pVERSIGHT EXT-18-248-B-000329 6) From: Edward Lloyd ~(b)( l§lgmail.com> "Lloyd, Scott (ACF) " Subject: Fwd: NVDaily - full page ad vs. PGK Scott Date: 2018/07/23 13:03:49 Priority: Normal Type: Note Sent from my iPhone Begin forwarded message: From: l(b)(6) @gmail.com> Date: Jul 23 2018 at 11:21 :01 AM EDT mail.com> fbl(5l To: (bl(5l ix.netcom.com>, Jim Clark j ;::b::::)(6::::) ::.......===::::::::: @::-y- a-=h-o-o_. .com> ,l(b)(6) bl(5l 6 ~b)(6) @gmail.com>, l, l J bl(5l @comcast.net> Cc: Scott Lloyd Subject: NVDaily - full page ad vs. PGK Scott I I In case you haven't heard yet, there was a full page ad in today's Northern Virginia Dail y bl aming PGK Scott Lloyd for the fam ily separatio ns at the border. I've attach ed a pictu re. The website also calls out Lega lWorks , Witness Wor ks, KofC, and th e Front Royal Pregnancy Center. I pray this doesn' t go further than words in the newspaper , but ther e are peop le out ther e listening when Maxine Waters says thin gs like, "Let's make sure we show up wherever we have to show up. And if yo u see anybody from that Cabinet in a restaurant , in a departm ent store, at a gasoline station, you ge t out and you create a crowd. And you push back on them. And you tell them they're not welcome anymore, anyw here. We've got to get the children connected to their parents." I don' t know what we can do to help, but as Kni ghts, neighbors, and friends, regardle ss of the po litics, we should be ready to support Scott and his fami ly. Scott, please don't hesitate to reac h out and let us know what wou ld (or wou ldn't) help. /\MERICAi\ pVERSIGHT EXT-18-248-B-000330 Those of us who live in Happy Creek Knolls might also want to be a little extra vigilant. NVDa ily.JPG Sender: Edward Lloyd ~(b)(6) IJ)gmail.com> "Lloyd, Scott (ACF) " Sent Date: 20 18/07/23 13:02 : 13 Delivered Date: 20 18/07/23 13:03 :49 /\MERICAi\ pVERSIGHT EXT-18-248-B-000331 From: Edward Lloyd l(b)(6) i§lgmail.com> "Lloyd, Scott (ACF) " Subject: Fwd: Iraq: quick int ro Date: 20 18/07/23 13:03 :50 Priority: Normal Type: Note Sent from my iPhone Begin forwarded message: From*b) (6) @yahoo.com > Date: July 23, 2018 at 11:07:52 AM EDT To:fb J(6) B}gmail.com, "Andrew. Walther@Kofc. Org" Subject: Re: Iraq: quick intro Andrew - thank you for the kind introduction. Hi Scott - pleasure to meet you . Should you have a moment please call me an (b)(6 ) m in Arizona this week but always reachable by phone. On Monday , July 23, 2018 , 10:27:34 AM EDT , Andrew .Walther@Kofc.Orq wrote: /\MERICAi\ pVERSIGHT EXT-18-248-B-000332 Scott , lat USAID . He's going to be the funding czar for Introducing you to fb)(5) USAID money to minorities in Iraq. He's a good guy and good friend . You two should connect. l(b)(6) I told you about Scott who was my partner on all things Middle East before he jo ined HHS as head of ORR. Happy connecting. Andrew CONFIDENTIALITY NOTICE : This message and any attachments may contain conf idential , proprietary or legally privileged information and is intended only for the use of the addressee or addressees named above for its intended purpose . If you are not the intended recipient of this message , this message constitutes notice that any review , retransmission , distribution , copying or other use or taking any action in reliance on the information in this message and its attachments , is prohibited. If you receive this communication in error, please immed iately advise the sender by reply e-mail and delete this message and its attachments from your system without keeping a copy. Unless expressly stated in this e-mail, noth ing in this message may be construed as a digital or electronic signature. Thank you. /\MERICAi\ pVERSIGHT EXT-18-248-B-000333 Sender: Edward Lloyd Recipient: "Lloyd, Scott (ACF) " Sent Date: 2018/07/23 13:02:49 Delivered Date: 2018/07/23 13:03:50 /\MERICAi\ pVERSIGHT EXT-18-248-B-000334 From: HHS Office of Public Affa irs To: "Lloyd, Scott (ACF) " Subject: Secretary Azar to Deliver Remarks at The Heritage Foundat ion Date: 20 18/07/25 13:54 : 12 Priority: Norma l Type: Note Media Advisory U.S. Department of Health and Hum an Serv ices 202-690-6343 media@hhs.gov www. hhs.gov/news Twitter @HHSMedia /\MERICAi\ pVERSIGHT EXT-18-248-B-000335 FOR PLANNING PURPOSES ONLY Wednesday, July 25, 2018 Tomorrow, Health and Human Services Secretary Alex Azar will deliver a speech at an event hosted by The Heritage Foundation , The Importance of Free-Market Principles in American Healthcare. His remarks will focus on his four secretarial priorities and how free-market principles improve affordability and care for patients. /\MERICAi\ pVERSIGHT EXT-18-248-B-000336 WHO : Secretary Alex M. Azar II WHEN : Thursday, July 26, 20 18, 11:00 AM ET WHERE : The Heritage Foundation, 2 14 Massach usetts Ave NE, Washington, DC, 20002 *** Questions regarding event logistics and media attendance should be directed to Marguerite Bowling at marguerite.bowling@heritage.org*** ### Follow @SecAzar on Twitter , like HHS on Facebook, and sign up for HHS Email Updates If you wou ld rather not rece ive future commun icat ions from U.S. Department of Hea lth and Human Services (HHS), let us know by click ing here. U.S. Department of Health and Human Serv ices (HHS), 200 Independence Avenue, SW 6th Floor Room 647 -D, Washington , DC 20201 United States Sender: HHS Office of Public Affairs . . "Lloyd, Scott (ACF) " /\MERICAi\ pVERSIGHT EXT-18-248-B-000337 Sent Date: 20 18/07/25 13:53:40 Delivered Date: 20 18/07/25 13:54: 12 Message Flags: Unread /\MERICAi\ pVERSIGHT EXT-18-248-B-000338 Oakley, Caitlin B. (OS/ASPA) To: "Oakley, Caitlin B. (05/ASPA) " Subject : Tomorrow: Secretary Azar @ The Heritage Foundation Date: 2018/07/25 18:39:49 Priority: Normal Type: Note Good evening, Tomorrow at 11:00 AM ET, Secretary Azar will deliver remarks at an event hosted by The Her itage Foundation, entitled, "The Importance of Free-Marke t Principles in Ame rican Healthcare." His remarks will focus on his four secretarial priorities and how free-ma rket pr inciples improve afforda bility and care for patients. In advance of the event, here is a prev iew of Secretaiy Azar ' s remarks (as pr epared for delivery): "One ofAmerica 's greatest leaders, President Ronald Reagan, applied commonsense solutions to the supposedl y intractable challenges of his time, like an overly compli cated tax cod e and a bloat ed, broken welfar e syst em. Lik e P resid ent Trump, he saw straight through how Washington works, and had a pithy description of how problems are usually handled here . 'Government 's view of the economy could be summed up in a few short phrases, ' he said. 'If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidi ze it. ' " "For too long, that has more or less been the federal government's approach to health care. We saw it most recently with the Affordable Care Act, which imposed a new tax or regulation, or sometimes both, on just about every moving part in our health care system. There was even a tax on not buying the right kind of insurance - until President Trump and Congress repealed it. " /\MERICAi\ pVERSIGHT EXT-18-248-B-000339 "The Trump Administration's first instincts are the opposite of the biggovernment nightmare President Reagan described. If something in our healthcare system isn't working, we'll see if there's a regulation in the way. If prices are high, we'll see if there's a tax involved. If prices keep rising, we'll see if there's a subsidy driving them. " "Today, I want to talk about how these principles apply to a few of the priorities I have laid out for HHS under President Trump : first, reforming the individual market for insurance; second, bringing down the high price ofprescription drugs; and third, transforming our health system into one that pays for value. " The event will be livestreamed here: https://www.heritage.org/event/the-importance-freemarket-principles-american-healthcare We will post the Secretary's full remarks, as prepared for delivery at approximate ly 11:00 AM ET here: https: //www.hhs.gov /about/leadership /secretary /speeches /index.html Please let me know if you have any questions . All the best, Caitlin B. Oakle y Nat iona l Spokespe rson, Senior Adv isor Office of the Assistant Secretary for Public Affairs U.S. Departmen t of Health and Human Services caitlin.oakley @hhs.gov ***Questions regarding event logistics and media attendance should be directed to Marguerite Bowling at margu erite.bowling @heritage.org*** Oakley, Caitlin B. (05/ASPA) Recipient: "Oakley, Caitlin B. (OS/ASPA) " Sent Date: 20 18/07/25 18 :39:36 Delivered Date: 20 18/07/25 18:39:49 Message Flags: Unread /\MERICAi\ pVERSIGHT EXT-18-248-B-000340 DEPARTMENT OF HEALTH & HUMAN SERVICES ADMINISTRATION FOR CHILDREN AND FAMILIES Mary E. Switzer Building 330 C ST, S.W. Washington, D.C. 20201 Case No: 18-F-0029 Civil Action 18-cv-0248 October 23, 2018 Ms. Katie O’Connor Legal Counsel Campaign for Accountability 611 Pennsylvania Avenue, SE, #337 Washington, D.C. 20003 Dear Ms. O’Connor: This is the third interim response of the Administration for Children and Families to Ms. Katie O’Connor’s October 27, 2017, Freedom of Information Act (FOIA) request for records related to services for pregnant unaccompanied immigrant minors. Specifically, Ms. O’Connor sought the following items: 1. All records related to Office of Refugee Resettlement (“ORR”) policy regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. This request includes memoranda, directives, policy statements, policy interpretations, policy guidance, talking points, and other similar documents reflecting ORR policy. 2. All records related to ORR Director Scott Lloyd’s visits to ORR grantee shelters that house unaccompanied immigrant minors. This request includes calendar entries, travel and accommodation requests and approvals, itineraries, briefing memoranda, and meeting notes. 3. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and representatives of the Susan B. Anthony List, Concerned Women for America, the Heritage Foundation, the Center for Family and Human Rights (“C-Fam”), National Right to Life, Alliance Defending Freedom, Legal Works Apostolate, or the Knights of Columbus regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. This request includes communications to or from anyone using email addresses from the following domains: a. @sba-list.org b. @cwfa.org c. @heritage.org d. @c-fam.org e. @nrlc.org f. @adflegal.org g. @legalworks.com h. @kofc.org 4. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged Case No. 18-F-0029 Civil Action 18-cv-0248 Page 2 of 2 between representatives of ORR and representatives of the White House regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. 5. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and members and staff of the U.S. Congress regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. Your request was sent to the Office of Refugee Resettlement (ORR) and the Office of the Chief Information Officer for a search for responsive records. Please find enclosed 465 pages of responsive records responsive in part to Item 1 above. Thirty-five pages were sent for consultation. Some of the information on the enclosed pages has been withheld under the FOIA exemptions (b)(5) and (b)(6). The exemption (b)(5) protects inter-agency or intra-agency memorandums or letters which would not be available by law to a party other than an agency in litigation with the agency. The exemption protects agency deliberations, both internal and with agency contractors and consultants, attorney-client privileged records and attorney work product. In this case, the withheld information includes predecisional discussions within the agency and between agency staff and contractors about management of ORR programs and/or individual children and sensitive communications between agency staff seeking legal advice and counsel on policy and other matters. The FOIA exemption (b)(6) permits the withholding of records which, if released, would constitute a clearly unwarranted invasion of personal privacy. In this case, the withheld information consists of the names, identity and/or other private information of private individuals and/or the identities of federal employees in sensitive positions and the work cell phones of federal employees. The withheld information also includes the locations of shelters housing vulnerable unaccompanied children and refugee centers. Public disclosure of this information would constitute an invasion of privacy of those individuals whose identifying information was disclosed. In particular, disclosing the locations of shelters subject the children to unwanted publicity and harassment. In withholding the information, the individual’s privacy interest was balanced against any public interest in disclosure. In each instance where information was withheld, it was determined that the individual’s privacy interests outweighed any public interest in disclosure of the withheld information. Disclosure of the withheld information would invade the privacy of the subject individuals but would reveal nothing about the operations or activities of the government. Sincerely yours, Celeste Smith Acting FOIA Officer Administration for Children and Families VERSIGHT White, Jonathan (ACF) To: "Lloyd, Scott (ACF) " CC: "Gregg, Laura (ACF) " Subject : RE: Headsup: UC requesting pregnancytermination Date: 2017/04/10 15:59:21 Priority : Normal Type: Note Scott, It was confirmed to me this afternoon that the UC was discharged on Sunday to her sponsor. Jonathan From: White, Jonathan (ACF) Sent: Monday, April 10, 2017 9:07 AM To: Lloyd, Scott (ACF) Cc: Gregg, Laura (ACF) Subject: Re: Heads up: UC requesting pregnancy termination Scott, She was scheduled to be discharged to sponsor on Saturday. I have an email inquiry out to confirm that she has been released and joined her family . I will advise when I know for certain, which I expect to be this morning. Jonathan CDRJonathan White Deputy Director for Ch ildren's Programs Office of Refugee Resettlement Administration for Children and Families Incident Commander, Unaccompanied Children Influx Response (202) 690-6984 (office) (blackberry) (202}fbl(6) Jonathan.white@acf .hhs.gov I From: Lloyd, Scott {ACF) Sent: Monday, April 10, 2017 8:57:57 AM To: White, Jonathan (ACF) Cc: Gregg, Laura (ACF) Subject: RE: Heads up: UC requesting pregnancy termination /\MERICAi\ pVERSIGHT EXT-18-248-C-000001 Jonathan, any updates on this case? Thank you, Scott From: White, Jonathan (ACF) Sent: Tuesday, April 04, 2017 5:28 PM To : Lloyd, Scott (ACF) Cc: Gregg, Laura (ACF) Subject: RE: Heads up: UC requesting pregnancy term ination Great, I will let the staff asking me know. Thank you for the prompt reply. From: Lloyd, Scott (ACF) Sent: Tuesday, April 04, 2017 4:31 PM To : White, Jonathan (ACF) Cc: Gregg, Laura (ACF) Subject: Re: Heads up: UC requesting pregnancy termination Yes-- they were going to a CPC site today and we're going to proceed to discharge according to my under standing. Thank yo u , Scott On : 04 April 2017 16:06, "White, Jonathan (ACF)" wrote: Scott, Were you able to speak with the pregnant girl at the SWK site to proceed with her discharge? f b)(B) I? And if so, are we green-lighted Jonathan From: Lloyd, Scott (ACF) Sent: Saturday, Apr il 01, 20 17 8:48 PM To : White, Jonathan (ACF) Cc: Gregg, Laura (ACF) Subject: Re: Heads up: UC request ing pregnancy termination Thx Jonathan. I'll be in the office Mond ay and half of Tuesday. On : 01 April 2017 16:47, "White, Jonathan (ACF)" wrote: Scott, I haven't heard from the field yet --which makes me think we are looking at Monday . /\MERICAi\ pVERSIGHT EXT-18-248-C-000002 I'll connect with Laura on your schedule for Monday. If memory serves, you're on the road then? At all events, please let me know anything else you may need this weekend. I am working on a couple other pieces including next steps on juvenile justice approaches. Jonathan CDRJonathan White Deputy Director for Children's Programs Office of Refugee Resettlement Administration for Children and Families Incident Commander, Unaccompanied Children Influx Response (202) 690-6984 (office) (20 lfb) (6) ~blackberry) Jonathan.white@acf.hhs.gov From: Lloyd, Scott (ACF) Sent: Saturday, April 1, 2017 5:52:08 AM To: White, Jonathan (ACF) Cc:Gregg, Laura {ACF) Subject: Re: Heads up: UC requesting pregnancy termination Jonathan, Thank you. Sounds like an honest mistake. (b)(5) Let me know. Thank you, Scott On: 01 April 2017 00:18 , "White, Jonathan (ACF)" wrote: /\MERICAi\ pVERSIGHT EXT-18-248-C-000003 Scott, See Arizona FFSSupervisor response below. When we spoke on the phone, she indicated that she had thought Adelante "is part of CPC"--it appears that a *different* CPC(Chicanos par la Casa) is a major network of Spanish-language health and social services providers in AZ. We can talk in the morning if that's helpful. Jonathan CDRJonathan White Deput y Director for Children's Programs Office of Refugee Resettlement Administration for Children and Families Incident Commander, Unaccompanied Children Influx Response (202) 690-6984 (office) (202) 570-8916 (blackberry) Jon at han.whit e@acf.hhs.gov From: Velazquez, Ivonne (ACF) Sent: Friday, March 31, 2017 9:25:10 PM To: White, Jonathan (ACF) Cc: Bartholomew, Michael (ACF);Sualog, Jallyn (ACF); De LA Cruz, James (ACF); Swartz, Tricia (ACF); Gregg, Laura (ACF) Subject: RE: Heads up: UC requesting pregnancy termination Dear Jonathan, I just got off the phone with SWK Program Director Reina Cossio. I was informed that the program did not thoroughly read and understood the directives given to them to take the UC to CPC. Instead the program took the UC to their regular provider Adelante Health Care. I was not aware that the program did not follow the directive as given until now as I also thought that Adel ante Helth Care was a network of CPC.I requested a response from the program to explain why the directive to take the UC to CPCwas not followed. Please let me know if you need anything else from me. Thanks Ivonne Ivonne Velazquez, LCSW Federal Field Specialist Supervisor United States Department of Health and Human Services Administration of Children and Famities Office of Refugee Resettlement /\MERICAi\ pVERSIGHT EXT-18-248-C-000004 Division of Unaccompanied Children Operations Cell: 202-~ http://www~s.go v/program s/orr X Get answers about the Health Insurance Marketplace & Obamacare lnformese acerca del mercado de seguros medicos y sus nuevas opciones de cobertura. From: White, Jonathan (ACF) Sent: Friday, March 31, 2017 5:25 PM To : Velazquez, Ivonne (ACF) Cc: Bartholomew, Michael (ACF); Sualog, Jallyn (ACF); De LA Cruz, James (ACF); Swartz, Tricia (ACF); Gregg, Laura (ACF) Subject: FW: Heads up: UC requesting pregnancy termination Importance: High Ivonne, (b)(S) I'd appreciate any updates we can get on this. Jonathan From: White, Jonathan (ACF) Sent: Friday, March 24, 2017 11:56 AM To: Velazquez, Ivonne (ACF); Bartholomew, Michael (ACF) Cc: Misegades, Lara (ACF); De LA Cruz, James (ACF); Sualog, Jallyn (ACF); Swartz, Tricia (ACF); Gregg, Laura (ACF) Subject: FW: Heads up: UC requesting pregnancy term inat ion Ivonne and Michael, /\MERICAi\ pVERSIGHT EXT-18-248-C-000005 I am writing to provide follow-up guidance from HHS Policy Team on the UC at SWK Casa Las Palmas who has requested abortion services l(b)(6) A#rb)(G) I I Please see guidance below from Scott Lloyd. It covers next steps. Please let me know if you have any questions but please communicate with the medical provider and management of the shelter regarding these next steps. Don't hesitate to let me know any questions and please have SWK continue to update as plan elements are implemented. ~b)(5l I Thank you. Jonathan From: Lloyd, Scott (ACF) Sent: Friday, March 24, 2017 11:21 AM To : White, Jonat han (ACF) Cc: Tota, Kenneth (ACF); Bowman, Matthew (HHS/OGC) Subject: RE: Heads up: UC requesting pregnancy termination Jonathan, b)(5) /\M~Hll...1/\1\ pVERSIGHT EXT-18-248-C-000006 We'll work on formalizing these procedures, but we'll have to do it ad hoc for now. Thank you, Scott *** E. Scott Lloyd U.S. Department of Health and Human Services (202) 260-7387 (202) !(bl/6} I (cell) scott. lloyd@acf. hhs.gov From: White, Jonathan (ACF) Sent: Thursday, March 23, 2017 9:05 AM To : Lloyd, Scott (ACF) Cc: Tota, Kenneth (ACF) Subject: RE: Heads up: UC requesting pregnancy termination Mesa, Arizona. Just arrived in Switzer so I can get into encrypted comms now . -)(6 _)________ UC isl(b ..... __,IA# j(b)(6) Attached is the SIR received . From: Lloyd, Scott (ACF) Sent: Thursday, March 23, 2017 9:00 AM To : White, Jonathan (ACF) Cc: Tota , Kenneth (ACF) Subject: Re: Heads up: UC requesting pregnancy termination Thank you. Which state is this? Also her UC portal# ? Scott /\MERICAi\ pVERSIGHT EXT-18-248-C-000007 On: 23 March 2017 08:36, "White, Jonathan (ACF) " wrote: Scott, Last night after midnight we received word that a UC at SWK Casa Las Palmas has requested abortion services. I don't have other details yet; shou ld have those shortly but wanted to provide heads up. I am informed this is not the same UC as in earlier advisory. Will get more information; standing by to receive guidance re next steps. Jonathan CDR Jonathan White Deputy Director for Children's Programs Office of Refugee Resettlement Administration for Children and Families Incident Commander, Unaccompanied Children Influx Response (202) 690-6984 (office) (202)l(b)(6) !(blackberry) Jonathan.white tmacf.hhs.1wv Sender: White, Jonathan (ACF) "Lloyd, Scott (ACF) "; Recipient: "Gregg, Laura (ACF) " Sent Date: 2017/04/10 15:59:19 Delivered Date: 2017/04/10 15:59:21 /\MERICAi\ pVERSIGHT EXT-18-248-C-000008 Russell, Elizabeth (ACF) To: "Lloyd, Scott (ACF) " Subject: Repatriation MOU and NERPPlan Date: 2017/04/11 09:52:19 Priority: Normal Type: Note Scott, Attached , please find the Repatriation MOU between ACF and ASPR . In addition , please find an electronic copy of the HHS National Emergency Repatriation Plan (NERP) , Base Plan, and NERP Operational Guide. Attachments are not included. A binder will be provided with all these documents. Best , Elizabeth LCDR Elizabeth B. Russell Emergency Management Coordinator U.S. Repatriation and Refugee Programs U.S. Department of Health and Human Services Administration for Children and Families Offic e of Refugee Resettlement Mary E. Switzer Building, 330 CST SW, Room 5123 Washington, DC 20201 Tel: (202) 401 -4845, BB: 202~ e-mail: Elizabeth.russe ll@acf.~ HSDN /STPR elizabeth.russell@dhs.sgov.gov P lease note change of BB# Russell, Elizabeth (ACF) Recipient: "Lloyd, Scott (ACF) " Sent Date: 2017/04/11 09:52:13 Delivered Date: 2017/04/11 09:52:19 /\MERICAi\ pVERSIGHT EXT-18-248-C-000009 From: Bena, Anna Marie (HHS/OGC)(ACF) To: "ORRSenior Leadership"; "Lloyd, Scott (ACF) " Subject: Weekly Litigation Update Date: 2017/04/13 16:15:10 Priority: Normal Type: Note I have attached this week's litigation update. In UC litigation, in ACLU v Pric e (family planning case), the judge reset the motion hearing to 4/27/ 17. In refugee litigation , in Alabama, oral argument has been set for 5/18/ 17 in Atlanta, Ga. The Oregon case has been added to the tracker. Sender: Bena, Anna Marie (HHS/OGC)(ACF) Recipient: "ORRSenior Leadership"; "Lloyd, Scott (ACF) " Sent Date: 2017/04/13 16:15:08 Delivered Date: 2017/04/13 16:15:10 /\MERICAi\ pVERSIGHT EXT-18-248-C-000010 From: Bena,Anna Marie (HHS/OGC)(ACF) To: "Lloyd, Scott (ACF)" CC: "Gregg, Laura (ACF) " Subject : FW: ACLUv. Burwell amended complaint Date: 2017/04/18 07:42:22 Priority: Normal Type: Note Scott, I think this is the most helpful - it's the first amended complaint, which added trafficking to the case. can also send the original and our reply briefs . AnnaMa ire From: Haran, Judith (HHS/OGC) Sent: Thursday, January 12, 2017 9:09 AM To : Chon, Katherine (ACF); Hightower, Carolyn (ACF) Cc: Lee, Gia (O5/OGC); Keith, Robert (HHS/OGC); Woolford, Llewellyn (HHS/OGC); Bena, Anna Marie (HHS/OGC) (ACF); Suh, Victor (HHS/OGC) (ACF) (CTR); Biswas, Toby R M (ACF) Subject: FW: ACLU v. Burwell amended complaint (b)(5) - Judy Har on Deputy Associat e General Coun sel Children , Famili es and Aging Divi sion HHS Offi ce of the General Counsel (202) 6 90 8 005 Notice: The cont ent s of thi s message and any attachme nts are privileged and confiden ti al. You should not disseminate or release this message and any attachments without the approval of the Office of t he General Counsel. If you are not an intended recipient, or have received t his message in error, please delete it wit hout reading it and please do not print, copy, fo rward, disseminate, or ot herwis e use the informa t ion . Also, please not ify the sender t hat you have received t his commun ication in error. Your receipt of this message is not int ended to wa ive any appl icable priv ilege. From:fb)(6) l(mailto l(b)(6) ~aclu.orgl Sent : Wednesday, January 11, 2017 4:12 PM To: Phipps, Peter CIV j(b)(6) Cc:b)(6) (b)(5) aclunc.or ) ~aclunc .org>i . EXT-18-248-C-000011 Peter - attached please find a red line of our proposed first amended complaint. Please let us know the government's position on our motion to amend the complaint, which we hope to file in the next few days or so. Best, Brigitte Brigitte Amiri Senior Staff Attorney ACLU Reproductive Freedom Project 125 Broad Street, 18 th Floor New York, NY 10004 212fb )(S) fb) (5) t@aclu.org I Sender: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; Recipient: "Gregg, Laura (ACF) " Sent Date: 2017/04/18 07:42:21 Delivered Date: 2017/04/18 07:42:22 /\MERICAi\ pVERSIGHT EXT-18-248-C-000012 From: To: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; "Gregg, Laura (ACF) " Subject: FW: ACLU v. Burwell Date: 2017/04/18 07:43:22 Priority: Normal Type: Note Original compla int From: Haron, Judith (HHS/OGC) Sent: Monday, October 24, 2016 9:24 AM To: Bena, Anna Marie (HHS/OGC) (ACF); Biswas, Toby R M (ACF); Suh, Victor (HHS/OGC) (ACF) (CTR) Cc: Woolford, Llewellyn (HHS/OGC) Subject: ACLU v. Burwell Anna Marie, Toby, and Victor. b)(5) Thank you and do not hesitate to contact me with question s. - Jud y Hara n Deputy Associate Gene ral Counse l Childr en , Fam ilies an d Aging Division HHS Office of th e Gen era l Cou nse l /\MERICAi\ pVERSIGHT EXT-18-248-C-000013 (202) 6 90 800 5 Notice: The contents of this message and any attachments are privileged and confidential. You should not disseminate or release this message and any attachments without the approval of the Office of the Genera l Counsel. If you are not an intended recipient, or have received this message in error, please delete it without reading it and please do not print, copy, forward, disseminate , or otherwise use the information. Also, please notify the sender that you have received this communication in error. Your receipt of this message is not intended to waive any applicable privilege. Sender: Recipient: Bena, Anna Marie (HHS/OGC) (ACF) "Lloyd, Scott (ACF) "; Laur>" Sent Dat e: 20 17/04/18 07 :43:21 Delivered Date: 2017/04/18 07:43:22 /\MERICAi\ pVERSIGHT EXT-18-248-C-000014 From: To: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; "Gregg, Laura (ACF) " Subject: FW: draft answer, ACLUv. Burwell Date: 2017/04/18 07:45:53 Priority: Normal Type: Note And here's the draft answer to the amended complaint. (I'll stop sending now.) I think the best doc to review is the amended complaint. From: Haran, Judith (HHS/OGC) Sent: Monday, February 13, 2017 12:06 PM To: Bena, Anna Marie (HHS/OGC)(ACF); Suh, Victor (HHS/OGC)(ACF) (CTR); Biswas, Toby R M (ACF); Chon, Katherine (ACF) Cc: Woolford, Llewellyn (HHS/OGC);Palacios,Caitlin (HHS/OGC) Subject: draft answer, ACLUv. Burwell ORR and OTIP, attached please find our draft answer to the amended complaint in ACLU v. Burwell (attached). (b)(5) - Judy Ha r on Deputy A ssocia t e Genera l Cou nsel Chil d re n, Fam ili es an d Agi ng Division HH S Offi ce of t h e Gen eral Cou nsel (202) 6 90 8005 Notice: The contents of this message and any attachment s are privileged and confidential. You should not diss eminate or releas e this message and any attachments without the approva l of the Office of the Genera l Coun sel. If you are not an intended recipient , or have rece ived this message in error , please delete it without reading it and p lease do not print , copy, forward , disseminat e, or otherwise use the information . Also, pleas e notify the sender that you have received this communication in error. Your receipt of this message is not intended to waiv e any applicab le privilege . Sender: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; Recipient: "Gregg, Laura (ACF) " /\MERICAi\ pVERSIGHT EXT-18-248-C-000015 Sent 07:45:53 EXT-1 8-248-C-00001 6 From: Bena, Anna Marie (HHS/OGC)(ACF) To: "Lloyd, Scott (ACF) " CC: "Gregg, Laura (ACF) "; "White, Jonathan (ACF) " Subject: PregnancyPolicy Date: 2017/04/19 11:33:02 Priority: Normal Type: Note I have attached a first draft of the pregnancy policy to see if this is going in the right direction. A few things to note: (b)(5) 1. 2. 3. 4. 5. Sender: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; "Gregg, Laura (ACF) "; "White, Jonathan (ACF) " Sent Date: 2017/04/19 11:33:02 /\MERICAi\ pVERSIGHT EXT-18-248-C-000017 From: To: Bena, Anna Marie (HHS/OGC)(ACF) "ORR Senior Leadership " Subject: Weekly Litigation Update Date: 2017/04/27 13:20:47 Priority: Normal Type: Note I have attached the weekly litigation update. In UC litigation: in ACLU v Pric e (family planning), Brian Hauss withdrew as counsel for ACLU, and there was a Stipulated Protective Order regarding disclosure and discovery activity; in SV (damages action again st DHS) , a Settlement Order was filed on 4/26 with joint stipulation for dismissal due by 6/26; in JLM (habeas case of the UAC who was repatriated) , the order dismissing the case was filed 4/20. In refugee litigation: in the Indiana case , there was a 4/25 Scheduling Order, setting a status conference for 5/16; in the Oregon case , on 4/26, the Defendants (including HHS) filed an Unopposed Motion for Extension of Time to Respond to Complaint. Sender: Recipient: Bena, Anna Marie (HHS/OGC)(ACF) "ORR Senior Leadership " Sent Date: 2017/04/27 13:20:45 Delivered Date: 2017/04/27 13:20:47 /\MERICAi\ pVERSIGHT EXT-18-248-C-000018 Kurkjy, Brian (ACF) (CTR) To: "Gregg, Laura (ACF) " CC: "Lloyd, Scott (ACF) " Subject: RE: Overdue - Commentsto OGA Date : 2017/04/27 17:05:52 Priority: Normal Type: Note Hi Laura -They are looking for comments on the attached . Should this go to Anna Marie and Tricia? From: Gregg, Laura (ACF) Sent: Thursday, April 27, 2017 4:58 PM To: Kurkjy, Brian (ACF) (CTR) Cc: Lloyd, Scott (ACF) Subject: FW: Overdue - Comments to OGA Brian- can you let us know what this reque st is? From: Barlow, Amanda (ACF) Sent: Thursday, April 27, 2017 4:58 PM To: Lloyd, Scott (ACF); Chon, Katherine (ACF) Cc: Hightower, Carolyn (ACF); Cottingham, Kenneth (ACF); Mella, Emily (ACF); Gregg, Laura (ACF) Subject: Overdue - Comments to OGA Scott and Katherine, (b)(5) Thanks! Amanda Amanda Barlow Acting Assistant Secretary Administration for Children and Familie s U.S. Departm ent of Health and Human Services (202)401-5009 Amanda.Bar low@ acf.hhs.gov www .acf.hhs.gov /\MERICAi\ pVERSIGHT EXT-18-248-C-000019 Kurkjy, Brian (ACF)(CTR) Recipient: "Gregg, Laura (ACF) "; "Lloyd, Scott (ACF) " Sent Date: 2017/04/27 17:05:42 Delivered Date: 2017/04/27 17:05:52 /\MERICAi\ pVERSIGHT EXT-18-248-C-000020 Simmons, Joann (ACF) "Lloyd, Scott (ACF) "; "Tota, Kenneth (ACF) "; "White, Jonathan (ACF) " Subject: FY 17 Approps Bill released Date: 2017/05/02 12:28:59 Importance: High Priority : Urgent Type: Note All, Our section of the attached FY 201 7 aooroo s bill is located on oage s 97 6 and (bl<5l J 977 of the attach ed docum ent. I (b)(5) Once the bill is signed , I will update our ORR Program File with the FY 2017 enact ed level and send to all Division/Program Directors. Joann Simmons Director Division of Budget and Data Analysis Office of Refugee Resettlement Administration for Children and Families Department of Health and Human Services (202) 401-5409 From: Jones, Robin (ACF) Sent: Tuesday, May 02, 2017 12:18 PM To: Simmons, Joann (ACF) Subject : FY 17 Approps Bill released Attac hed is the FY I 7 approp s bill we expe ct Cong ress to pass this week. Robin Simmons, Joann (ACF) Recipient: "Lloyd, Scott (ACF) "; "Tota, Kenneth(ACF) "; "White, Jonathan (ACF)" Sent Date: 2017/05/02 12:28:49 Delivered Date: 2017/05/02 12:28:59 /\MERICAi\ pVERSIGHT EXT-18-248-C-000022 From: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; To: "Swartz, Tricia (ACF) "; "Sualog, Jallyn (ACF) " "Gregg, Laura (ACF) "; CC: (FYDIBOHF23SPDL "Biswas,Toby RM (ACF) " Subject: FW: Revisedinterrogatories and RFAs Date: 2017/05/03 09:00:05 Priority: Normal Type: Note FYI only. -----Original Message- ---F rom: Haron, Judith (HHS /OGC) Sent: Wednesday , May 03, 2017 8:36 AM To: Bena , Anna Marie (HHS /OGC) (ACF); Suh , Victor (HHS /OGC) (ACF) (CTR); Biswas , Toby RM (ACF) Cc: Bowman , Matthew (HHS /OGC); Palacios , Caitlin (HHS /OGC) Subjec t: FW: Revised interroga tories and RFAs (b)(5) - Judy Haron Deputy Associate General Cou nsel Children, Familie s and Aging Divi sion HHS Office of the General Counsel (202) 690 8005 Notice: The contents of this message and any attachment s are privileged and confidential. You should not disseminate or release this message and any attachment s without the approval of the Office of the Genera l Counsel. If you are not an intended recipi ent, or have received this message in error , please delete it without reading it and please do not print, copy, forward, disseminate , or otherwise use the informat ion. Also , please notify the sender that you have receiv ed this communication in error. Your receipt of this message is not intended to waive any applicable privilege. -----Original Message----From: Phipps, Peter (CIV) [mailto:Peter.Phipps @usdoj .gov] Sent: Wedne sday , May 03, 2017 1: 18 AM To: Haron , Judith (HHS /OGC); Woolford , Llewellyn (HHS /OGC) ; Palacios , Caitlin (HHS /OGC) Cc: Grogg, Adam A. (CIV) Subject : Revised interrogatorie s and RF As /\MERICAi\ pVERSIGHT EXT-18-248-C-000023 (b)( S) Sincerely, Peter Sender: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "i "White, Jonathan (ACF) "; "Swartz, Tricia (ACF) "; Recipient: "Sualog, Jallyn (ACF) "; "Gregg, Laura (ACF) "; "Biswas, Toby RM (ACF) " Sent Date: 2017/05/03 09:00:04 Delivered Date: 2017/05/03 09:00:05 /\MERICAi\ pVERSIGHT EXT-18-248-C-000024 From: To: Bena,Anna Marie (HHS/OGC)(ACF) "ORRSenior Leadership" Subject: Weekly Litigation Update Date: 2017/05/04 12:42:03 Priority: Normal Type: Note I have attached this week's litigation update. Summary: UAC litigation. In ACLU v Price (family planning), on 4/28 the court denied the government's motion to transfer the case to the District Court for the District of Columbia. In OGLS (habeas), the judge granted the government's motion to seal its response brief and accompanying exhibits . Refugee litigation. In Tennessee, various affidavits of service for the Summons and Complaint on the parties were filed. In Oregon, the judge granted the government's unopposed motion for extension of time to respond to the complaint (a response is now due by 6/27/17). Sender: Recipient: Bena,Anna Marie (HHS/OGC)(ACF) "ORRSenior Leadership" Sent Date: 2017/05/04 12:42:01 Delivered Date: 2017/05/04 12:42:03 /\MERICAi\ pVERSIGHT EXT-18-248-C-000025 From: To: Bena, Anna Marie (HHS/OGC)(ACF) "ORR Senior Leadership" Subject: Weekly Litigation Update Date: 2017/05/1116:07:18 Priority: Normal Type: Note Ih ave attac hed the wee klly r.1tlgation upd ate. Sender: Recipient: Bena, Anna Marie (HHS/OGC)(ACF) "ORRSenior Leadership" Sent Date: 2017/05/1116:07:16 Delivered Date: 2017/05/1116:07:18 /\MERICAi\ pVERSIGHT EXT-18-248-C-000026 From: Bena,Anna Marie (HHS/OGC)(ACF) To: "Lucas, Sarah(ACF)(CTR) " CC: "Gregg, Laura (ACF) "; "Lloyd, Scott (ACF) " Subject: FW: Statutory Authorities Date: 2017/05/1116 :17:55 Priority: Normal Type: Note Hi Sarah , Here are the refugee authorit ies for Scott's binder. AnnaMarie From: Schmalz, Jennifer (ACF) Sent: Thursday, May 11, 2017 2:31 PM To: Bena, Anna Marie (HHS/OGC) (ACF) Subject: RE: Statutory Authorities Statutory The Refugee Act of 1980 (8 U.S .C. 1522) The Refugee Education Ass istance Act of 1980 (Pub. L 96-422) Trafficking Victims Protection Act of 2000 (22 U.S.C. 7105(b)(l)(C) ) Trafficking Victims Protection and Reauth orization Act of 2008 (8 U.S.C. 1232 (d)( 4)) 8 USC 1157 note 8 USC 1101 note Regulatory 45 CFR Part 400 and 40 1 45 CFR Part 402 From: Bena, Anna Marie (HHS/OGC) (ACF) Sent: Thursday, May 11, 2017 12:39 PM To: Schmalz, Jennifer (ACF) Subject: FW: Statutory Authorities From: Lloyd, Scott (ACF) Sent: Thursday, May 11, 2017 12:38 PM To: Bena, Anna Marie (HHS/OGC) (ACF) /\MERICAi\ pVERSIGHT EXT-18-248-C-000027 Cc: Tota, Kenneth (ACF); Lucas, Sarah (ACF) (CTR); Gregg, Laura (ACF) Subject: Statut ory Aut horit ies AnnaMarie, Ken may have reached out to you, but I thought I would send a quick note : I was hoping that you could provide a list of statutory / regulatory authorities for the refugee side of the house so that Sarah can comp ile a binder. The UAC binder has been very helpfu l. Thank you, Scott *** E. Scott Lloyd Director Office of Refugee Resett lement U.S. Department of Health and Human Services (202) 401-7269 I ( cell) (202) ICb)(6) scott. lloyd@acf.hhs.gov Sender : Bena, Anna Marie (HHS/OGC)(ACF) "Lucas, Sarah (ACF) (CTR) "; "Gregg, Laura (ACF) "; "Lloyd, Scott (ACF) " Sent Date: 2017/05/11 16: 17:50 Delivered Date: 2017/05/1116:17:55 /\MERICAi\ pVERSIGHT EXT-18-248-C-000028 From: Kelly Duguay "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; "Gregg, Laura (ACF) " Subject: california Continuum of care Reforms Date: 2017/05/16 14:41:57 Priority: Normal Type : Note Dear Guests, Thank you for visiting our program today. As promised, I have attached a copy of the legislative report highlighting California child welfare reforms recommended under Assembly Bill 403. Despite these changes, State Licensing has affirmed BCFSwill retain license as a Group Home. However, we can also apply to operate a Short Term Residential Treatment Program (STRTP)should the opportunity present itself. A program of this type would certainly meet a need for the network at large. Respectfu Ily, Kelly P.S. I have also attached a copy of the Interim Standards specific to the operation of a STRTP. Kelly Duguay Associate Executive Director BCFS Health and Human Services Residential Services Division 2301 Pennsylvania A venue I Fairfield, CA 94533 office (707) 422-8802 I fax (707) 422-8821 direct (707) 422-8802 Extension 3752 I cell (707) 1 (bl( 6l corporate website www. BCFS.net I program website www.DiscoverBCFS.net Arizona • Ca lifornia • Colorado• Florida • Illinois • New York• Ohio • Oregon • Tennessee • Texas • Washington, D.C. Africa • Eastern Europe • Latin America • Southeast Asia Sender : Kelly Duguay "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; "Gregg, Laura (ACF) " Sent Date: 2017/05/16 14:40:44 Delivered Date: 2017/05/16 14:41:57 /\MERICAi\ pVERSIGHT EXT-18-248-C-000029 From: To: Bartholomew, Michael (ACF) "Lloyd, Scott (ACF) " "Gregg, Laura (ACF) "; "White, Jonathan (ACF) "; "Tota, Kenneth (ACF) "; "Misegades,Lara (ACF) "; "Bartholomew, Michael (ACF) " Subject: PregnancyNotifications Date: 2017/05/19 22:57:33 Priority: Normal Type: Note Mr. Lloyd, Below is the requested information regarding pregnancy notifications . The date range is from May 1219, 2017. • 16 yo UAC, admitted on May 18, 2017 to SWK Hacienda del Sol was screen positive for pregnancy during the initial medical exam. Child report pregnancy was a result of consensual sexual relations. DHUC was informed via standard reporting procedures. The child was referred to OB/GYN services and was evaluated on 5/19 and determined to be 13 weeks gestation via ultrasound. The UAC made no statement or allegation of sexual abuse or assault. There is no medical concern related to this pregnancy identified at this time. The portal does not indicate any request related to information regarding pregnancy termination. • 16 yo UAC, admitted on May 16, 2017, to BCFSSan Antonio TFC in San Antonio TX, was reported to be 7-8 months pregnant. Child reported the pregnancy was a result of consensual sexual relations however to a 24 yo male in COO. FOCwas reported by UAC to be aggressive and having a short temper. DHUC was informed via Intake notification on May 17. The child was referred to OB/GYN services and is continuing routine prenatal care. Minor does have a mental health history. UAC reported that at mother and uncle made her consume an herbal remedy t o abort the pregnancy. UAC reported intermittent prenatal care in COO but was taking prenatal vitamins. OB evaluation is pending at this time. The portal does not indicate any request related to information regarding pregnancy termination . • 16 yo UAC, admitted on May 16, 2017 to Youth for Tomorrow in Bristow, VA, reported to be 2 months pregnant. Child reported the pregnancy was a result of consensual sexual relations however to a 20 yo male in COO. DHUC was informed via Intake notification on May 16, 2017. DHUC is following up with the program to determine the current clinical plan for the UAC. The porta l does not indicate any request related to information regarding pregnancy termination. /\MERICAi\ pVERSIGHT EXT-18-248-C-000030 • 16 yo UAC, admitted on May 12, 2017 to SWK Lemon Grove was screen positive for pregnancy during the initial medical exam (5/15) despite child reporting sexual activity. Child's pregnancy was confirmed via serum pregnancy test on 5/16. Child eventually reported the pregnancy was a result of consensual sexual relations. DHUC was informed via standard reporting procedures. The child was referred to OB/GYN services and was evaluated on 5/19 and determined to be 10 weeks gestation via hCG levels. An ultrasound is scheduled for 5/23 and a follow-up evaluation by OBGYNon 6/16. The UAC made no statement or allegation of sexual abuse or assault. There is no medical concern related to this pregnancy identified at this time. The portal does not indicate any request related to information regarding pregnancy termination. UPDATEon Prior Pregnancy Notifications: • 15 yo UAC, admitted on May 13, 2017 to Crittenton Shelter in Fullerton, CA was reported to be 34 weeks gestation. Child reported the pregnancy was a result of consensual sexual relations however to a 22 yo male in COO. FOCwas reported by UAC to be physically abusive and threatened UAC and unborn child. DHUC was informed via Intake notification on May 12. The child was referred to OB/GYN services and is continuing routine prenatal care. There is no medical concern related to this pregnancy identified at this time. • 15 yo UAC, admitted on May 4, 2017 to Heartland International Childrens Center in Chicago, IL, was reported to be 6 months pregnant. Child reported the pregnancy was a result of a consensual sexual relationship to a 17 yo male in COO. UAC reported living with FOCfor the past 2 years and that both sets of parents are aware of the pregnancy. Report indicates both UAC and FOCwere planning a family for the past year. Child received OB/GYN services in COO approximately 1 month prior. UAC was referred to OB services and is continuing routine prenatal care. There is no medical concern related to this pregnancy identified at this time. The portal does not indicate any request related to information regarding pregnancy termination. • Previously reported (May 12) 16 yo UAC at SKW Casa Franklin was reported to have continuous cramping and was transported to the local ED for evaluation on May 17. Patient was discharged and followed up with OB services. Patient had an ultrasound indicating the pregnancy to be at 5 week gestation and reported have unknown viability (per SIR). Physician recommended the importance that minor be checking to see if she noticed any spotting and if so to return to the ERas soon as possible. UAC will continue with prenatal vitamins and Tylenol as needed, if minor has vaginal bleeding or severe pelvic pain she will need to return to the ER,she is not allowed to do sports. Michael L. Bartholomew , M.D., FAAP CDR, U.S. Public Health Service Director, Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Admin istration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Building /\MERICAi\ pVERSIGHT EXT-18-248-C-000031 330 C St SW, MS 5123 Washington, DC 20201 Phone: 202-401-5375 m ichael. ba rtholomew@acf. h hs.gov www.acf.hhs.gov Sender: Bartholomew, Michael (ACF) "Lloyd, Scott (ACF) "; "Gregg, Laura (ACF) "; "White, Jonathan (ACF) "; Recipient: "Tota, Kenneth (ACF) "; "Misegades,Lara (ACF) "; "Bartholomew, Michael(ACF) " Sent Date: 2017/05/19 22:57:32 Delivered Date: 2017/05/19 22:57:33 /\MERICAi\ pVERSIGHT EXT-18-248-C-000032 Simmons, Joann (ACF) "Lloyd, Scott (ACF) "; "Tota, Kenneth (ACF) "; "Moreno, Pedro (ACF) "; "White, Jonathan (ACF) "; "Swartz, Tricia (ACF) "; "Sualog, Jallyn (ACF) "; "Brown, Anastasia (ACF) "; "Rubenstein, Carl (ACF) "; "Kim, Curi (ACF) "; "Bena, Anna Marie (HHS/OGC)(ACF) "; "Holt, Lydia (ACF) " "Hall, Wanda (ACF) "; "Miller, Lora (ACF) "; "Mai, Dinh (ACF) "; "Kramar, Iulia (ACF) "; "Papanicolas,Koula (ACF)(CTR) "; "Ali, Khalil (ACF)(CTR) "; "Gregg, Laura (ACF) "; "Robinson, Trina (ACF) "; "Davis, Gregory (ACF) " Subject: FY 2018 President'sBudget with New ProposedAppropriations Languagespecific to the UAC program Date: 2017/05/25 08:13:31 Priority: Normal Type: Note All, Attached please find a copy of the FY 2018 President's Budget Request. If you have any questions about the Refugee and Entrant Assistance Chapter, please let me know. Our chapter begins on page 171 of the document. I would like to point out that the proposed Appropriation Language for our account includes new language for the UAC program: /\MERICAi\ pVERSIGHT EXT-18-248-C-000033 (b) (S) Joann Simmons Director Division of Budget and Data Analysis Office of Refugee Resettlement Administration for Children and Families Department of Health and Human Services (202) 401-5409 Simmons,Joann (ACF) "Lloyd, Scott (ACF) "i "Tota, Kenneth (ACF) "; "Moreno, Pedro (ACF) "; "White, Jonathan (ACF) "; "Swartz, Tricia (ACF) "; /\MERICAi\ pVERSIGHT EXT-18-248-C-000034 "Sualog, Jallyn (ACF) "; "Brown, Anastasia (ACF) "; "Rubenstein, Carl (ACF) "; "Kim, Curi (ACF) "; "Bena, Anna Marie (HHS/OGC)(ACF) "; "Holt, Lydia (ACF) "; "Hall, Wanda (ACF) "; "Miller, Lora (ACF) "; "Mai, Dinh (ACF) "; "Kramar, Iulia (ACF) "; "Papanicolas,Koula (ACF)(CTR) "; "Ali, Khalil (ACF)(CTR) "; "Gregg, Laura (ACF) "; "Robinson, Trina (ACF) "; "Davis, Gregory (ACF) " Sent Date: 2017/05/25 08:13:20 Delivered Date: 2017/05/25 08:13:31 /\MERICAi\ pVERSIGHT EXT-18-248-C-000035 From: Bena, Anna Marie (HHS/OGC)(ACF) To: "ORRSenior Leadership"; "Moreno, Pedro(ACF)" Subject: Weekly Litigation Update Date: 2017/05/25 13:27:05 Priority : Normal Type: Note I have attached the weekly litigation update. In UAC litigation, Scott Lloyd replaced Ken Tota as a party in OGLS on 5/25. (Congra tulations Ken. Sorry Scott.) In refugee litigation, we had no substantive updates. Sender: Bena,Anna Marie (HHS/OGC)(ACF) "ORRSenior Leadership"; Recipient: "Moreno, Pedro(ACF)" Sent Date: 2017/05/25 13:27:02 Delivered Date: 2017/05/25 13:27:05 /\MERICAi\ pVERSIGHT EXT-18-248-C-000036 From: Bartholomew, Michael (ACF) To: "White, Jonathan (ACF) "; "Lloyd, Scott (ACF) " "Misegades, Lara (ACF) "; CC: "Gregg, Laura (ACF) " Subject: RE: PregnancyNotification May 20-26, 2017 Date: 2017/05/26 12:12:23 Priority: Normal Type: Note Hi Scott and Jonathan, (b)(5) Michael Michael L. Bart holomew, M .D., FAAP CDR, U.S. Public Health Service Director, Division of Health for Unaccompanied Children (DHUC ) Unaccompan ied Children Programs Office of Refugee Resett lement Adminis tration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Bu ilding 330 C St SW, MS 5123 Washington , DC 20201 Phone: 202-401-5375 michael. bartholomew @acf.hh s.gov www.acf.hh s.gov From: White, Jonathan (ACF) Sent: Friday, May 26, 2017 11:59 AM To: Lloyd, Scott (ACF); Bartholomew, Michael (ACF) Cc: Misegades, Lara (ACF); Gregg, Laura (ACF) Subject: RE: Pregnancy Notification May 20-26, 2017 Scott , /\MERICAi\ pVERSIGHT EXT-18-248-C-000037 (b)(5) Jonathan From: Lloyd, Scott (ACF) Sent: Friday, May 26, 2017 11:11 AM To: Bartholomew, Michael (ACF) Cc: White, Jonathan (ACF); Misegades, Lara (ACF); Gregg, Laura (ACF) Subject: RE: Pregnancy Notification May 20-26, 2017 Thank you, Michael. {b){5) /\MERICAi\ pVERSIGHT EXT-18-248-C-000038 (b)(5) Scott From: Bartholomew, Michael (ACF) Sent: Friday, May 26, 2017 10:41 AM To: Lloyd, Scott (ACF) Cc: White, Jonathan (ACF); Misegades, Lara (ACF) Subject: Pregnancy Notification May 20-26, 2017 Mr. Lloyd, Below is the requested infonnation regarding pregnancy notifications . The date range is from May 20-26, 2017. 16 yo UAC, admitted on May 22, 2017 to SWK Casa Phoenix was screen positive for pregnancy during the initial medical exam . Child report pregnancy was a result of consensual sexual relations with a 19 yo male in COO. UAC reported that she was approximately 24 weeks pregnant. DHUC was informed via standard reporting procedures . The child is being referred to OB/GYN services and was started on prenatal vitamins. The UAC made no statement or allegation of sexual abuse or assault. There is no medical concern related to this pregnancy identified at this time. The portal does not indicate any request related to information regarding pregnancy termination. UPDATE on Prior Pregnancy Notifications: 16 yo UAC, admitted on May 16, 2017 to Youth for Tomorrow in Bristow, VA, reported to be 2 months pregnant. Child reported the pregnancy was a result of consensual sexual relations however to a 20 yo male in COO. DHUC was informed via Intake notification on May 16, 2017. DHUC is following up with the program to determine the current clinical plan for the UAC. The portal does not indicate any request related to information regarding pregnancy termination . UPDATE: UAC evaluated by OB Services and determined via US to be ~ 10 weeks pregnant. The child is continuing routine prenatal care. There is no medical concern related to this pregnancy identified at this time. Michael L. Bartholomew , M.D., FAAP CDR, U.S. Public Health Service Director , Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs /\MERICAi\ pVERSIGHT EXT-18-248-C-000039 Office of Refugee Resettlement Adm inistration for Children and Fami lies U.S. Department of Health and Huma n Services Mary E. Switzer Building 330 C St SW, MS 5123 Washi ngton, DC 20201 Phone:202-401-5375 michael. bartholom ew@acf.hhs.go v www.acf .hhs.gov Sender: Bartholomew, Michael (ACF) "White, Jonathan (ACF) "; "Lloyd, Scott (ACF) "; Recipient : "Misegades, Lara (ACF) "; "Gregg, Laura (ACF) " Sent Date: 2017/05/26 12:12:23 /\MERICAi\ pVERSIGHT EXT-18-248-C-000040 From: Bena,Anna Marie (HHS/OGC)(ACF) To: "ORRSenior Leadership"; "Moreno, Pedro(ACF)" Subject: Weekly Litigation Update Date: 2017/06/0114:25:34 Priority: Normal Type: Note I have attached the weekly litigation update. UAC litigation. In ACLU v Pri ce (family planning litigation) , the court granted a stipulated revised case management calendar (Discovery completion date is now 10/9/17) . In OGLS, there was some procedural activity (sealing an exhibit, motion to substitute attorney by government). In City of Escondido, the partie s agreed to settle, and SWK filed a Notice of Settlement on 5/31. Refugee litigation. In the Indiana case, the status conference originally set for 6/14, was reset for 7/ 12. Sender: Bena,Anna Marie (HHS/OGC)(ACF) "ORRSenior Leadership"; Recipient: "Moreno, Pedro(ACF)" Sent Date: 2017/06/0114:25:30 Delivered Date: 2017/06/0114:25:34 /\MERICAi\ pVERSIGHT EXT-18-248-C-000041 From: Bena, Anna Marie (HHS/OGC)(ACF) To: "ORR Senior Leadership"; "Moreno, Pedro (ACF) " Subject: Weekly Litigation Update Date: 2017/06/08 16:04:11 Priority: Normal Type: Note I have attached the weekly litigation update . UAC litigation. In OGLS, the court granted habeas on 6/1, and ORR released the youth to his mother. In City of Escondido, on 6/1 the court issued an Order confirming the 5/31 settlement agreement. Refugee litigation. In Alabama, Governor Ivey has dropped the appeal of the state's previously dismissed suit. In Tennessee, on 6/1, all federal defendants filed Motions to Dismiss (for lack of jurisdiction and for failure to state a claim). Sender: Bena, Anna Marie (HHS/OGC)(ACF) Recipient: "ORRSenior Leadership"; "Moreno, Pedro (ACF) " Sent Date: 2017/06/08 16:04:08 Delivered Date: 2017/06/08 16:04:11 /\MERICAi\ pVERSIGHT EXT-18-248-C-000042 From: Grants Monitoring To: "Lloyd, Scott (ACF) " Subject: Tasks - MON_ DRS ECDCPhoenix, AZ_FY17 Date: 2017/06/09 09:45:50 Priority: Normal Type: Note.Microsoft.Workflow Task assigned by Siraj, Tabassum (ACF) on 6/9/2017. {b){5) To complete this task: 1. Review MON DRS ECDCPhoenix, AZ FY17. 2. Perform the specific activities required for this task. 3. Use the Open this task button to mark the task as completed. (If you cannot update this task, you might not have access to it .) Sender: Grants Monitoring Recipient: "Lloyd, Scott (ACF) " Sent Date: 2017/06/09 09:44:30 /\MERICAi\ pVERSIGHT EXT-18-248-C-000043 Delivered 09:45:50 Sohn, Elizabeth (ACF) "Bena, Anna Marie (HHS/OGC)(ACF) "; "White, Jonathan (ACF) "; To: "Logan, Scott (ACF) "; "Lloyd, Scott (ACF) " CC: "Gregg, Laura (ACF) " Subject: RE: Final ORRDraft of Q&A Date: 2017/06/16 13:30:40 Priority: Normal Type: Note By the way , ASL said that this Q&A set looked really great, and I wanted to make sure I passed on their accolades. Thanks for putting these together. Elizabet h From: Sohn, Elizabeth (ACF) Sent: Friday, June 16, 2017 1:18 PM To: Bena, Anna Marie (HHS/OGC)(ACF); White, Jonathan (ACF); Logan, Scott (ACF); Lloyd, Scott (ACF) Cc: Gregg, Laura (ACF) Subject: RE: Final ORR Draft of Q&A Thank you , and I hope you feel better! I noticed Toby and Laura are out. If we have any urgent request s/question s today, I' ll make sure to include Jonathan. Hopefully it wi ll be a quiet afternoon ... knock on wood. Thanks aga in, Elizabet h From: Bena, Anna Marie (HHS/OGC) (ACF) Sent: Friday, June 16, 2017 1:11 PM To: White, Jonathan {ACF); Logan, Scott (ACF); Lloyd, Scott (ACF); Sohn, Elizabeth (ACF) Cc: Gregg, Laura (ACF) Subject: RE: Final ORR Draft of Q&A Here is the revi sed fina l draft with addition s/cha nges based on the OLAB comments . (All - I have had a terribl e headache all day. I'm going to sign off for a bit and see if I can shake it.) /\MERICAi\ pVERSIGHT EXT-18-248-C-000045 From: White, Jonathan (ACF) Sent: Friday, June 16, 2017 11:50 AM To: Bena, Anna Marie (HHS/OGC) (ACF); Logan, Scott (ACF); Lloyd, Scott (ACF); Sohn, Elizabeth (ACF) Cc: Gregg, Laura (ACF) Subject: RE: Final ORR Draft of Q&A Anna Marie, Consulted with the medical team, and I would recommend as the QA bullet, based on the question posed about the three probable or confinned Zika cases, would be: • (b)(5) Jonathan From: Bena, Anna Marie (HHS/OGC) (ACF) Sent: Friday, June 16, 2017 7:55 AM To: Logan, Scott (ACF); Lloyd, Scott (ACF); Sohn, Elizabeth (ACF) Cc: Wh ite, Jonathan (ACF); Gregg, Laura (ACF) Subject: RE: Final ORR Draft of Q&A Thanks, Scott! Jonathan ~ (b)(S) other three. ~-------------~ I'll take care of the From: Logan, Scott (ACF) Sent: Thursday, June 15, 2017 10:54 PM To: Bena, Anna Marie (HHS/OGC) (ACF); Lloyd, Scott (ACF); Sohn, Elizabeth (ACF) Cc: Wh ite, Jonathan (ACF); Gregg, Laura (ACF) Subject: RE: Final ORR Draft of Q&A I've seen a lot of Q&A docs for our UAC hearings and I think this is the best set and really hits the right points/right level of detail! I just had 4 Qs/suggestions in the attached. I don't know who pulled this together but great job! Scott Logan Director Division of Legislative and Regulatory Affairs Office of Legislative Affairs and Budget Administration for Children and Families U.S. Department of Health and Human Services 330 CST, SW Suite 5020D Washington, D.C. 20201 202.401.4529 /\MERICAi\ pVERSIGHT EXT-18-248-C-000046 From: Bena, Anna Marie ( HHS/OGC) (ACF) Sent: Thursday, June 15, 2017 4: 05 PM To: Logan, Scott (ACF); Lloyd, Scott (ACF); Sohn, Elizabet h (ACF) Cc: White, Jonat han (ACF); Gregg, Laura (ACF) Subject: Final ORR Draft of Q&A I have attached the final ORR draft of the Q&A for the June 21 Senate Judiciary hearing. Sohn, Elizabeth (ACF) "Bena, Anna Marie (HHS/OGC)(ACF) "i "White, Jonathan (ACF) "; "Logan, Scott (ACF) "; "Lloyd, Scott (ACF) "i "Gregg, Laura (ACF) " Sent Dat e: 2017/06/16 13:30:39 Delivered Dat e: 2017/06/16 13:30:40 Message Flags: Unread /\MERICAi\ pVERSIGHT EXT-18-248-C-000047 Russell,Elizabeth(ACF) To: "Leinberger, Thomas (OS/ASPR/OEM)" "Tota, Kenneth (ACF) "; "Lloyd, Scott (ACF) "; "Vineyard, Michael(OS/ASPR/OEM)"; "Fontenot, Rebecca(OS/ASPR/OEM)"; "Lamana, Joseph (OS/ASPR/OEM)" Subject: RE: AIR Work Group meeting June 26 Date: 2017/06/19 10:15:28 Priority: Normal Type: Note Good morning Tom , See our preliminary comme nts to the NERP Base Plan. I saved the informat ion in the ASPRIAIR WG portal. v/r, Elizabet h From: Leinberger, Thomas (OS/ASPR/OEM) Sent: Thursday, June 15, 2017 3:11 PM To: Russell,Elizabeth (ACF); Peerbolte, Stacy (OS/ASPR/OEM);Mackay, Thomas (OS/ASPR/OEM);Nurthen, Nancy (OS/ASPR/OEM);Trombley, Dean (OS/ASPR);Hadzibegovic, Diana (OS/ASPR/OEM);Harahan, Kevin (OS/ASPR/OEM);Harvey, Melissa (OS/ASPR/IO);Yue, David (OS/ASPR/OEM);Speth, Sarah (OS/ASPR/OEM);AvilesMendoza,Guillermo (OS/ASPR/OEM) Cc: Lamana, Joseph (OS/ASPR/OEM);Kuhn-McClain,Tonya (HHS/ASPR/OEM);Vineyard, Michael (OS/ASPR/OEM);Fontenot, Rebecca(OS/ASPR/OEM);Hannah, Jennifer (OS/ASPR/OEM);Buckser,Jeffrey (OS/ASPR/OE M) Subject: AIR Work Group meeting June 26 Importance: High AIR Work Group members, Thank you for your participation at the OEM Directors' meeting on June 14. Elizabeth present a priorit ized list to get us toward comp leted State Emergency Repatriation Plans (SERP). The first item on that list is making sure the Nat ional Emergency Repatriat ion Plan (NERP) is accurate. The below link takes you to the AIR Work Group site where I have posted an interim NERP. https://asprwg.hhs. gov/aspr/air/ layouts/ 15/WopiFrame.aspx? sourcedo c=/aspr/air/DocLi bl /2017%20NERP%20Ba se%20Plan%20%20FINAL %20INTERIM %20DRAFT %20(F or%20AIR %20WG%20Review)( 170615). /\MERICAi\ pVERSIGHT EXT-18-248-C-000048 docx&action=default&Source=https%3A %2F%2F asprwg%2Ehhs%2Egov%2Faspr%2Fa ir%2FDocLib 1%2FF orms%2F AIIItems%2Easpx&DefaultltemOpen= 1&DefaultltemOpe n=l Please read /review and be prepared to discuss any issues and/or solutions at the next AIR Work Group meeting scheduled for June 26 th at 11 AM. Thank you, Thomas A. Leinberger , MA,MHA Director, Divisionof Planning Office of Emergency Management Office of the Assistant Secretary for Preparedness and Response Office of the Secretary Department of Health and Human Services Office: 202-401-2267 Email: thomas.leinberger@hhs.gov Russell, Elizabeth (ACF) "Leinberger, Thomas (O5/ASPR/OEM) "; "Tota, Kenneth (ACF) "; "Lloyd, Scott (ACF) "; Recipient: "Vineyard, Michael (OS/ASPR/OEM) "; "Fontenot, Rebecca (OS/ASPR/OEM) "; "Lamana, Joseph (O5/ASPR/OEM) " Sent Date: 2017/06/19 10:15:24 Delivered Date: 2017/06/19 10:15:28 /\MERICAi\ pVERSIGHT EXT-18-248-C-000049 Suh, Victor (HHS/OGC)(ACF) (CTR) "Gregg, Laura (ACF) "; To: "Blake, Sebrina(ACF) " "Bena, Anna Marie (HHS/OGC)(ACF) "; "Lloyd, Scott (ACF) "; CC: "White, Jonathan (ACF) "; "Biswas,Toby RM (ACF) " Subject: RE: Email Searchand instructions Date: 2017/06/19 12:43:52 Priority: Normal Type: Note Hi Laura, Please see attached email search terms from OGC. OGC notes: (b)(5) My understanding is that, based on feedback about these terms, I (b)(5) (b)(5) Thanks, Victor From: Gregg, Laura (ACF) Sent: Friday, June 09, 20 17 1:36 PM To: Blake, Sebrina (ACF) Cc: Bena, Anna Marie (HHS/OGC) (ACF); Lloyd, Scott (ACF); White, Jonathan (ACF); Suh, Victor (HHS/OGC) (ACF) (CTR) Subject: Re: Email Search and instructions l __ Victor- see below. Can you advise re: .... /\MERICAi\ pVERSIGHT <_bJ_<5_J _ __. EXT-18-248-C-000050 On: 09 June 2017 12:42, "Blake, Sebrina (ACF)" wrote: Laura, (b)(5) From: Gregg, Laura (ACF) Sent: Friday, June 09, 20 17 10:30 AM To: Blake, Sebrina (ACF) Cc: Bena, Anna Marie (HHS/OGC) (ACF); Lloyd, Scott (ACF); White, Jonat han (ACF) Subject: RE: Email Search and instr uctions Hi Sebrina, (b){5) Kindly, Laura Gregg Special Assistant Office of the Director From: Gregg, Laura (ACF) Sent: Monday, June 05, 2017 1:37 PM To: Blake, Sebrina (ACF) Cc: Bena, Anna Marie (HHS/OGC) (ACF); Lloyd, Scott (ACF); White, Jonath an (ACF) Subject: Email Search and instructions Hi Sebrina, (b)(5) Please let me know if you need additio nal informat ion. Kindly , Laura Gregg Spec ial Assistant Office of the Director Suh, Victor (HHS/OGC)(ACF) (CTR) Recipient: "Gregg, Laura (ACF) "; "Blake, Sebrina(ACF) "; "Bena, Anna Marie (HHS/OGC)(ACF) "; "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; "Biswas,Toby RM (ACF) " Sent Date: 2017/06/19 12:43:51 Delivered Date: 2017/06/19 12:43:52 /\MERICAi\ pVERSIGHT EXT-18-248-C-000052 Gregg, Laura (ACF) "Lucas, Sarah (ACF) (CTR) " CC: "Lloyd, Scott (ACF) " Subject: FW: Sen. Judiciary Question Date: 2017/06/20 15:13:20 Priority: Normal Type: Note Sarah, Please print for Scott's hearing binder. Thanks, Laura From: Bena, Anna Marie (HHS/OGC) (ACF) Sent: Tuesday, June 20, 2017 1:30 PM To: Lloyd, Scott (ACF); White, Jonathan (ACF) Cc: Gregg, Laura (ACF) Subject: FW: Sen. Judiciary Question I added these numbers at the end of the post -release section in case it comes up tomorrow. From: Gregg, Laura (ACF) Sent: Tuesday, June 20, 2017 11:40 AM To: Sohn, Elizabeth (ACF) Cc: Bena, Anna Marie (HHS/OGC) (ACF); White, Jonathan (ACF); Logan, Scott (ACF) Subject: FW: Sen. Judiciary Question Hi Eli zabeth , (b)(5) Thank s, Laura From: Sohn, Elizabeth (ACF) Sent: Monday, June 19, 2017 3:09 PM To: Bena, Anna Marie (HHS/OGC) (ACF); Gregg, Laura (ACF) /\MERICAi\ pVERSIGHT EXT-18-248-C-000053 Cc: Logan, Scott (ACF) Subject: Sen. Judiciary Question Hi AnnaMarie and Laura, (b)( S) Thanks, Elizabeth Elizabeth Sohn Legislative Analyst Office of Legislative Affairs and Budget Administration for Children and Families (202) 260-6829 Elizabeth.Sohn@acf.hhs.gov Gregg, Laura (ACF) Recipient: "Lucas, Sarah (ACF) (CTR) "; "Lloyd, Scott (ACF) " Sent Date: 2017/06/20 15:13:19 Delivered Date: 2017/06/20 15:13:20 /\MERICAi\ pVERSIGHT EXT-18-248-C-000054 From: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; "Sualog, Jallyn (ACF) " "Swartz, Tricia (ACF) "; "Suh, Victor (HHS/OGC)(ACF) (CTR) "; "De LA Cruz, James (ACF) "; "Biswas,Toby R M (ACF) "; "Gregg, Laura (ACF) "; "Moreno, Pedro (ACF) " Subject: AH Case ResponseDue Tuesday Date : 2017/06/26 09:02:01 Importan ce : High Priority: Urgent Type: Note (b)(5) From: Furna, Julia (HHS/OGC) Sent: Sunday, June 25, 20 17 9:01 PM To: Fabian, Sarah B (CIV); Bena, Anna Marie (H HS/OGC) (ACF); Biswas, Toby R M (ACF); Haron, Judith (HHS/OGC) Cc: Andrapalliyal, Vinita B. (CIV) /\MERICAi\ pVERSIGHT EXT-18-248-C-000055 (b)(5) Julia Furna Attorney Office of the General Counsel Children, Families and Aging Division U.S. Dep't of Health & Human Services 202-690-7791 Julia.fuma@hhs .gov Notice: The contents of this message and any attachments may be privileged and confidential. Please do not disseminate without the approval of the Office of the General Counsel. If you are not an intended recipient, or have received this message in error, please delete it without reading it and please do not print, copy, forward, disseminate, or otherwise use the information. Also, please notify the sender that you have received this communication in error . Your receipt of this message is not intended to waive any applicable privilege. From: Fabian, Sarah B (CIV) [ mailto:Sarah.B.Fabian@usdoj.gov ] Sent: Sunday, June 25, 2017 12:35 AM To: Furna, Julia (HHS/OGC); Bena, Anna Marie (HHS/OGC) (ACF); Biswas, Toby RM (ACF); Haron, Judith (HHS/OGC) Cc: Andrapalliyal, Vinita B. (CIV) Subject: RE: Copy of the Petition for Writ of Habeas Corpus and Complaint for Injunctive and Declaratory Relief All: /\MERICAi\ pVERSIGHT EXT-18-248-C-000056 (b)(5) Thanks! Sarah B. Fabian Senior Litigation Counsel Office of Immigration Litigation - District Court Section (202) 532-4824 From: Fabian, Sarah B {CIV) Sent: Friday, June 23, 2017 9:07 PM To: 'Furna, Julia {HHS/OGC)' ; Bena, Anna Marie {HHS/OGC) {ACF) ; Biswas, Toby R M {ACF) Cc:Andrapalliyal, Vinita B. {CIV) Subject: RE: Copy of the Petition for Writ of Habeas Corpus and Complaint for Injunctive and Declaratory Relie f (b)(5) Sarah B. Fabian Senior Litigation Counsel Office of Immigration Litigation - District Court Section {202) 532-4824 /\MERICAi\ pVERSIGHT EXT-18-248-C-000057 From: Furna, Julia (HHS/OGC) [mailto:Julia.Fuma@hhs.gov ] Sent: Friday, June 23, 2017 9:05 AM To: Fabian, Sarah B (CIV) ; Bena, Anna Marie (HHS/OGC) (ACF) ; Biswas, Toby R M (ACF) Subject: RE: Copy of the Petition for Writ of Habeas Corpus and Complaint for Injunctive and Declaratory Relief Thanks. I will give you a call as soon as I get the case file. From: Fabian, Sarah B (CIV) [ mailto:Sarah.B.Fabian@usdoj.gov ] Sent: Friday, June 23, 2017 9:02 AM To: Furna, Julia (HHS/OGC); Bena, Anna Marie (HHS/OGC) (ACF); Biswas, Toby R M (ACF) Subject: FW: Copy of the Petition for Writ of Habeas Corpus and Complaint for Injunctive and Declaratory Relief FYI Sarah B. Fabian Senior Litigation Counsel Office of Immigration Litigation - District Court Section (202) 532-4824 From: Norris, Raven (USACAN) [mailto:Raven.Norris@usdoj.gov ] Sent: Friday, June 23, 2017 1:39 AM To: Fabian, Sarah B (CIV) Subject: Fwd: Copy of the Petition for Writ of Habeas Corpus and Complaint for Injunctive and Declaratory Relief Here it is.~l______ <_bl_<5_ ) -----~ Sent from my iPhone Begin forwarded message: From: "Cecilia Bermudez" To: " james.delacruz@acf.hhs.gov " , "elicia.smith@acf.hhs.gov " , "Norris, Raven (USACAN)" , "Winslow, Sara (USACAN)" , (b){6) (bJ(6J p>yolocounty.org > Cc:' (b)(6J aclunc.or >, '1 (bJ(6J ~aclunc .org > Subject: Copy of the Petition for Writ of Habeas Corpus and Complaint for Injunctive and Declaratory Relief Dear All, Enclosed please find a copy of today's filings. We expect to file the Application for Temporary Restraining Order tomorrow and we will provide a copy before filing . Thank you! /\MERICAi\ pVERSIGHT EXT-18-248-C-000058 Best, Cecilia Bermudez Pronouns: She/Her/Hers Intake Program Manager & Litigation Assistant ACLU of Northern California 39 Drumm St., San Francisco, CA 94111 (415) 621-2493 x 329 I cbermudez@aclunc .org This email has been scanned for email related threats and delivered safely by Mimecast. For more information please visit http://www.mimecast.com Sender: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; "Sualog, Jallyn (ACF) "; "Swartz, Tricia (ACF) "; "Suh, Victor (HHS/OGC)(ACF) (CTR) "; "De LA Cruz, James(ACF) "; "Biswas, Toby RM (ACF) "; "Gregg, Laura (ACF) "; "Moreno, Pedro (ACF) " Sent Date: 2017/06/26 09:01:59 Delivered Date: 2017/06/26 09:02:01 /\MERICAi\ pVERSIGHT EXT-18-248-C-000059 From: To: Bartholomew,Michael(ACF) "Lloyd, Scott (ACF) " "Gregg, Laura (ACF) "; "White, Jonathan (ACF) "; "Sualog, Jallyn (ACF) "; "De LA Cruz, James (ACF) "; "Misegades,Lara (ACF) " Subject: TOP Request Date: 2017/07/05 13:14:39 Priority: Normal Type: Note Mr . Lloyd, DHUC was notified of this UAC over the past few days. However , today , I received a call from Dr. (bJ(6J indicating that one of the SWK programs has a UAC that will be making a formal request for Termination of Pregnancy (TOP). I (bJ(6l iwas looking for guidance to give to the program. I I I I 16 yo UAC (bJ(6J admitted on June 30, 2017 to SWK Sol was ident ified by ICE to be pregnant. UAC reports her pregnancy to be ~8 weeks. IME confirms pregnancy with positive urine pregnancy test. Child reported the pregnancy was a result of consensual sexual relations with a 16 yo male in COO. DHUC was informed of the pregnancy via standard reporting procedures . The child is being referred to OB/GYN services . The UAC made no statement that the pregnancy is a result of sexual abuse or assault. The portal (IME) does indicate the child has had thoughts about not wanting to keep the pregnancy however there is no current documentation/information requesting pregnancy termination until today. The program is attempting to have the current OB appointment moved up from July 12. Since the program is in the Phoenix area , the SWK program is setting up a spiritual counse ling sess ion and a family session for the UAC (similar to what was done with previous TOP requests). I (bl( 6l Idid mention the clinicians are looking for input on what information they can provide to the UAC. Please adv ise if there is anything further you would like the program to do? Michael L. Bartholomew, M.D., FAAP CDR , U.S. Public Health Service Director, Division of Health for Unaccompanied Chi ldren (DHUC) Unaccompanied Chi ldren Programs /\MERICAi\ pVERSIGHT EXT-18-248-C-000060 Office of Refugee Resettlement Adm inistration for Children and Fami lies U.S. Department of Health and Huma n Services Mary E. Switzer Building 330 C St SW, MS 5123 Washi ngton, DC 20201 Phone:202-401-5375 michael. bartholomew@acf.hhs.gov www.acf.hhs.gov Sender: Bartholomew, Michael (ACF) "Lloyd, Scott (ACF) "; "Gregg, Laura (ACF) "; "White, Jonathan (ACF) "; Recipient: "Sualog, Jallyn (ACF) "; "De LA Cruz, James (ACF) "; "Misegades, Lara (ACF) " Sent Date: 2017/07/05 13:14:39 /\MERICAi\ pVERSIGHT EXT-18-248-C-000061 From: To: Bartholomew,Michael(ACF) "Lloyd, Scott (ACF) " "White, Jonathan (ACF) "; "Gregg, Laura (ACF) "; CC: "Misegades,Lara (ACF) "; "De LA Cruz, James (ACF) " Subject: RE:Termination of Pregnancyj(b)(6) ~ase Date: 2017/07/05 15:10:45 Priority: Normal Type: Note Thank you. I will advi se the program . Michael Michael L. Bart holomew , M.D., FAAP CDR, U.S. Public Health Serv ice Director, Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resett lement Adm inistration for Ch ildren and Fam ilies U.S. Department of Health and Human Services Mary E. Switzer Building 330 C St SW, MS 5123 Washington, DC 20201 Phone: 202-401-5375 michael.bartholom ew@acf.hh s.gov www.acf.hh s.gov From: Lloyd, Scott (ACF) Sent: Wednesday, July 05, 2017 2:47 PM To: Bartholomew, Michael (ACF) Cc: White, Jonathan (ACF); Gregg, Laura (ACF); Misegades, Lara (ACF); De LA Cruz, James (ACF) Subject: RE: Termination of Pregnancy~ case Michael , /\MERICAi\ pVERSIGHT EXT-18-248-C-000062 (b)(S) ~1Let me know if you need clarification ~fb_ )<5 _)____________ anything. on Thank you , Scott From: Bartholomew, Michael (ACF) Sent: Wednesday, July 05, 2017 2:16 PM To: Lloyd, Scott (ACF) Cc: White, Jonathan (ACF); Gregg, Laura (ACF); Misegades, Lara (ACF); De LA Cruz, James (ACF) Subject: FW: Terminat ion of Pregnan ~ case fysa Michael L. Bartholomew , M.D. , FAAP CDR , U.S. Public Health Service Director, Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Building 330 C St SW, MS 5123 Washington , DC 20201 Phone: 202-401-5375 michael. bartholomew@acf.hhs .gov www.acf.hhs.gov From: I (bJ(6J I[mailtd (bJ(6J @swkey.org] Sent: Wednesday, July 05, 2017 1:54 PM To: Bartho lomew, Michael (ACF) 5) lease Subject: Termination of Pregnancyl "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; "Gregg, Laura (ACF) "; "Misegades, Lara (ACF) "; "De LA Cruz, James (ACF) " Sent Date: 2017/07/05 15:10:45 /\MERICAi\ pVERSIGHT EXT-18-248-C-000064 From: Bena, Anna Marie (HHS/OGC)(ACF) "Bartholomew, Michael (ACF) "; "Bena, Anna Marie (HHS/OGC)(ACF) "; "Brown, Anastasia (ACF) "; "Davis, Gregory (ACF) "; "Gregg, Laura (ACF) "; "Kim, Curi (ACF) "; "Lloyd, Scott (ACF) "; "Moreno, Pedro (ACF) "; To: "Robinson, Trina (ACF) "; "Rubenstein, Carl (ACF) "; "Simmons, Joann (ACF) "; "Sualog, Jallyn (ACF) "; "Swartz, Tricia (ACF) "; "Tota, Kenneth (ACF) "; "White, Jonathan (ACF) "; "Wynne, Maggie (HHS/1OS)" Subject: Litigation Update Date: 2017/07/06 15:39:48 Priority: Normal Type: Note I have attached this week's litigation update. UA C Litigation . In AH ("Savaria"), the District Court for the Northern District of California ordered ORR to provide AH an opportunity to be heard regarding his placement in ORR care, including his custody at the Yolo secure facility; the ORR Director will hold a conference call with the child and his attorneys on 7/7. In Flores, on 7/5, the 9 th Circu it lifted the stay on the district court's order; as a result , ORR must for now imp lement bond hearings for all UAC in care . In ACLU v Price (fam ily planning litigation) , internally, ORR is preparing to submit updated responses to the Request for Production , to be current through 6/30. In Nash (FOIA litigation regarding the JRP program), a pretrial conference has been set for 1/2/18, and the ACLU filed a proposed schedu ling order on 7/5/1 7. Refugee Litigation. In the Indiana case, the case was reassigned to a new judge and the court ordered a status conference to take place 7/10/17. In Oregon, the court granted in /\MERICAi\ pVERSIGHT EXT-18-248-C-000065 part the defendant's motion for extension of time to file a response to the plaintiffs motion to dismiss; response is due by 8/ 1/17. Sender: Bena, Anna Marie (HHS/OGC) (ACF) "Bartholomew, Michael (ACF) "; "Bena, Anna Marie (HHS/OGC) (ACF) "; "Brown, Anastasia (ACF) "; "Davis, Gregory (ACF) "; "Gregg, Laura (ACF) "; "Kim, Curi (ACF) "; "Lloyd, Scott (ACF) "; "Moreno, Pedro (ACF) "; Recipient: "Robinson, Trina (ACF) "; "Rubenstein, Carl (ACF) "; "Simmons, Joann (ACF) "; "Sualog, Jallyn (ACF) "; "Swartz, Tricia (ACF) "; "Tota, Kenneth (ACF) "; "White, Jonathan (ACF) "; "Wynne, Maggie (HHS/IOS) " Sent Date: 2017/07/06 15:39:47 Delivered Date: 2017/07/06 15:39:48 /\MERICAi\ pVERSIGHT EXT-18-248-C-000066 From: To: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; "Gregg, Laura (ACF) " "Biswas, Toby RM (ACF) "; CC: "White, Jonathan (ACF) " Subject: Fwd: Hearing with ORR Date: 2017/07/07 16:34:40 Priority: Normal Type: Note Exhibits the ACLU mentioned. From: "Furna, Julia (HHS/OGC)" Subject: FW: Hearing with ORR Date: 07 July 2017 16:32 To: "Bena, Anna Marie (HHS/OGC) (ACF)" , "Biswas, Toby RM (ACF)" Cc: "Haron, Judith (HHS/OGC)" Sent my comment too soon. Here are the exhibits. -----Original Message----From: Fabian, Sarah B (CIV) (mailto:Sarah .B.Fabian@usdoj.gov] Sent: Friday, July 07, 2017 4:26 PM To: Furna, Julia (HHS/OGC) Subject: RE: Hearing with ORR Sarah B. Fabian Senior Litigation Counsel Office of Immigration Litigation - District Court Section (202) 532-4824 -----Original Message---- From: Furna, Julia (HHS/OGC) [mailto:Julia.Fuma @hhs.gov] Sent: Friday, July 07, 2017 3:48 PM To: Fabian, Sarah B (CIV) Subject: RE: Hearing with ORR (b)(S) -----Original Message----From: Fabian, Sarah B (CIV) (mailto:Sarah.B.Fabian @usdoj.gov] /\MERICAi\ pVERSIGHT EXT-18-248-C-000067 Sent: Friday, July 07, 2017 2:34 PM To: Furna, Julia (HHS/OGC) Subject: Re: Hearing with ORR (b)(5) Sent from my Verizon, Samsung Galaxy smartphone -------- Original message -------From: "Furna, Julia (HHS/OGC)" Date: 7/7/17 11:32 AM (GMT-08:00) To: "Fabian, Sarah B (CIV)" Subject: RE: Hearing with ORR (b)(5) -----Original Message----From: Fabian, Sarah B (CIV) [mailto:Sarah.B.Fabian @usdoj .gov] Sent: Friday, July 07, 2017 2:29 PM To: Furna, Julia (HHS/OGC) Subject: Re: Hearing with ORR (b)(5) Sent from my Verizon , Samsung Galaxy smartphone -------- Original message -------From: "Furna, Julia (HHS/OGC)" Date: 7/7/17 11:05 AM (GMT-08:00) To: "Fabian, Sarah B (CIV)" Subject: FW: Hearing with ORR From: Biswas, Toby R M (ACF) Sent: Friday, July 07, 2017 2:02 PM To: Julia Mass; Stephanie Gibbs; wfreeman@aclunc.org Cc: Bena, Anna Marie (HHS/OGC) (ACF); Furna, Julia (HHS/OGC); Haron, Judith (HHS/OGC); Suh, Victor (HHS/OGC) (ACF) (CTR); Mestre, Lisette (HHS/OGC); Gregg, Laura (ACF); De LA Cruz, James (ACF); Smith, Elicia (ACF) Subject: RE: Hearing with ORR Here are the rest of the documents. Thank you, Toby Toby R. M. Biswas, ESQ. Unaccompanied Alien Children Policy Supervisor /\MERICAi\ pVERSIGHT EXT-18-248-C-000068 U.S. Department of Health and Human Services Administration for Children and Families Office of Refugee Resettlement Office of the Director - Division of Policy and Procedures (202) 205 -4440 (0) (30 I) I (b)(6) I(C) (202) 401- l 022 (F) From: Julia Mass [mailto:jmass @aclunc.org1 Sent: Thursday, July 06 , 2017 11:00 PM To: Biswas, Toby R M (ACF); Stephanie Gibbs Cc: Bena , Anna Marie (HHS/OGC) (ACF); Furna, Julia (HHS/OGC); Haron, Judith (HHS/OGC); Suh, Victor (HHS/OGC) (ACF) (CTR); Mestre, Lisette (HHS/OGC); Gregg, Laura (ACF); De LA Cruz, James (ACF); Smith, Elicia (ACF) Subject: RE: Hearing with ORR Dear Toby, Please pass along the attached letter and supporting documents to Mr . Lloyd from Stephanie Gibbs and me. Thank you, Julia Julia Harumi Mass, Senior Staff Attorney American Civil Liberties Union Foundation of Northern California 39 Drumm Street San Francisco, CA 941 11 tel (415) 621-2493 ext. 339 fax (415) 255-8437 www.aclunc.org From: Biswas, Toby RM (ACF) (mailto:Toby.Biswas @ACF.hhs.gov] Sent: Thursday, July 06 , 2017 12:34 PM To: Stephanie Gibbs Cc: Julia Mass; Bena, Anna Marie (HHS/OGC) (ACF); Furna, Julia (I-IHS/OGC) ; Haron, Judith (HHS/OGC); Suh, Victor (HHS/OGC) (ACF) (CTR); Mestre , Lisette (HHS/OGC) ; Gregg, Laura (ACF); De LA Cruz , James (ACF) ; Smith, Elicia (ACF) Subject: RE: Hearing with ORR Stephanie and Julia : Here is the call-in information for tomorrow's call: Call in:~l (b_)(_5l__ 5 ~I Participan t Access Code j._ (b_)(_ l__ _. A room and telephone will be available at Yolo. Addi tionally , an interpreter will be available in person for the call. Yolo has been informed that you will be arriving to speak to your client 30 minutes prior to the call. Thank you, Toby Toby R. M. Biswas, ESQ. Unaccompanied Alien Chi ldren Policy Supervisor U.S. Department of Health and Human Service s Administration for Children and Families Office of /\MERICAi\ pVERSIGHT EXT-18-248-C-000069 Refugee Resettlement Office of the Director - Division of Policy and Procedures (202) 205-4440 (0) (301) I (b)(6) I(C) (202) 401- 1022 (F) From: Stephanie Gibbs [mailto:sgibbs@safepassageproject.org] Sent: Wednesday , July 05, 2017 8:54 PM To: Biswas, Toby R M (ACF) Cc: Julia Mass; Bena, Anna Marie (HHS/OGC) (ACF); Furna, Julia (HHS/OGC); Haron, Judith (HHS/OGC); Suh, Victor (HHS/OGC) (ACF) (CTR); Mestre, Lisette (HHS/OGC); Gregg, Laura (ACF) Subject: Re: Hearing with ORR Toby, Thank you for sending these along. Stephanie On Wed, Jul 5, 2017 at 8:08 PM, Biswas, Toby RM (ACF) > wrote: Julia and Stephanie: Please find attached a case review recommendation from the~ current placement, along with supporting SIRs and OY AS tool. ORR is currently considering the recommendation that the minor remain in Yolo-Secure. We are working on the logistics for Friday's teleconference and will update you as soon as possible. Thank you, Toby Toby R. M. Biswas, ESQ. Unaccompanied Alien Children Policy Supervisor U.S. Department of Health and Human Services Administration for Children and Families Office of Refugee Resettlement Office of the Director - Division of Policy and Procedures (202) 205-4440 (0) (301) (b)(6) (C) (202) 401-1022 (F) From: Julia Mass [mailto:jmass@aclunc.org ] Sent: Wednesday, July 05, 2017 6:02 PM To: Biswas, Toby R M (ACF); Stephanie Gibbs Cc: Bena, Anna Marie (HHS/OGC) (ACF); Furna, Julia (HHS/OGC); Haron, Judith (HHS/OGC); Suh, Victor (HHS/OGC) (ACF) (CTR); Mestre , Lisette (HHS/OGC); Gregg, Laura (ACF) Subject: RE: Hearing with ORR ry I will be out of the office and without access to email for most of the day tomorrow. Please contact me by more information that ORR will be phone if needed and let us know as soon as possible if you have using in its consideration of this case. My mobile number is 510 ~b)(6) f. Please let me know as soon as you know where~ will be participating in the teleconference so that I can join him there. I would like to meet him 30 minutes prior to the meeting with Mr. Lloyd to go over any last /\MERICAi\ pVERSIGHT EXT-18-248-C-000070 minute questions. In addition , please be advised that lili1llil will need an interpreter for this hearing. Thanks , Julia From: Biswas , Toby RM (ACF) [mailto:Toby.Biswas@ACF.hhs.gov] Sent: Wednesday , July 5, 2017 9:58 AM To: Stephanie Gibbs > ; Julia Mass > Cc: Bena, Anna Marie (HHS /OGC) (ACF) >; Furna, Julia (HHS /OGC) >; Haron , Judith (HHS /OGC) > ; Mestre, Lisette (HHS/OGC) >; Gregg, Laura (ACF) > Subject: RE: Hearing with ORR Stephanie and Julia: We are scheduling the call for 10am PST/lpm EST. We will provide call in information soon. referral and placement documents used to justify his placement in a secure care Please find attached lilillfilJ provider. As you are aware lilillfilJ placement in secure is undergoing review. I anticipate that documents related to the case review will be available later this afternoon. I will forward them as soon as they are available. Please let me know if you have any questions. Thanks, Toby Toby R. M. Biswas, ESQ. Unaccompanied Alien Children Policy Supervisor U.S. Department of Health and Human Services Admin istration for Children and Famili es Offic e of Refugee Resettlement Office of the Director - Division of Policy and Procedures (202) 205-4440 (0) (301) (b)(6) (C) (202) 401-1022 (F) From: Stephanie Gibbs [mailto:sgibbs@safepassageproject.org] Sent: Wednesday , July 05, 2017 10:05 AM To: Julia Mass Cc: Biswas, Toby R M (ACF); Bena, Anna Marie (HHS /OGC) (ACF); Furna, Julia (HHS/OGC); Haron , Judith (HHS/OGC); Suh , Victor (HHS /OGC) (ACF) (CTR); Mestre , Lisette (HHS /OGC); Gregg , Laura (ACF) Subject: Re: Hearing with ORR Julia , thank you for taking the lead on this. Toby, I am also available on F riday, July 7, 20 17 at either lOam PST /I pm EST or I lam PST /2pm EST. I'm looking forward to your confirmation on the time and the opportunity to review the evidence in advance of Friday's hearing. /\MERICAi\ pVERSIGHT EXT-18-248-C-000071 Thank you kindly. Best , Stephanie On Mon , Jul 3, 2017 at 7:40 PM, Julia Mass > wrote: Thank you. Also, in order for us to have sufficient time to review the evidence ORR used and is using to make its custody deter mination, please share that with us by I0:00 a.m. Pacific/I :00 p.m. Eastern on Wednesday , Jul y 5. If you can't reach me at my office (4 l 5-293-6339 ), please call my mobile phone at 510~(b)(6) I Thank s again, Julia From: Biswas, Toby R M (AC F) [mailto:Toby.Biswas @AC F.hhs.gov] Sent: Monday, July 3, 2017 12:52 PM To: Julia Mass >; sgibb s@safepassagepro jec t.org Cc: Bena, Anna Mar ie (HHS/ OGC) {ACF) >; Furna, Juli a (HHS/OGC) >; Haro n, Judith (HHS/OGC) >; Mestre, Lisette (HHS/ OGC) >; Gregg, Laura (ACF) > Subject: RE: Hearing with ORR Julia: I'm working with the Director's ass istant to schedule. We'll confirm with you on Wednesday of the exact time. I'm working on the logistics with the program office to have your client avai lable as well. I'll be in touch soon. -Tob y Toby R. M. Biswas, ESQ. Unaccomp anied Alien Children Policy Supervisor U.S. Department of Health and Human Services Admin istration for Children and Families Office of Refugee Resettlement Office of the Director - Division of Policy and Procedures (202) 205-4440< tel: 202)%20205-4440> (0) (301) (b)(6) (C) (202) 401-1022 (F) From: Ju lia Mass [mai lto:jmass@aclunc.org l Sent: Monday , July 03, 2017 3:44 PM To: Biswas, Toby RM (ACF); sgibbs@safepassageproject.org Cc: Bena , Anna Marie (HHS/ OGC) (ACF); Furna, Julia (HHS/OGC); Haro n, Judith (HHS/OGC); Suh, Victor (HH S/OGC) {ACF) (CTR); Mestre , Lisette (HHS/OGC); Gregg , Laura (ACF) Subject: RE: Hearing with ORR /\MERICAi\ pVERSIGHT EXT-18-248-C-000072 Toby, Please call me Julia. I am available on Friday. Ifwe make it early in the day, I can arrange to be present with our client at the Yolo Facility or other location in northern Californi a. For this reason, I would prefer to have the call at I 0:00 or 11:00 Pacific time. Thank you, Julia Julia Harumi Mass Senior Staff Attorney ACLU Foundation of Northern California 39 Drumm Street San Francisco, California 94111 tel. (415) 621-2493 ext 339 fax. (415) 255-8437 pronouns: she/her/hers www .aclunc.org This message and any files or text attached to it are intended only for the recipients named above, and contain information that may be confidential or privileged. If you are not an intended recipient, you must not read, copy, use or disclose this communication. Please also notify the sender by replying to this message , and then delete all copies of it from your system. Thank you. From: Biswas, Toby RM (ACF) (mailto:Toby .Biswas@ACF.hhs.gov] Sent: Monday, July 3, 2017 12:38 PM To: Julia Mass >; sgibbs @safepassageproject.org Cc: Bena , Anna Marie (HHS/OGC) (ACF) > ; Furna, Julia (HHS/OGC) > ; Haron , Judith (HHS/OGC) > ; Mestre, Lisette (HHS/OGC) >; Gregg, Laura (ACF) > Subject: Hearing with ORR Ms. Mass and Ms. Gibbs: Are you available for a conference call with the Scott Lloyd the ORR Director, July 7th, 2017 (Friday)? The discussion will cover the information ORR reviews in regards to your client's referral, placement, review of the placement and release assessment , as required by Judge Chhabria. I'm still waiting for that information from the program office and will provide it as soon as it is available . Please let me know if you have any questions. Thanks , Toby Biswas Toby R. M. Biswas, ESQ. Unaccompanied Alien Children Policy Supervisor U.S. Department of Health and Human Services Administration for Children and Families Office of Refugee Resettlement Office of the Director - Division of Policy and Procedur es /\MERICAi\ pVERSIGHT EXT-18-248-C-000073 (202) 205-4440 (0) (30 I) (b)(6) (C) (202) 401 - 1022 (F) I I This email has been scanned for ema il related threats and del ivered safely by Mimecast. Fo r more informatio n please visit http://www .mimeca st.com _____________ _ This email has been scanned for ema il re lated threats and del ivered safely by Mimecast. For more information p lease visit http: //www.mimecast.com _____________ _ Stephanie E. Gibbs Supervising Attorney, Long Island Safe Passage Project 185 West Broadway New York, NY 10013 T : 212-324-6558 (Main Office); 646-657- 77 l 5 (Direct) F: 34 7-368-22 l 3 E: sgibbs@safepassageproject.org www.safepassageproject.org > This email has been scanned for ema il re lated threats and del ivered safely by Mimecast. Fo r more informatio n please visit http://www.mimecast.com _____________ _ Stephanie E. Gibbs Supervising Attorney, Long Island Safe Passage Project 185 West Broadway New York, NY 10013 T: 212-324-6558 (Main Office); 646-657-7715 (Direct) F : 347-368-2213 E: sgibbs@safepassageproject .org www.safepassageproject.org> This email has been scanned for email related threats and delivered safely by Mimecast. For more information please visit http://\'1'1vw.mimecast.com _____________ Sender: _ Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; Recipient: "Gregg, Laura (ACF) "; /\MERICAi\ pVERSIGHT EXT-18-248-C-000074 "Biswas,Toby RM (ACF) "; "White, Jonathan (ACF)" Sent Date: 2017/07/07 16:34:35 Delivered Date: 2017/07/07 16:34:40 /\MERICAi\ pVERSIGHT EXT-18-248-C-000075 Biswas,Toby R M (ACF) To: "Lloyd, Scott (ACF) " "Bena, Anna Marie (HHS/OGC)(ACF) "i "Gregg, Laura (ACF) "; "White, Jonathan (ACF) " Subject: Fwd: Hearing with ORR Date: 2017/07/07 17:33:31 Priority: Normal Type: Note All exhibits. From: "Furna, Julia (HHS/OGC)" Subject: FW: Hearing with ORR Date: 07 July 2017 17:15 To: "Biswas, Toby RM (ACF)" , "Bena, Anna Marie (HHS/OGC) (ACF)" -----Original Message----From: Fabian, Sarah B (CIV) [mailto:Sarah .B.Fa bian@usdo j.gov] Sent: Friday, July 07, 2017 5:06 PM To: Furna , Julia (HHS/OGC) Subject: RE: Hearing with ORR Sarah B. Fabian Senior Litigation Counsel Office of Immigration Litigation - District Court Section (202) 532-4824 -----Original Message----From: Furna, Julia (HHS/OGC) [mailto:Julia.Fuma @hhs.gov] Sent: Friday, July 07, 2017 5:02 PM To: Fabian, Sarah B (CIV) Subject: RE: Hearing with ORR b)(S) -----Original Message----From: Fabian, Sarah B (CIV) [mailto:Sarah .B.Fa bian@usdoj .gov] /\MERICAi\ pVERSIGHT EXT-18-248-C-000076 Sent: Friday, July 07, 2017 4:26 PM To: Furna, Julia (HHS/OGC) Subject: RE: Hearing with ORR Sarah B. Fabian Senior Litigation Counsel Office of Immigration Litigation - District Court Section (202) 532-4824 -----Original Message----From: Furna, Julia (HHS/OGC) [mailto:Julia.Fuma @hhs.gov] Sent: Friday, July 07, 2017 3:48 PM To: Fabian, Sarah B (CIV) Subject: RE: Hearing with ORR b)(5) -----Original Message----From: Fabian, Sarah B (CIV) [mailto:Sarah.B.Fabian@usdoj.gov] Sent: Friday, July 07, 2017 2:34 PM To: Furna, Julia (HHS/OGC) Subject: Re: Hearing with ORR 1~)(5) Sent from my Verizon, Samsung Galaxy smartphone -------- Original message -------From: "Furna, Julia (HHS/OGC)" Date: 7/7/17 11:32 AM (GMT-08:00) To: "Fabian, Sarah B (CIV)" Subject: RE: Hearing with ORR (b)(5) -----Original Message----Frorn: Fabian, Sarah B (CIV) [rnailto:Sarah.B.Fabian@usdoj.gov] Sent: Friday, July 07, 2017 2:29 PM To: Furna, Julia (HHS/OGC) Subject: Re: Hearing with ORR (b)(5) Sent from my Verizon , Samsung Galaxy smartphone -------- Original message -------- /\MERICAi\ pVERSIGHT EXT-18-248-C-000077 From: "Furna, Julia (HHS/OGC)" Date: 7/7/ 17 l 1:05 AM (GMT-08:00) To: "Fabian, Sarah B (CTV)" Subject: FW: Hearing with ORR From: Biswas, Toby R M (ACF) Sent: Friday, July 07, 2017 2:02 PM To: Julia Mass; Stephanie Gibbs ; wfreeman @aclunc.org Cc: Bena, Anna Marie (HHS/OGC) (ACF) ; Furna, Julia (HHS/OGC); Haron, Judith (HHS/OGC); Suh, Victor (HHS/OGC) (ACF) (CTR); Mestre, Lisette (HHS/OGC); Gregg, Laura (ACF); De LA Cruz, James (ACF) ; Smith, Elicia (ACF) Subject: RE: Hearing with ORR Here are the rest of the documents. Thank you, Toby Toby R. M. Biswas , ESQ. Unaccompanied Alien Children Policy Supervisor U.S. Department of Heal th and Human Services Administration for Children and Families Office of Refugee Resettlement Office of the Director - Division of Policy and Procedures (202) 205-4440 (0) (30 I) I (b)(6) I(C) (202) 401 - 1022 (F) From: Julia Mass [mailto:jmass@ aclun c.org] Sent: Thursday, July 06 , 2017 11:00 PM To: Biswas, Toby R M (ACF); Stephanie Gibbs Cc: Bena , Anna Marie (HHS/OGC) (ACF) ; Furna, Julia (HHS/OGC) ; Haron, Judith (HHS/OGC); Suh, Victor (HHS/OGC) (ACF) (CTR); Mestre , Lisette (HHS/OGC); Gregg, Laura (ACF) ; De LA Cruz, James (ACF); Smith , Elicia (ACF) Subject: RE: Hearing with ORR Dear Toby, Please pass along the attached letter and supporting documents to Mr. Lloyd from Stephanie Gibbs and me. Thank you, Julia Julia Harumi Mass, Senior Staff Attorney American Civil Libert ies Union Foundation of Northern California 39 Drumm Street San Francisco, CA 9411 l tel (415) 621-2493 ext. 339 fax (415)255-8437 www .aclunc.org From: Biswas, Toby RM (ACF) [mailto:To by.Biswas@ACF. hhs.gov] Sent: Thursday , July 06 , 2017 12:34 PM To: Stephanie Gibbs Cc: Julia Mass ; Bena, Anna Marie (HHS/OGC) (ACF); Furna, Julia (HHS/OGC) ; Haron, Judith /\MERICAi\ pVERSIGHT EXT-18-248-C-000078 (HHS /OGC); Suh, Victor (HHS /OGC) (ACF) (CTR); Mestre , Lisette (HHS/OGC); Gregg, Laura (ACF); De LA Cruz, James (ACF); Smith, Elicia (ACF) Subject: RE: Hearing with ORR Stephanie and Julia: Here is the call-in information for tomorrow's call: 5 Call inf~b-)(_ l___ 5 ~IParticipant Access Code j~ (b_)(_l__ ~ A room and telephone will be available at Yolo. Additionally, an interpreter will be available in person for the call. Yolo has been infonned that you will be arriving to speak to your client 30 minutes prior to the call. Thank you, Toby Toby R. M. Biswas, ESQ. Unaccompanied Alien Children Policy Supervisor U.S. Department of Health and Human Services Administration for Children and Families Office of Refugee Resettlement Office of the Director - Division of Policy and Procedures (202) 205-4440 (0) (30 I) I (b)(6) I(C) (202) 401- l 022 (F) From: Stephanie Gibbs [mailt o:sgibbs @safepa ssageproject.org] Sent: Wednesday , July 05, 2017 8:54 PM To: Biswas, Toby R M (ACF) Cc: Julia Mass; Bena, Anna Marie (HHS/OGC) (ACF); Furna, Julia (HHS /OGC); Haron, Judith (HHS /OGC); Suh, Victor (HHS /OGC) (ACF) (CTR); Mestre , Lisette (HHS/OGC); Gregg, Laura (ACF) Subject: Re: Hearing with ORR Toby , Thank you for sending these along. Stephanie On Wed, Jul 5, 2017 at 8:08 PM, Biswas, Toby RM (ACF) > wrote: Julia and Stephanie: Please find attached a case review recommendation from the~ current placement, along with supporting SIRs and OY AS tool. ORR is currently considering the recommendation that the minor remain in Yolo-Secure. We are working on the logistics for Friday's teleconference and will update you as soon as possible. Thank you, Toby Toby R. M. Biswas , ESQ. Unaccompanied Alien Children Policy Supervisor /\MERICAi\ pVERSIGHT EXT-18-248-C-000079 U.S. Department of Health and Human Services Administration for Children and Families Office of Refugee Resettlement Office of the Director - Division of Policy and Procedures (202) 205 -4440 (0) (b)(6) (C) (30 I) (202) 401- l 022 (F) I I From: Julia Mass [mailto:jma ss@ aclunc.org ] Sent: Wednesday, July 05, 2017 6:02 PM To: Biswas, Toby R M (ACF); Stephanie Gibbs Cc: Bena , Anna Marie (HHS/OGC) (ACF); Furna, Julia (HHS/OGC); Haron, Judith (HHS/OGC); Suh, Victor (HHS/OGC) (ACF) (CTR); Mestre, Lisette (HHS/OGC); Gregg, Laura (ACF) Subject: RE: Hearing with ORR I will be out of the office and without access to email for most of the day tomorrow. Please contact me by phone if needed and let us know as soon as possible if you have any more information that ORR will be using in its considera tion of this case. My mobile number is 51O~(b)(6) I Please let me know as soon as you know where~ will be participating in the teleconference so that I can join him there. I would like to meet him 30 minutes J)rior to the meeting with Mr. Lloyd to go over any last minute questions. In addition , please be advised that~ will need an interpreter for this hearing. Thanks, Julia From: Biswas, Toby RM (ACF) [mailto:Toby .Biswas@ ACF.hhs.gov] Sent: Wedne sday , Ju ly 5, 2017 9:58 AM To: Stephanie Gibbs > ; Julia Mass > Cc: Bena , Anna Marie (HHS/OGC) (ACF) > ; Furna, Julia (HHS/OGC) > ; Haron , Judith (HHS/OGC) > ; Mestre, Lisette (HHS/OGC) >; Gregg, Laura (ACF) > Subject: RE: Hearing with ORR Stephanie and Julia : We are scheduling the call for 10am PST/ lpm EST. We will provide call in information soon. Please find attached~ referral and placement documents used to just ify his placement in a secure care provide r . As you are aware~ placement in secure is undergoing review. I anticipate that documents related to the case review will be available later this afternoon. I will forward them as soon as they are available. Please let me know if you have any questions. Thanks, Toby Toby R. M. Biswas, ESQ. /\MERICAi\ pVERSIGHT EXT-18-248-C-000080 Unaccompanied Alien Children Policy Supervisor U.S. Department of Health and Human Services Administration for Childre n and Families Office of Refugee Resettlement Office of the Director - Division of Policy and Procedures (202) 205-4440 (0) (30 I) (b)(6) (C) (202) 401 - 1022 (F) I I From: Stephanie Gibbs [mailto:sgibbs@safepassageproject.org] Sent: Wednesday, July 05, 2017 I 0:05 AM To: Julia Mass Cc: Biswas, Toby R M (ACF); Bena , Anna Marie (HHS/OGC) (ACF); Furna, Julia (HHS/OGC); Haron, Judith (HHS/OGC); Suh, Victor (HHS/OGC) (ACF) (CT R); Mestre, Lisette (HHS/OGC); Gregg , Laura (ACF) Subject: Re: Hearing with ORR Julia , thank you for taking the lead on this. Toby, I am also available on Friday, July 7, 2017 at either 10am PST/l pm EST or 11am PST/2pm EST. I'm looking forward to your confumation on the time and the opportunity to review the evidence in advance of Friday's hearing. Thank you kindly. Best , Stephanie On Mon , Jul 3, 2017 at 7:40 PM, Julia Mass > wrote: Thank you. Also, in order for us to have sufficie nt time to review the evidence ORR used and is using to make its custody determination , plea se share that with us by 10:00 a.m. Pacific /I :00 p.m. Eastern on Wednesday, July 5. If you can't reach me at my office (4 l 5-293-6339 ), plea se call my mobile phon e at 510-385-4214 . Thank s again, Julia From: Biswas, Toby RM (ACF) [mailto :Toby.Bis was@AC F.hhs.gov] Sent: Monday, July 3, 2017 12:52 PM To: Julia Mass >; sgibbs @safepassageproject.org Cc: Bena , Anna Marie (HHS/OGC) (ACF) >; Furna, Julia (HHS/OGC) > ; Haron , Judith (HHS/OGC) >; Mestre, Lisette (HHS/OGC) >; Gregg , Laura (ACF) > Subject: RE: Hearing with ORR Julia: I'm working with the Director's ass istant to schedule . We'll confirm with you on Wednesday of the exact time. I'm working on the logistics with the program office to have your client available as well. I'll be in /\MERICAi\ pVERSIGHT EXT-18-248-C-000081 touch soon. -Toby Toby R. M. Biswas, ESQ. Unaccompanied Alien Children Policy Supervisor U.S. Department of Health and Human Services Administration for Children and Families Office of Refugee Resettlement Office of the Director - Division of Policy and Procedures (202) 205-4440 (0) (30 I) (b)(6) (C) (202) 401- 1022 (F) From: Julia Mass [mailto:jmass@aclunc.org l Sent: Monday, July 03, 2017 3:44 PM To: Biswas, Toby R M (ACF); sgibbs@safepassageproject.org Cc: Bena, Anna Marie (HHS/OGC) (ACF); Furna, Julia (HHS/OGC); Haron, Judith (HHS/OGC); Suh, Victor (HHS/OGC) (ACF) (CTR); Mestre, Lisette (HHS/OGC); Gregg, Laura (ACF) Subject: RE: Hearing with ORR Toby, Please call me Julia. I am available on Friday. Ifwe make it early in the day, I can arrange to be present with our client at the Yolo Facility or other location in northern California. For this reason, I would prefer to have the call at I 0:00 or 11:00 Pacific time. Thank you, Julia Julia Harumi Mass Senior Staff Attorney ACLU Foundation of Northern California 39 Drumm Street San Francisco, California 94111 tel. (4 15) 621-2493 ext 339 fax. (415) 255-8437 pronouns: she/her/hers www .aclunc.org This message and any files or text attached to it are intended only for the recipients named above, and contain information that may be confidential or privileged. If you are not an intended recipient, you must not read, copy, use or disclose this communication . Please also notify the sender by replying to this message , and then delete all copies of it from your system. Thank you. From: Biswas, Toby RM (ACF) [mailto:Toby.Bi swas@ACF.hhs.gov] Sent: Monday, July 3, 2017 12:38 PM To: Julia Mass >; sgibbs @safepassageproject.org Cc: Bena , Anna Marie (HHS/OGC) (ACF) >; Furna, Julia (HHS/OGC) >; Haron, Judith (HHS/OGC) > ; Mestre, Lisette (HHS/OGC) /\MERICAi\ pVERSIGHT EXT-18-248-C-000082 >; Gregg, Laura (ACF) > Subject: Hearing with ORR Ms. Mass and Ms. Gibbs: Are you available for a conference call with the Scott Lloyd the ORR Director , July 7th , 2017 (Friday)? The discussion will cover the information ORR reviews in regards to your client's referral, placement, review of the placement and release assessment, as required by Judge Chhabria. I'm still waiting for that information from the program office and will provide it as soon as it is available. Please let me know if you have any questions. Thanks, Toby Biswas Toby R. M. Biswas, ESQ. Unaccompanied Alien Children Polic y Supervisor U.S. Department of Heal th and Human Services Administration for Children and Families Office of Refugee Resettlement Office of the Director - Division of Policy and Procedures (202) 205-4440 (0) (30 l) (b)(6) (C) (202) 40 l- l 022 (F) This email has been scanned for ema il related threats and delivered safely by Mimecast. Fo r more information please visit http://www.mimecast.com _____________ _ This email has been scanned for email related threats and delivered safely by Mimecast. For more information please visit http: //www.mimccast.com _____________ _ Stephanie E. Gibbs Supervising Attorney, Long Island Safe Passage Project 185 West Broadway New York, NY 10013 T: 2I2-324-6558 (Main Office); 646-657-7715 (Direct) F : 347-368-22 l 3 E: sgibbs@safepassageproject.org www.safepassageproject.org > This email has been scanned for ema il related threats and delivered safely by Mimecast. For more information p lease visit http://www.mimecast.com _____________ /\MERICAi\ pVERSIGHT _ EXT-18-248-C-000083 Stephanie E. Gibbs Supervising Attorney, Long Island Safe Passage Project I 85 West Broadway New York, NY 10013 T: 212-324 -6558 (Main Office); 646 -657-7715 (Direct) F: 347-368-22 13 E: sgibbs@safepassageproject.org www.safepassageproject.org > This email has been scanned for email related threats and delivered safely by Mimecast. For more information p lease visit http://www.mimecast.com _____________ _ Biswas,Toby R M (ACF) "Lloyd, Scott (ACF) "; "Bena, Anna Marie (HHS/OGC)(ACF) "; Recipient: "Gregg, Laura (ACF) "; "White, Jonathan (ACF) " Sent Date: 2017/07/07 17:33:13 Delivered Date: 2017/07/07 17:33:31 /\MERICAi\ pVERSIGHT EXT-18-248-C-000084 White, Jonathan (ACF) "Bartholomew, Michael(ACF) "; To: "Lloyd, Scott (ACF) " CC: "Misegades,Lara (ACF) " Subject: Re: casa PhoenixSMPR1 of 2 Date: 2017/07/13 06:52:35 Priority: Normal Type: Note Thanks, Michael. Will advise if other information is needed. Jonathan White Commander, US Public Health Service Deputy Director for Children's Programs Office of Refugee Resettlement Administration for Children and Families Jonathan. White @acf.hhs.gov (202) 570-8916 On: 12 July 2017 23:36, "Bartholomew, Michael (ACF)" wrote: Hi Scott and Jonathan, This SMR is being prepped for your approval. This SMR is in regards to the following UAC that was reported on last week. 14 yo UAC I (bJ(6J Iadmitted on June 24, 2017 to SKW Phoenix, Phoenix, AZ was reported by herself to be pregnant. Child stated that she was evaluated by a medical provider in home country and was notified of her pregnancy; however she was never evaluated by OB/GYN. Urine pregnancy was positive during the IME. Child reported the pregnancy was a result of consensual sexual relations with her boyfriend in COO. DHUC was informed via standard reporting procedures. The child is being referred to OB/GYN services. The UAC made no statement or allegation of sexual abuse or assault. The portal does not indicate any request related to information regarding pregnancy termination. UPDATE: Further information obtained indicated the child had US at the border and was told the fetus did not have a heartbeat however the UAC did not fully understand this. UAC was seen by OB services on 6/29/2017 her pregnancy was confirmed to be approximately 10 weeks. Additionally, the fetus had growth of an 8 week fetus and did not have a heartbeat. UAC is to follow-up with OB in one week. The UAC was advised that she might undergo miscarriage naturally during the interim period. /\MERICAi\ pVERSIGHT EXT-18-248-C-000085 UPDATE #2: The UAC had a re-evaluation by OB on 7/6. She continues to have no signs or sympto ms of abort ing. The clinician has recom mend ed a D&E to avoid any complication or infection. Per SIR reports, the UACs mother was contacted and advised of the clinical situation of her daughter. "Mother expressed to Clinician that she wants UA C to receive what is medically needed and recommended. " Password:l,___ <_lb_<6 _) _ _. Please let me know if you need any further information. Michael Michael L. Bartho lomew, M.D., FAAP CDR, U.S. Public Health Service Director, Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Admin istration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Build ing 330 C St SW, M S 5123 Washing t on, DC 20201 Phone: 202-401-5375 michael. bartholomew@acf.hhs.gov www .acf.hhs.gov From:I (b)( 6) Sent: Wednesday, July 12, 2017 5:39 PM ~swkey.org] To: ORR DHUC; UMP Medical Cc: Eva Torres Subject: [WARNING : MESSAGEENCRYPTED]Casa Phoenix SMPR 1 of 2 Good afternoon Team: Please review attached form for a needed procedure as re commended by O 8/Gyn Doctor Notes are password encrypted . A separate email will be sent with password . FYI SMRform is not passwordencrypted becauseit was already encryptedby creator of originalform. Thank You, ~---- (-b)-(6_) ___ ~1 RMA Assistant Lead Med ical Coordinator Southwest Key Programs- Casa Phoenix 922 Office: 602.396.7040 ext 3822 /\MERICAi\ pVERSIGHT EXT-18-248-C-000086 Cell: 602.~I_ ~ (b_)(6 _> Fax: 602.532.7525 e-mail: LI _....: (....: b>.:.... (6:.... > _...Jfi? =sw '-'-"-" ke=-y'-'.o =r=q White, Jonathan (ACF) "Bartholomew, Michael (ACF) "; "Lloyd, Scott (ACF) "; "Misegades,Lara (ACF) " Sent Dat e: 2017/07/13 06:52:34 Delivered Date: 2017/07/13 06:52:35 /\MERICAi\ pVERSIGHT EXT-18-248-C-000087 From: Bena, Anna Marie (HHS/OGC)(ACF) To: "ORR Senior Leadership"; "Wynne, Maggie (HHS/IOS) " Subject: Weekly Litigation Update Date: 2017/07/13 13:55:44 Priority: Normal Type: Note I have attached the weekly litigation update. UC litigation. In AH, the ORR Director decided to step down AH to staff-secure care, and DOJ filed the decision with the court. At the status conference on Wednesday , plaintiffs announced that they would amend their complaint and add AP A and constitutional claims. They have until August 11. In Nash, the court issued a scheduling order and granted the federal defendants ' unopposed motion to extend the deadline for completing settlement negotiations by one week. The deadline is now 7/18. In the ACLU case, IT was unable to complete an email search, and ORR staff will likely need to produce their emails to update the discovery for April through June. Refugee litigation. There were no significant updates to refugee litigation this week. Sender: Bena, Anna Marie (HHS/OGC)(ACF) Recipient: "ORR Senior Leadership"; "Wynne, Maggie (HHS/IOS) " Sent Date: 2017/07/13 13:55:41 Delivered Date: 2017/07/13 13:55:44 /\MERICAi\ pVERSIGHT EXT-18-248-C-000088 Biswas,Toby R M (ACF) "Lloyd, Scott (ACF) "; To: "Bena, Anna Marie (HHS/OGC)(ACF) " Subject: RE: Requestsfrom Steve Date: 2017/07/24 13:34:38 Priority: Normal Type: Note Scott: See attached . • • (b)(5) • Let me know if you have any question s. Thanks, Toby Toby R. M. Biswas, ESQ. Unaccompanied Alien Children Policy Supervisor U.S. Department of Health and Human Services Administration for Children and Families Office of Refugee Resettlemen t Office of the Director - Di vision of Po licy and Procedures (202) 205-4440 (0) (301) 1 {b){6) l(C) (202) 401 - 1022 (F) /\MERICAi\ pVERSIGHT EXT-18-248-C-000089 From: Lloyd, Scott (ACF) Sent: Monday, July 24, 2017 1:00 PM To: Biswas, Toby R M (ACF); Bena, Anna Marie ( HHS/OGC) (ACF) Subject: Requests from Steve Importance: High I need a copy of the Flores implementation reg and the PREA reg in whatever shape they are in at this point. Steve asked for drafts . Thank you, Scott Biswas, Toby R M (ACF) Recipient: "Lloyd, Scott (ACF) "; "Bena, Anna Marie (HHS/OGC)(ACF) " Sent Date: 2017/07/24 13:34:36 Delivered Date: 2017/07/24 13:34:38 /\MERICAi\ pVERSIGHT EXT-18-248-C-000090 ACFMedia Clips (ACF) To: "ACF- All ACFStaff " Subject : ACFMedia Clips for July 25, 2017 Date: 2017/07/25 12:33:50 Priority : Normal Type: Note ACF Media Clips for July 25, 2017 - Children, Youth & Families Child welfare ideas from the experts #4: A national foster youth taxonomy (featuring ACF) This taxonomy would also improve the federal understanding of what's happening with foster youth, writes Rodgers. The Adoption and Foster Care Analys is and Reporting System (AFCARS) collects placement and demographic information , and the Nationa l Child Abuse and Neglect Data System monitors the nature of maltreatment reports and substantiation. Analys is Chronicle of Social Change, CA July 25, 2017 Teen pregnancy program abruptly loses millions from feds A spokesperson for the Department of Health and Human Services told VTDigger that a policy statement allows an agency to discontinue a grant "because continued funding would not be in the best interests of the federal government." VT Digger, VT July 24, 2017 Texas had a teen pregnancy crisis - even before Trump started slashing funding Leaders here recognize what a serious problem this is. Teen pregnancy is linked to poverty , and when it is concentrated in certain ZIP codes, it becomes a driver of entrenched neighborhood poverty. Edi torial Dallas Morning News, TX July 24, 2017 New attitudes toward adoption from foster care offer hope Choosing to adopt through the foster care system means accepting that the process, and sometimes the outcome , can be uncertain. Bureaucratic procedures vary from state to state and even county to county, but the practice of concurrent planning , which places children with potentia l adoptive families before the termination of parental rights , is standard . Perspe ctive Washington Post, DC /\MERICAi\ pVERSIGHT EXT-18-248-C-000091 July 24, 2017 In past decade, foster care-adoption gains popularity while private adoption's rep takes hit There are also some noteworthy increase s in which Americans are considering adoption. Trends in education and income demographics suggest a "donut-hole " effect. Analysis Chronicle of Social Change, CA July 24, 2017 Child Support Cruz blasts AG First, allowing the statute of limitations to expire to select a Special Prosecutor to investigate the Governor for his illegal issuance ofretroactive bonus pay to his employees in 2014, second, remaining silent when government officia ls took money from the Child Support Enforcement Fund, and lastly, willfully exploiting her office to benefit her employees and then deceiving the legislature to do so. KUAM, Guam July 24, 2017 Community Services Americans: Getting by, but not getting ahead (featuring ACF) For instance, Prosperity Now notes that in 2017, Congress "gutted" the federa llysupported Assets for Independence anti-poverty program. This little-known, 19-year-old program , administered by the U.S. Department of Health and Human Services, has helped lowand moderate-income fami lies save to buy a home, pay for college or start or expand a busine ss by matching a portion of the money they've put aside. Opinion Next Avenue , MN July 25, 2017 - Family Assistance District does an about-face on welfare reform with decision to keep helping long-term recipients (featuring A CF) Under the city's recently enacted budget for the next fiscal year, not only will long-term welfare clients continue to receive monthly payments, they eventually will get substantial increases in benefits after enduring incrementa l reductions over the past several years . Washington Post, DC July 24, 2017 -Cash assistance cases still above pre-recession levels (featuring ACF) The number of Orego nians receiving federal cash assistance remain s higher than it was at the start of the Great Recession , but state analysts expect the number to shrink to pre-recession levels by early 2019. /\MERICAi\ pVERSIGHT EXT-18-248-C-000092 Portland Tribune, OR July 24, 2017 - Head Start SMILE holds first of three meetings on Head Start (featuring ACF) The first of three SMILE parent meetings this week is underway. SMILE is holding the meetings to talk to parents about the future of its Head Start and Early Head Start schools. Earlier this month, the U.S. Department of Health and Human Services has terminated the SMILE Community Action Agency's Head Start grant. KATC, LA July 24, 2017 - Helping expectant and new mothers can lead to health and education gains for children, new paper says A new paper released Monday identifie s health and educational benefits for children whose mothers participated in a home visitation program that provides medical assistance and early childhood development. The Nurse-Family Partnership program begins in prenatal stages and ends when the child turns 2. The program offers care to disadvantaged, first-time and single mothers. Registered nurses visit the women's homes and assist both with medical need s and early education. Chalkbeat, NY July 24, 2017 - Refugee Resettlement Trump will resettle Australia's refugees next year The Trump Administration will resettle foreign refugees from the Middle East that are currently in detention centers in Australia. Despite previous reports that Trump would cancel the Australian refugee deal, the President is going through with the plan, but the refugees will be admitted in the next Fiscal Year, noted by the Center for Immigration Studies, as the 50,000 cap for Fiscal Year 2017 has already been reached. Breitbart News, CA July 25, 2017 As refu2ee admissions slow, where does LSS sit amid travel bans and court rulin2s? "So I would describe it as almost a roller coaster of changes ," said Shirley Dykshoom , one of several Vice Presidents at Lutheran Social Services of North Dakota. "The uncertainty affects the staff and the funding levels will affect what we're able to do going forward. So we just take it a day at a time because certainly in the last few months there have been lots of changes," explained Shirley Dykshoom. What looms now for the agency is a biennium study approved by the North Dakota legislature wherein the refugee resettlement program and its effects will be looked at. LSS says they have not laid any staff off within the resettlement program at this time. KVLY, ND July 24, 2017 /\MERICAi\ pVERSIGHT EXT-18-248-C-000093 State revolts against feds: No more refugees! Of all the recent state lawsuits filed against the federal government's refugee resettlement program , which annually distributes tens of thou sands of Third World migrants to more than 300 U.S. cities and towns , the one filed by Tennessee might be the most significant. Tennessee attacks the program at its core, challenging the federal government's self-proclaimed right to secretly plant foreign nationals of its own choosing - and the choosing of the United Nations into U.S. cities and towns. Tennessee contends this is a blatant violation of the 10th Amendment and an unconstitutional infringement on state sovereignty. Opinion World Net Daily, DC July 24, 2017 - Trafficking Trafficking, 'monstrous form of modern slavery,' killed immigrants in Texas "It" is a mass murder and it did not begin with a desperate request for water. It began with a broken immigration system that is navigated by heartless people who traffic in human being s, turning tractor-trailers into 21st century equivalents of slave ships. while the human traffickers bear the immediate responsibility for this horrible crime, our nation bears a mediate responsibility as well. Comprehensive immigration reform would not eliminate all smuggling, even the smuggling of human being s. But, it would help. Opinion National Catholic Reporter , MO July 25, 2017 Labor trafficking, exposed in Walmart parking lot, is one of the world's most underreported crimes Three out of every 1,000 people in the world are held in slavery. They are the victims of human trafficking , at once one of the world's most high-profile and under-reported crimes. Over the weekend authorities announced deaths of nine people who were found, along with approximately 30 others , locked in a truck outside of a San Antonio Walmart. According to law enforcement all were victims of a human smuggling ring with suspected links to labor trafficking. These victims are the tip of a very large iceberg. Human trafficking is not a problem for the developing world or a niche issue. It is real and it affects hundreds of thousands of people right here in the United States. Street, NY July 25, 2017 There are thousands of human trafficking victims each year. Here's how you can help. Thousands of people fall victim to human trafficking across the globe each year, and the number of reported cases in the U.S. is on the rise, human right s groups say. The latest trafficking tragedy occurred over the weekend when authorities in Texas found a tractor-trailer at a Walmart parking lot packed with more than two-do zen immigrants. Ten of the passengers have died in what San Antonio Police Chief William McManus called a "horrific" human-trafficking crime. Time, NY July 24, 2017 /\MERICAi\ pVERSIGHT EXT-18-248-C-000094 Unaccompanied Children Feds arrest Memphis immigrants in Sunday 'surge', outraging activists The arrests were part of a "surge" targeting "family units, adults who entered the U.S. as unaccompanied alien children (UAC), and UACs who are at least 16 years old and have criminal histories and/or suspected gang ties," according to a statement released by U.S. Immigration and Customs Enforcement regional spokesman Thomas Byrd. ICE will announce the number of arrests followi ng the surge, Byrd said. He declined to offer more details abo ut the surge or how long it would last. "Attempt ing to unlawfully enter the United States as a family unit or UAC does not protect individuals from being subject to the immigration laws of this country," Byrd stated. Memphis Commercial Appeal, TN July 24, 2017 Spotlight: New York killings undersco re US problem with violent gangs The UAC rule was intended initially to help young children who came over the borde r without their parents . But the majority ofUACs were not small children, but rather 14-15-year-o ld teenagers, some belonging to gangs - such as MS-13 - and some having already committed crimes, even murders, on behalf of the gang, Telford said. Previously, the policy of detainment served as a deterrent to those entering illegally, but during the Obama yea rs, the lenient approach toward UACs prompted a surge in young illegal immigrants in the Un ited States, Telford said. Xinhua News, China July 24, 2 017 This information is provided for internal research purposes and should not be circulated outside of ACF. Each article is copyrighted by the source listed, and the prior written permission of the source is needed for further copying. Sender: Recipient: ACF Media Clips (ACF) "ACF- All ACFStaff " Sent Date: 2017/07/25 12:27:21 Delivered Date: 2017/07/25 12:33:50 /\MERICAi\ pVERSIGHT EXT-18-248-C-000095 From: To: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) " Subject: RE: Draft with comments Date: 2017/07/26 13:12:30 Priority: Normal Type: Note I've added a section on TOP. I left in your earlier comment s, and the new info is in track (bl(5l changes. I think l I (b)(5) From: Lloyd, Scott (ACF) Sent: Thursday, June 01, 20 17 11:19 AM To: Bena, Anna Marie (HHS/O GC) (ACF) Subject: Draft wit h comme nts AnnaMarie, As disc ussed earlier. Scott *** E. Scott Lloyd Director Office of Refugee Rese ttlemen t U.S. D epartment of Health and Human Services (202) 401-7269 (202) !Cb)(6) I (cell) scott. lloyd@acf. hhs. gov Sender: Recipient: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) " Sent Date: 2017/07/26 13:12:30 /\MERICAi\ pVERSIGHT EXT-18-248-C-000096 Biswas,Toby R M (ACF) "Bena, Anna Marie (HHS/OGC)(ACF) "; To: "Lloyd, Scott (ACF) " CC: "Gregg, Laura (ACF) " Subject: Draft Submissionto Court Date: 2017/07/26 22:39:52 Priority: Normal Type: Note (b)(5) Toby R. M. Biswas, ESQ. Unaccompanied Alien Children Policy Supervisor U.S. Department of Health and Human Services Administration for Children and Families Office of Refugee Resettlement Office of the Director - Division of Policy and Procedures (202) 205-4440 (0) (301) 1 (b)(6) l( C) (202) 401-1022 (F) Biswas, Toby R M (ACF) "Bena, Anna Marie (HHS/OGC)(ACF) "; "Lloyd, Scott (ACF) "; "Gregg, Laura (ACF) " Sent Date: 2017/07/26 22:39:51 Delivered Date: 2017/07/26 22:39:52 /\MERICAi\ pVERSIGHT EXT-18-248-C-000097 From: Bena, Anna Marie (HHS/OGC)(ACF) To: "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) " CC: "Gregg, Laura (ACF) " Subject: FW: Bond hearing next week - FW: Time-sensitive! {b){ 6) I Date: 2017/07/27 07:43:25 Priority : Normal Type: Note 1~()5) From: Biswas, Toby RM (ACF) Sent: Wednesday, July 26, 2017 11:34 PM To : Lloyd, Scott (ACF); White, Jonat han (ACF) Cc: Bena, Anna Marie (HHS/OGC) (ACF); Gregg, Laura (ACF) ,--------, Subject: FW : Bond hearing next week - FW: T ime-sensit ive: ~I__ <_Dl_<6_) -~ Just sent forward. Good night. -Toby Toby R. M . Bi swas, ESQ. Unaccompan ied Alien Chi ldren Pol icy Supervisor U.S. Department of Health and Human Servic es Admini stration for Children and Fami lies Office of Refugee Resett lement Offic e of the Director - Division of Policy and Procedures (202) 205-4440 (0 ) (301) 1 (b)( 6) l (C) (202) 401-1022 (F) From: Biswas, Toby R M (ACF) Jul 26 20 17 11:33 PM Sent: Wednesda To: (bJ(6J Cc: caircoalit ion .or ; Haron, Judith (HHS/OGC); Suh, Victor ( HHS/OGC) (ACF) (CTR); Bena, Anna Marie ( HHS/OGC) (ACF) Subject: RE: Bond hearing next week - FW: Time-se nsitive :! {b){ 6) /\MERICAi\ pVERSIGHT EXT-18-248-C-000098 Good evening . Please see attached HHS submission per Judge Bryant's order . We note that this required submission to be outside the scope of the Flores decision but are submitting in compliance with the order. Thank you, Toby Toby R. M. Biswas, ESQ. Unaccompanied Alien Children Policy Supervisor U.S. Department of Health and Human Services Administration for Children and Families Office of Refugee Resettlement Office of the Director - Division of Policy and Procedures (202) 205-4440 (0) (301) 1 (b)(6) l (C) (202) 401-1022 (F) From:~ (bJ(6J @caircoalition.org l Sent: onday, July 24, 2017 5:29 PM To: Biswas Tob R M ACF) Cc: (bJ(6l caircoalition.or ; Haron, Judith (HHS/OGC); Suh, Victor (HHS/OGC) (ACF) (CTR); Mansilla, Jessie (ACF); Fink, David (ACF) Subject: Re: Bond hearing next week - FW: Time-sensitive: Emmanuel (501) Good Afternoon, Thank you for alerting us to the process for requesting the home study, and for emailing a copy of the motion. I rec eived th e physical copy today, but it includ ed severa l blank pages. Please see attached a scanned copy of Respondent's Opposition Motion. I have also mailed a copy, which you should receive tomorrow morning. It is our position that the youth's impending birthday does not justify a delay, or und ermine the nec essity for th e hearing. Best, l I (b)(6) On Fri, Jul 21, 2017 at 1:49 PM, Biswas , Toby RM (ACF) wrote: (b)(6) I: The subject of the home study is the potential sponsor not the UAC . You need the potential sponsor's consent to the home study. This requires a separate Authorization for Release of Records with the potential sponsor as the "subject" of the records per the form. /\MERICAi\ pVERSIGHT EXT-18-248-C-000099 Additionally, HHS is filing a motion for a continuance with the immigration court this afternoon. We have mailed the motion to you ~ see attached). It is our position that the government's interest would better be represented by TIHS ""' ar the youth is aging out the day after the hearing at which point he would be transferred to DHS custody. Thanks, Toby Toby R. M. Biswas, ESQ. Unaccompan ied Alien Chi ldren Pol icy Supervisor U.S. Department of Health and Human Services Adm inistrat ion for Children and Families Office of Refugee Resett lement Office of the Director - Division of Policy and Procedures (202) 205-4440 (0) (301) I (b)(6) I(C) {202) 401 -1022 (F) From: I (bl (6l l@caircoal it ion.org] Sent: Friday, July 21, 2017 11:09 AM To: Biswas, Toby RM (ACF) Cc:I (b)(6l k,alcaircoalitio n.org; Haran, Judith (HHS/OGC); Suh, Victor (HHS/OGC) (ACF) (CTR); Mansilla, Jessie (ACF); Fink, David (ACF); Karine Noncent Shaw Subject: Re: Bond hearing next week - FW: Time-sensitive:! (b)(6J Hello, Thank you for your quick respon se. We did receive the subject child's permission to receive the home study as part of our ORR file request but it appears that the report , along with any significant incident reports, were omitted from the file we received. The immigration judge granted the hearing for July 26th at 4 pm in order to provide ORR appropr iate notice of the child's intent to request a review of his current placement. As you mentioned, this is a new process for us as we ll and we understand that all parties are figuring out the best way to proceed. We made the request because our client wishes to have the opportunity to present his expe rience to the immigration judge even though the hearing is right before his 18th birthday. If you have any additional questions or concerns , please don't hesitate to reach out to me and my colleague Karine Nonce nt cc'ed here, she will be handling the hearing on Wednesday. Thanks, I (b)(6) /\MERICAi\ pVERSIGHT EXT-18-248-C-000100 On Fri, Jul 21, 2017 at 7:31 AM, Biswas , Toby RM (ACF) wrote: I (b)(6) I (b)(6) I l's out office listed you as her point of contact. See below. Thanks, Toby Toby R. M. Biswas, ESQ. Unaccompanied Alien Chi ldren Policy Supervisor U.S. Department of Health and Human Services Administration for Children and Families Office of Refugee Resett lement Office of the Director - Division of Policy and Procedures (202) 205-4440 (0) (301) I (b)( G) I(C) (202) 40 1-1022 (F) From: Biswas, Toby RM (ACF) Sent: Th ursday, July 20, 20 17 9:56 PM To :I (bl(6l @caircoalition.org ' Cc: Haron, Judit h ( HHS/OGC); Suh, Victor (HHS/OGC) (ACF) (CTR); Mansilla, Jessie (ACF); Fink, David (ACF) Subject: FW : Bond hearing next week - FW: T ime-sensitive ~ (bl( 6l (b)(6) Good evening. I received your email below from Jessie. As you noted this is a new process for all parties involved so thank you for your patience. At this time Judith (Judy) Haron and I will be representing HHS in this matter. We are trying to determine the appropriateness of a bond hearing involving HHS as a par1y when the youth will age out of HHS custody the day after the planned hearing. As for the question about the Home Study report, did you receive the subject of the home study's permission for the home study when you submitted your Authorization for Release of Records? Thanks, Toby Toby R. M. Biswas, ESQ. Unaccompanied Alien Children Policy Supervisor U.S. Department of Health and Human Services Administration for Children and Families Office of Refugee Resettlement Office of the Director - Division of Pol icy and Procedures (202) 205-4440 (0) /\MERICAi\ pVERSIGHT EXT-18-248-C-000101 (301) I (b)( 6) I(C) {202) 401-10 22 (F) From:I (bJ(6J @caircoalition.org1 Sent: Thursday, July 20, 2017 3:51 PM ~~j MansiHaJessie/ACF; Subject: Time-sensitive:_ '' "" (b)(6J Dear Jessie, Iredetermination hearin lwho is presently at Shenandoah, is scheduled for a Flores custody on 07/ 26 / 17 at 4pm. At the hearing,! Ientered 5 (bl( l (bH6l appearance o (bl( 6l s behalf and was told by DHS that ORR will be appearing on the 26th, and not ICE. As this type of hearing is very new, we are following up with two questions and a logistical request. Could you please advise who in ORR will be the point of contact for the hearing? We'd like to coordinate with that person to ensure that the hearing (which is at the end of the day on the 26th) is an efficient and child-friendly forum. Judge Bryant and DHS were unaware who would appear on ORR's behalf. l's whole file, including his Additionally, we made an ORR file request for I (bl( 5l Home Study. Unfortunately, the files we received in reply did not include the Home Study Re ort. I attached our request and response.) Could you please share it with my colleague (bJ(6l CC'd? Last, we'd like to request that I (bl( 6l !appear in person to his hearing on the 26th. The hearing is scheduled as an individual hearing, and could last up to two hours . As customary with these individual hearings, we ask that I (bl( 6l Jappear in his own clothes, and without soft or hard restraints. Thank you, I ~ (b)(6) Staff Attorney Detained Children's Program Capital Area Immigrant s' Rights (CAIR) Coalition 1612 K St NW, Suite 204, Washington, DC 20006 Dire ct: (2 0 2) 899-8614 Fax: (202) 33 1-3341 Pronouns: She/Her/Hers (b)(6) /\MERICAi\ pVERSIGHT EXT-18-248-C-000102 Program Director Detained Children's Program Capital Area Immigrants' Rights (CAIR) Coalition 1612 K Street, N.W., Suite 204 Washington, D.C. 20006 Tel: 202-331-3320 extension 7016 Direct Dial: 202-899-8621 Visit our website at www.caircoalition.org . Follow us on Facebook , Linkedin , and Twitter . Catalogue for Philanthropy "One of the Best" I I (b)(6) Senior Attorney, Detain ed Children's Program Capital Area Imm igrants' Rights (CAIR) Coalition 1612 K Street, N.W., Suite 204 Washington, D.C. 20006 Direct Dial: (202) 899-1424 Tel: (202) 331-3320 Fax: (202) 331-3341 I (b)(6) r@caircoalition.org CAPITAL AREA IMMIGRANTS' RIGHTS COALITION Visit our website at www.caircoalition.org . Follow us on Facebook, Linkedln, and Twitter . Sender: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; "Gregg, Laura (ACF) " Sent Date: 2017/07/27 07:43:24 Delivered Date: 2017/07/27 07:43:25 /\MERICAi\ pVERSIGHT EXT-18-248-C-000103 Kurkjy, Brian (ACF) (CTR) To: "Lloyd, Scott (ACF) " CC: "Bena, Anna Marie (HHS/OGC)(ACF) " Subject: Clearance1 of 2: Sustainable Health Agenda for the Americas (2018-2030). Date: 2017/08/1110 :27:35 Priority: Normal Type: Note Hi Scott, This is the first of the two clearances that I just mentioned, Exec Sec would like our response by noon. Policy had no comment. Do you have any comments on the attached docuemnts? Best, Brian Brian Kurkjy Special Assistant to the Deputy Director for Children's Programs Office of Refugee Resettlement U.S. Department of Health & Human Services Office: (202) 260-1249 brian.kurkjy @acf.hhs.gov Kurkjy, Brian (ACF) (CTR) "Lloyd, Scott (ACF) "; Recipient: "Bena, Anna Marie (HHS/OGC)(ACF) " Sent Date: 2017/08/11 10:27:30 Delivered Date: 2017/08/1110:27:35 /\MERICAi\ pVERSIGHT EXT-18-248-C-000104 ACFMedia Clips (ACF) To: "ACF- All ACFStaff " Subject : ACFMedia Clips for Aug 15, 2017 Date: 2017/08/15 12:00:28 Priority : Normal Type: Note ACF Media Clips for Aug 15, 2017 - Children, Youth & Families Coming into Focus: States can and must ensure school stability for youth in foster care One of the most exciting recent developments in the field came in December 2015 , when Congres s passed the Every Student Succeeds Act ("ESSA"), which includes provisions about child welfare and education agencies' responsibility to ensure and prioritize school stability for all children and youth in foster care. Opinion Chronicle of Social Change, CA Aug. 15, 2017 Number of Montana kids in foster care sets record, homes for less than one in three In 2015, the number of children in Montana ' s foster care system had spiked to an all-time high, but new number released last week show things are even worse today. KGVO,MT Aug. 14, 2017 Some Louisiana foster parents could present danger to kids An audit of the state's foster care program unveiled some surprising shortcomings . Karen Leblanc with the legislative auditor's office says they found not all foster care providers had the required criminal background checks. They either had no check, or they were not completed in a timely manner. WWL,LA Aug. 14, 2017 Foster child says she reported abuse of grace packer years before her murder The woman who spoke to NBClO Monday is the third person who claimed they witnessed Grace Packer being abused and reported it to the Impact Project , a foster care agency . WCAU, PA Aug. 14, 2017 Supply of foster homes doesn't meet demand for Sacramento youth /\MERICAi\ pVERSIGHT EXT-18-248-C-000105 The stakes are high. Among children who 'age out' of foster care, by age 22, more than 65 percent of young women are pregnant or have had a child; more than half are homeless, imprisoned or dead; and more than half haven't completed high school, Heme said. Opinion KXTV, CA Aug. 14, 2017 Stop putting PC ideology before the needs of foster kids It's surely true that not everyone is fit to take in a child who has been abused, neglected or abandoned. Yet instead of focusing on real issues of child safety, they're pushing their own social agenda. Opinion New York Post, NY Aug. 14, 2017 Abstinence-only sexed gets an amen from Trump, N.J. congressman In New Jersey, teen births declined about 37 percent from 2011 to 2015. The downward trend is not because teens are having less sex, studies show; it's because they are using more contraceptives. Which is a goal of these programs: to teach not just about abstinence , but also safe sex and sexually-transmitted diseases. Editorial Newark Star-L edg er, NJ Aug. 14, 2017 Data will help DSS guide families According to N.C. Department of Health and Human Services, the system being developed will keep foster and other vulnerable children safer by centralizing information in a statewide repository, reducing paperwork and streamlining the flow of information between county social services departments. Richmond County Daily Journal, NC Aug. 14, 2017 Democrats blast President Donald Trump for defunding Planned Parenthood sex-ed programs The Trump administration is scaling back funding for a sex education program that started in 2010 under President Obama. The 81 Teen Pregnancy Prevention grantees were supposed to receive $200 million through 2020, but were informed by the Department of Health and Human Services last month that the money would dry up in June 2018. Opinion Life News, NY Aug. 14, 2017 Why are there more maternal deaths in the U.S. than in other advanced nation? Prospects are grim for improving health outcomes for pregnant women and those in childbirth because of the Trump administration's $213 million in cuts for teen pregnancy programs , combined with efforts to defund Planned Parenthood, where more low-income women receive contraceptive and prenatal care than abortions. /\MERICAi\ pVERSIGHT EXT-18-248-C-000106 Editorial St. Louis Dispatch, MO Aug. 13, 2017 Child Support Onslow child support takes proactive approach The name outside the building of the child support office serving Onslow County says a lot about the work that goes on inside. The word enforcement is no longer part of the agency title, Child Support Services of No11h Carolina. Enforcement of child support orders is only part of what they do and Onslow County Project Manager Tammy Pearson wants community members to know their doors are open to anyone who needs assistance with a child support issue. Jacksonville Daily News , NC Aug.15, 2017 Butler County child support offering amnesty program In honor of Child Support Awareness Month, which is in August , the CSEA is offering parents an opportunity to get their driver's licenses back by paying one month of support instead of the normal requirement of three months. Hamilton Journal-News, OH Aug.I 5, 2017 Onslow Child Support Services helping send kids back to school August is National Child Support Awareness Month and as part of their outreach efforts the office's staff has taken on a project to help local children get ready for their return to school. A table full of school supplies and backpacks sits at the entrance of the room where case specialists work; all the items collected and ready to be distributed as part of the Backpacks to School project. Jacksonville Daily News, NC Aug.I 5, 2017 New child support guidelines effective September 15, 2017 New child support guidelines have been issued by Chief Justice Paula Carey , which go into effect on September 15, 2017. The new guidelines apply to all child support orders issued after that date. JD Supra, CA Aug.14, 2017 AG Hood recognizes Child Support Awareness Month The goal of the month is to focus on informing families on the services dedicated to helping children receive support from both parents. Government agencies and non-profits from all over the United States are participating in the national month of recognition. WJTV, MS Aug.14, 2017 /\MERICAi\ pVERSIGHT EXT-18-248-C-000107 Community Services More than 200 attend conference to learn about issues facing seniors {featuring ACF) Casey said the current proposed federal budget call for cuts to key programs and elimination of others, such as Meals on Wheels, Community Development Block Grants , and LIHEAP - the Low-Income Home Energy Assistance Program. Wilkes-Barre Times-Leader, PA Aug. 14, 2017 - Family Assistance Perdue cites data on immigrant households benefiting from social welfare programs (featuring A CF) Using data from the Census Bureau's Survey oflncome and Program Participation, the study found that in 2012, 51 percent of immigrant-headed households (living here legally or illegally) reported having used at least one welfare program during the year, compared with 30 percent of native-born households. The study factored in the following programs: Supplemental Security Income (SSI); Temporary Assistance for Needy Families (T ANF); Women, Infants, and Children food program (WIC); free or subsidized school lunches; Supplemental Nutrition Assistance Program (SNAP, previously known as the Food Stamp program); Medicaid, and public housing and rent subsidies. Opinion Politifact, DC Aug. 14, 2017 - Head Start NASD receives state funding for Head Start, pre-k programs (featuring ACF) Northampton Area School District has received approval and funding for a Head Start and two pre-kindergarten programs. District Superintendent Joseph Kovalchik informed the school board at Monday evening's meeting the Head Start and two pre-kindergarten programs will cost the district nothing. WFMZ,PA Aug. 15, 2015 -More funding needed to expand Head Start program (featuring ACF) If local and national elected officials truly cared about the quality of public education, they would work to find the money and other resources needed to expand the Head Start Program. Opinion Pacific Daily News, Guam Aug. 14, 2017 - Refugee Resettlement Within 7 years, refugees are self-sufficient and contributing to the US , on average How well do refugees integrate into local U.S. communities? Are they an economic burden or boon? We examined these questions for refugee s resettled in the city of Philadelphia between /\MERICAi\ pVERSIGHT EXT-18-248-C-000108 2000 and 2015. Our findings suggest that within a handful of years after arriving, quite a few refugees are doing as well as or perhaps better than the average Philadelphian, according to basic economic indicators. Within seven years, refugees reach a higher median income and lower use of food stamps than their neighbors. They develop language competency fairly quickly, and remain active in the workforce, buoying the local economy. Analysis Washington Post, DC Aug. 15, 2017 Trafficking Sex traffickers use social media to trick aspiring models, experts say An estimated 20.9 million people are currently "trapped in jobs into which they were coerced or deceived and which they cannot leave," according to the International Labor Organization's Global Estimate of Forced Labor. And, sadly, predators of young women are finding it easier than ever to capture their prey, thanks to social media apps like Ins ta gram that models use to promote their careers. Fox News, NY Aug. 15, 2017 Training doctors, nurses to identify human trafficking victims The Attorney General's Office says many human trafficking victims interact with doctors and nurses while they're being trafficked , so they got Wayne State University's School of Medicine and the Wayne County Medical Society on board to create the training video. It's intended to explain the crime, teach them how to approach a potential victim and get the victim help. The 3rd District created a Human Trafficking Task Force a little over six to eight months ago. Since then, they've been working to train employees at the hospitals in Genesee and Shiawasee counties. WJRT, MI Aug. 14, 2017 - Is your teen at risk for human trafficking? The Modesto Police Department advises families to be alert to a different kind of "traffic" risk: human trafficking. The department joined with the Modesto-based nonprofit organization Without Permission to produce a video that notes a rise in high school-age victims and provides parents with "tools and advice" to protect their children. Modesto Bee, CA Aug. 14, 2017 - Unaccompanied Alien Children How Central American youth test outdated US immi2ration laws Pence knows that Central American children have been fleeing to the United States. But he should also recognize the staggering scale of this wave, and what's behind it. Understanding both is key to creating policy that can prevent surges like this in the future. First, it's important to grasp the scale of this movement of people. From 2011 through the end of last year, 178,825 /\MERICAi\ pVERSIGHT EXT-18-248-C-000109 minors from El Salvador, Honduras, and Guatemala were apprehended by the U.S. border patrol while traveling without adult relatives and without a visa. Opinion Americas Quarterly, NY Aug. 15, 2017 The Trump administration is detaining immigrant kids for gang membership without evidence. So we sued. (featuring ACF) 6 ) Ione of the children involved in our class action suit, an ORR In testimony in the case of l "ACF - All ACF Staff " Sent Date: 2017/08/15 11:57:36 Delivered Date: 2017/08/15 12:00:28 /\MERICAi\ pVERSIGHT EXT-18-248-C-000110 From: Bena, Anna Marie (HHS/OGC)(ACF) To: "ORRSenior Leadership "; "Wynne, Maggie (HHS/IOS) " Subject: ORRWeekly Litigation Update Date: 2017/08/18 12:30:28 Priority: Normal Type: Note I have attached the weekly litigation update. We have added bond hearings to this weekly update. UAC litigation. In Gomez v Sessions ("AH" habeas case), the plaintiff filed an amended complaint and ORR received plaintiffs' requests for production of documents. In Flores (bond hearings), government defendants filed a motion to extend the deadline for petitioning for rehearing en bane until 9/20/17 (current deadline is 8/21 ). Refugee litigation. In Indiana, plaintiff Exodus Refugee Immigration, Inc. filed an unoppo sed motion for extension of time, until 8/31/17, to file for summary judgment. In Oregon, the court granted defendants' unopposed motion for extension of time to file a response to plaintiffs Motion to Dismiss (reply due 9/ 12/ 17). UAC Bond hearings. There are 21 outstanding requests from UACs to file bond hearings (see last table in tracker). This week, there were: 6 bond hearings: 4 requests were withdrawn in court; 1 request was transferred to another jurisdiction for later scheduling; and for 1 request, ORR submitted a letter stating it did not consider the UAC to be a danger. 2 family reunifications, which removed the need for bond hearings. 2 cases in which UACs requesting hearings were ordered removed. Sender: Bena, Anna Marie (HHS/OGC)(ACF) "ORRSenior Leadership"; Recipient: "Wynne, Maggie (HHS/IOS) " Sent Date: 2017/08/18 12:30:24 Delivered Date: 2017/08/18 12:30:28 /\MERICAi\ pVERSIGHT EXT-18-248-C-000111 From: Bena, Anna Marie (HHS/OGC)(ACF) To: "ORR Senior Leadership "; "Wynne, Maggie (HHS/IOS) " Subject: ORRLitigation Update Date: 2017/08/3113 :42:38 Priority: Normal Type: Note I have attached this week's litigation update (including bond hearings). UAC litigation. In Gomez (AH habeas case), there was a case management conference , with a status report due by today, 8/31. In Flores (bond hearings) , the 9th Circuit assigned a case number and briefing schedule as to a petition for en bane rehearing (petition to be filed by 9/20/17). In "Nash" (FOIA litigation related to the Juvenile Referral Program; aka "footguides") , ORR filed a letter requesting rolling production of remaining documents after 10/2/17 deadline; ACLU consented to extension of original deadline of 9/ 1 to 10/2, but opposes any additional extension. Refugee litigation. In Indiana, the plaintiff Exodus Refugee Immigration , Inc. filed a Motion for Summary Judgment on 8/24. In Tenness ee, on 8/28 the State filed a Reply related to Federal defendants ' Motion to Dismiss. UAC bond hearin gs. There were no bond hearings this week. As of today there are 18 outstanding bond hearing requests. Of these: • 1 telephonic hearing was scheduled for 9/1 in Phoenix, but the minor is being reunified today (8/31 ), so the hearing will be cancelled • 3 hearings are scheduled for next week (2 in Arlington , VA; 1 in Houston , TX-though with the flooding the status of this case is uncertain) • • 1 hearing is scheduled in San Francisco, CA for 9/18 6 motions were mailed to the New York immigration court last week. We are following up with the court there regarding scheduling. Sender: Bena, Anna Marie (HHS/OGC)(ACF) Recipient: "ORR Senior Leadership "; "Wynne, Maggie (HHS/IOS) " Sent Date : 2017/08/3113 :42:34 /\MERICAi\ pVERSIGHT EXT-18-248-C-000112 Delivered 13:42:33 EXT-1 8-248-C-0001 13 Hooban, Christopher (ACF) "Garza, Roberto (ACF) "; "App legate, Allen (ACF) "; "Barlow, Amanda (ACF) "; "Dugan, Meghan R. (ACF) "; "Duran, Mishaela (ACF) "; "Gnipp, Gregg (ACF) "; "Goldhabe r, Ben (ACF) "; "White, Laura (ACF) "; "Hooban, Tala (ACF) "; "Jones, Robin (ACF) "; "Kurkjy, Brian (ACF) (CTR) "; "Marriott, Brian (ACF) "; "Lloyd, Scott (ACF) "; "Monroe, Johnathan (ACF) "; "Moreno, Pedro (ACF) "; "Pilato, Anna (ACF) "; "Powers, Mary (ACF) "; "Russell, Elizabeth (ACF) "; "Ball, Harvey (ACF) "; "Simmons, Joann (ACF) "; "Tota, Kenneth (ACF) "; "Vineyard, Michael (OS/ASPR/OEM) "; "Wagner, Steven (ACF) "; "Wallace, Monte (ACF) "; "Wh ite, Jonathan (ACF) "; "Thomas, Joyce (ACF) "; "Hatch, Nikki (ACF) "; "Karpovich, Glen (ACF) "; "Everson, Ms. Suzanne (ACF) "; /\MERICAi\ pVERSIGHT EXT-18-248-C-000114 "McCormack, Tiffany (ACF) "; "Brown, Charles (ACF) " ; "Samp le, Allen (PSC/OD) "; "Wh ite, Laura (ACF) "; "Wolfe, Kenneth (ACF) "; "Dav is, Gregory (ACF) "; "Negr i, Warren A. (ACF) "; "Goldstein, Naomi (ACF) " CC: Subject: "ACF hswatchofficer " RE: Upcoming Emergency Repatriat ion br iefing on Thursday 9/7 from 11am to 12pm in Switzer Rm 4323/4401 Date: 20 17/09/05 12: 10:32 Priority: Normal Type: Note All, Good morning. Please find attached the read-ahead materials (which some of you already have received hard cop ies of) for the 7 SEPT. The attached documents include : Tabletop Exercise Overview ACF Repatriation Program Fact Sheet After Even Analysis Haiti ACF Repatriation Internal Guide ACF NERP Base Plan (DRAFT) ACF NERP Operational Guide Interna l Procedural Manua l (Interna l Financial Management Guide) ACF/ASPR MOU List of PO Es Sample DOS Notification /\MERICAi\ pVERSIGHT EXT-18-248-C-000115 Notice to Activate State Plan The participant list is also included. In it you will find what your identified role is for the exercise on 14 SEPT. Thank you for your time. Chris Hooban , MS, MPH Preparedne ss & Community Resilience Coordinator Office of Human Service s Emergency Preparedne ss and Response (OHS EPR) Administration for Children and Families (ACF) U.S. Department of Health and Human Service s ov From: Garza, Roberto (ACF) Sent: Tuesday, September 05, 2017 11:17 AM To: Applegate, Allen (ACF); Barlow, Amanda (ACF); gregg.davis@acf.hhs.gov; Dugan, Meghan R. (ACF); Duran, Mishaela (ACF); Garza, Roberto (ACF); Gnipp, Gregg (ACF); Goldhaber, Ben (ACF); Naomi.Goldstien@acf.hhs.gov; White, Laura (ACF); Hooban, Christopher (ACF); Hooban, Tala (ACF); Jones, Robin (ACF); Kurkjy, Brian (ACF) (CTR); Lloyd.Scott@acf.hhs.gov; Marriott, Brian (ACF); Monroe, Johnathan (ACF); Moreno, Pedro (ACF); negri.warren@acf.hhs.gov; Pilato, Anna (ACF); Powers, Mary (ACF); Russell, Elizabeth (ACF); Ball, Harvey (ACF); Simmons, Joann (ACF); Tota, Kenneth (ACF); Vineyard, Michael (OS/ASPR/OEM); Wagner, Steven (ACF); Wallace, Monte (ACF); White, Jonathan (ACF); Thomas, Joyce (ACF); Hatch, Nikki (ACF); Karpovich, Glen (ACF); Everson, Ms. Suzanne (ACF); McCormack, Tiffany (ACF); Brown, Charles (ACF); Sample, Allen (PSC/OD); White, Laura (ACF); Wolfe, Kenneth (ACF); Hooban, Christopher (ACF) Cc: Garza, Roberto (ACF); ACF hswatchoffice r Subject: Upcoming Emergency Repatriation briefing on Thursday 9/7 from 11am to 12pm in Switzer Rm 4323/4401 Dear Colleague s: As you know, OHS EPR and ORR will co-host an Emergency Repatriation briefing later this week on Thursday September 7th from 11am to 12 pm EST in Switzer Building, Room 4323/4401 , or via bridgeline for our Regional participants. /\MERICAi\ pVERSIGHT EXT-18-248-C-000116 This briefing will include essential information that you will need to participate in next week's Tabletop Exercise on Thursday September 14th from 2-4pm EST in Humphrey Building Rm 505A. Everyone is undoubtedly very busy with both end-of-Fiscal Year activities and ongoing Hurricane Harvey response and recovery efforts, but it is also vital that we review ACF's Emergency Repatriation responsibilities through this upcoming briefing and through the subsequent Tabletop Exercise. I look forward to having you join ACF's Senior Leadership in this activity. If you have any questions, please let me know. Respectfully , R Roberto C. Garza, MPH, MPA LCDR, USPHS Commissioned Corps Acting Director Office of Human Services Emergency Preparedness and Response (OHSEPR) Administration for Children and Families (ACF) U.S. Department of Health and Human Services Office (202) 401-9313 Mobile (301) 1 (b)(6) Roberto.Garza@acf.hhs.gov I From: Garza, Roberto (ACF) Sent: Thursday, July 20, 2017 1:57 PM To: Subject: More information on the upcoming EmergencyRepatriationTabletop exercise Dear Colleagues: Two days ago, you received two calendar invites from ORR Director Scott Lloyd to participate in an Emergency Repatriation Tabletop Exercise. The genesis of this activity is a request by Acting Assistant Secretary Steve Wagner, who asked that OHSEPR conduct an exercise in close collaboration with ORR. ORR administers the Repatriation Program, and although a 2016 Memorandum of Understanding with the Assistant Secretary for Preparedness and Response (ASPR) reassigned operational coordination for Emergency Repatriation to ASPR, ACF still has significant responsibilities in an Emergency Repatriation event. The overall goal of this exercise will be for ACF Senior Leadership to carefully review and, through an exercise that simulates a real life event, understand the key decisions and issues that we would encounter during a mass Emergency Repatriation event declared by the State Department. /\MERICAi\ pVERSIGHT EXT-18-248-C-000117 The first invite is for a one hour briefing on Thursday, September 7th from 11am to 12pm. During this briefing , exercise participants will be provided a background on Emergency Repatriation and ACF's responsibilities in an Emergency Repatriation event, as well as providing information you will need to participate in the exercise itself. The second invite is for a two hour Tabletop exercise on Thursday, September 14th from 2-4pm. During the exercise, the design team will present the participants with the Emergency Repatriation scenario, and then lead an active dialogue as the group moves through the simulation, working together to resolve issues and make key decisions. Throughout the exercise, the design team will include observer /evaluators and note takers who will capture lessons learned and areas for further consideration. Background information and read-aheads will be provided in the coming days. The exercise will be prepared by a trained exercise design team from OHSEPR and ORR. Your participation is very important to the success of ACF's efforts to be prepared for future Emergency Repatriation events. Because repatriations are infrequent events that happen on short notice, but are critical to the safety and well-being of American citizens and their dependents abroad, it is our goal that ACF's learning experience happen in this exercise, rather than in a real-world event. Please save these times on your schedule. If you have any questions, please don't hesitate in letting me know. I would be more than happy to meet with you to discuss this important event further. Best regards , Roberto Roberto C. Garza, MPH, MPA LCDR, USPHS Commissioned Corps Acting Director Office of Human Services Emergency Preparedness and Response (OHSEPR) Administration for Children and Families (ACF) U.S. Department of Health and Human Services Office (202) 401-9313 (b)(6) Mobile (30 I Roberto.Garza(dlacf.hhs.gov )j I Hooban, Christopher (ACF) "Garza, Roberto (ACF) "; "Applegate, Allen (ACF) "; Recipient: "Barlow, Amanda (ACF) "; "Dugan, Meghan R. (ACF) "; "Duran, Mishaela (ACF) "; "Gnipp, Gregg (ACF) "; "Goldhaber, Ben (ACF) "; "White, Laura (ACF) "; "Hooban, Tala (ACF) "; "Jones, Robin (ACF) "; "Kurkjy, Brian (ACF)(CTR) "; "Marriott, Brian (ACF) "; "Lloyd, Scott (ACF) "; "Monroe, Johnathan (ACF) "; "Moreno, Pedro (ACF) "; "Pilato, Anna (ACF) "; "Powers, Mary (ACF) "; "Russell, Elizabeth (ACF) "; "Ball, Harvey (ACF) "; "Simmons, Joann (ACF) "; "Tota, Kenneth (ACF) "; "Vineyard, Michael (OS/ASPR/OEM)"; "Wagner, Steven (ACF) "; "Wallace, Monte (ACF) "; "White, Jonathan (ACF) "; "Thomas, Joyce (ACF) "; "Hatch, Nikki (ACF) "; "Karpovich, Glen (ACF) "; "Everson, Ms. Suzanne(ACF) "; "McCormack,Tiffany (ACF) "; "Brown, Charles(ACF) "; "Sample, Allen (PSC/O0) "; "White, Laura (ACF) "; "Wolfe, Kenneth (ACF) "; /\MERICAi\ pVERSIGHT EXT-18-248-C-000119 "Davis, Gregory (ACF) "; "Negri, Warren A. (ACF) "; "Goldstein, Naomi (ACF) "; "ACF hswatchofficer " Sent Date: 2017/09/05 12:10:20 De liver ed Date: 2017/09/05 12:10:32 Message Flags: Unread /\MERICAi\ pVERSIGHT EXT-18-248-C-000120 Maycock, Brett (OS/OSSI) "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; To: "Johnson, James (OS/ASA/OSSI)"; "Brucklier, April (HHS/OSSI) " CC: "Schmoyer, Michael (OS/OSSI) " Subject: FW: UACStatistics Update Date: 2017/09/05 13:39:46 Priority: Normal Type: Note FYSA ensu ring you all saw this. V/r Br ett CDR Brett Maycock, USPHS Acting, Associate Deputy Assistant Secretary Office of Security and Strategic Information U.S. Department of Health and Human Services (0) 202 -260 -7509 I (C) 202~ (b)( 6) (S) 936-2131 I/ Unclassified E-Mail: Brett.Maycock @hhs.gov SIPR/HSDN: Brett.M.Maycock@dhs.sgov.gov JWICS: MaycockB@csp.ic.gov From: Koren, Elizabeth [mailto:Elizabeth.Koren@fema.dhs.gov] Sent: Tuesday, September OS, 2017 1:31 PM To: Lapinski, Michael; Chisolm, Daymone; Martinez, Terry; White, Eric; Agnew Jr, Theodore; Jackson, Daphine; Blaz, Christopher; Wilson, Ian; Soucie, Eric Cc: Macintyre, Anthony (OHS.GOV); Maycock, Brett (OS/OSSI); Vineyard, Michael (OS/ASPR/OEM); TWYFORD, DONNA L; McIntosh, Paul; Pack, Eddie; Harris, Ulister; Nicorvo, Richard H; Parker, Robert; Toomey, Lauren (05/ASPR/OEM); Davis, Gregory (ACF); Raines, Russ C CAPT USN OSD OUSD POLICY (US); Ignazzitto, Joseph V (Joe) II COL USARMY OSD OUSD POLICY (US); gerald.d.wrightl.ctr@mail.mil; Wright, Gerald D (OGA); Salazar, Roberto R; Russell, Maureen (CTR); Roessner, Acadia Subject: UAC Statistics Update Good afternoon, /\MERICAi\ pVERSIGHT EXT-18-248-C-000121 Many of you remain activated in suppo rt of Harvey /Irma; howeve r, I've been gett ing daily quest ions about UAC trends and analysis. For everyone's situational awareness, I've updated the UAC Statistics (attached). Based on today's ACF report, they are at 70% capacity. Note also that although the August referra ls were up 21 % over previous month, discharges kept pace (up 20% over past month). I'm also pleased to attach the final updated UCG Plan for your records. Please let me know if you have suggestions for additional analysis. V/r, Elizabeth Koren Elizabe th J. Koren, Esq. Future Planner , Response Directorate Federal Eme rgency Management Agency U.S. Department of Homeland Security 202~iPhone 619~ additional cell Elizabeth .Koren@fema.dhs.gov This communication, along with any attachments, is covered by Federal and state law governing law governing electronic communications and may contain confidential and legally privileged information . If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution, use, or copying of this message is strictly prohibited. If you have received this in error, please reply immediately to the sender and delete this message. /\MERICAi\ pVERSIGHT EXT-18-248-C-000122 Maycock, Brett (05/0551) "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; "Johnson, James (O5/ASNOSSI) "; "Brucklier, April (HHS/O55I) "; "Schmoyer, Michael (OS/O551)" Sent Date : 2017/09/05 13:39:42 Delivered Date: 2017/09/05 13:39:46 /\MERICAi\ pVERSIGHT EXT-18-248-C-000123 White, Laura (ACF) To: "Bena, Anna Marie (HHS/OGC)(ACF) " CC: "Lloyd, Scott (ACF) " FW: SWI FT: 081120172004- The attached draft ACFresponseto the OIG Memorandum Subject: a€c:eSafetyIncidents Related to Unaccompanied Children under the Care of the Office of Refugee Resettlementand its Granteesa€is ready for Steve Wagner's review and approval. Date: 2017/09/06 09:29:38 Priority : Normal Type: Note HiAMB, Based on your comments that nothing substantive changed in the attached document that Scott has already reviewed and cleared , he does not need to review the changes. He approved for us to send this forward to OLAB. Thanks, Laura From: Bena, Anna Marie {HHS/OGC) (ACF) Sent: Monday, August 28, 2017 1:26 PM To : Whit e, Laura (ACF) Cc: Biswas, Toby R M (ACF) Subject: FW : SWIFT: 081120172004 - The attached draft ACF response to t he OIG Memorandum a€reSafety Incidents Related to Unaccompanied Children under the Care of the Office of Refugee Resettlement and its Granteesa€ □ is ready for Steve Wagner's review and approval. Laura, This is the OIG 5 questions. Do you know how we get it back through clearance? Thanks! AM From: Biswas, Toby R M (ACF) Sent: Monday, August 28, 2017 12:02 PM To : Bena, Anna Marie ( HHS/OGC) (ACF) Subject: FW: SWI FT: 081120172004 - The attached draft ACF response to t he OIG Memorandum a€ceSafety Inc idents Related to Unaccompanied Children under the ca re of the Office of Refugee Resettle ment and its Granteesa€ □ is ready fo r Steve Wagner's review and app roval. He doub le checked . Good to go. Toby R. M. Biswas, ESQ. Unaccompanied Alien Chi ldren Polic y Supervisor U.S. Departme nt of Health and Human Services /\MERICAi\ pVERSIGHT EXT-18-248-C-000124 Administration for Children and Families Office of Refugee Resett lement Office of the Director- Division of Policy and Procedures (202) 205-4440 (0) (301) 1 (b)( 6) l (C) (202) 401-1022 (F) From: Suh, Victor (HHS/OGC) (ACF) (CTR) Sent: Monday, August 28, 2017 10:38 AM To : Biswas, Toby R M (ACF) Subject: RE: SWIFT: 081120172004 - The attached draft ACF response to the OIG Memorandum a€reSafety Incidents Related to Unaccompanied Children under the care of the Office of Refugee Resettlement and its Granteesa€ □ is ready for Steve Wagner's review and approval. Checked. Made two very stylistic minor changes, but otherwise don't see any typos. From: Biswas, Toby R M (ACF) Sent: Monday, August 28, 2017 10:21 AM To: Suh, Victor (HHS/OGC) (ACF) (CTR) Subject: RE: SWIFT: 081120172004 - The attached draft ACF response to the OIG Memorandum a€reSafety Incidents Related to Unaccompanied Children under the care of the Office of Refugee Resettlement and its Granteesa€ □ is ready for Steve Wagner's review and approval. Victor: I think this is good. Can you just do one more quality check for typos etc? Hopefully this nightmare will be over soon. Toby R. M. Biswas, ESQ. Unaccompanied Alien Children Policy Supervisor U.S. Department of Health and Human Services Administration for Children and Families Office of Refugee Resett lement Office of the Director - Division of Policy and Procedures (202) 205-4440 (0) (301) I (b)( 6) I (C) (202) 40 l -1022 (F) From: Biswas, Toby R M (ACF) Sent: Monday, August 28, 2017 10:12 AM To : Bena, Anna Marie (HHS/OGC) (ACF) Subject: FW: SWIFT: 081120172004 - The attached draft ACF response to the OIG Memorandum a€reSafety Incidents Related to Unaccompanied Children under the Care of the Office of Refugee Resettlement and its Granteesa€ □ is ready for Steve Wagner's review and approval. What do you think of this layout? Toby R. M. Biswas, ESQ. /\MERICAi\ pVERSIGHT EXT-18-248-C-000125 Unaccompanied Alien Chi ldren Policy Supervisor U.S . Department of Health and Human Services Administration for Children and Families Office of Refugee Resett lement Office of the Director - Divis ion of Policy and Procedu res (202) 205 -4440 (0) (30 I) I (b)(6) I (C) (202) 401 -1022 (F) From: Suh, Victor (HHS/OGC) (ACF) (CTR) Sent: Monday, August 28, 2017 9:50 AM To: Biswas, Toby R M (ACF) Subject: RE: SWIFT: 081120172004 - The attached draft ACF response to the OIG Memorandum a€reSafety Incidents Related to Unaccompanied Children under the Care of the Office of Refugee Resettlement and its Granteesa€ □ is ready for Steve Wagner's review and approval. Toby, Please see attached (about the OIG report on the 5 incidents). I've responded to t he comments on the memo by renam ing all attachments simp ly as "Attachment A," "Attachment B," etc . (Not e the date field for the memo still remains blank). Also, I combined all attachments (includ ing emails and attachments to emails) in a single PDF.This way t he attachments can either be printed from a single document , or navigated in Adobe using the built-in bookmarks . Thanks, Victor From: Owens, Javan (ACF) Sent: Tuesday , August 15, 2017 9:53 AM To: Bena, Anna Marie (HHS/OGC) (ACF); Gregg, Laura (ACF) Cc: Kanodia, Preeti (ACF) Subject: FW: SWIFT: 081120172004 - The attached draft ACF response to the OIG Memorandum a€reSafety Incidents Related to Unaccompanied Children under the Care of the Office of Refugee Resettlement and its Grantees§€ □ is ready for Steve Wagner's review and approval. Anna Marie, Can you please review the working document, and respond to the questions from the front office . As to the question about the uploading a zip file, my experience has been in the past that OIG sends a link to a confidential portal t hat one can upload documents to. Is that your understanding as well? Please let me know if you have any additional questions. Javan From : Akers, Ms. Mary (ACF) Sent: Monday, August 14, 2017 5:29 PM /\MERICAi\ pVERSIGHT EXT-18-248-C-000126 To: Logan, Scott (ACF); Owens, Javan (ACF); Kanodia, Preeti (ACF); Davis, Ms. Cynthia (ACF) Cc: Cottingham, Kenneth (ACF) Subject: SWIFT: 081120172004 - The attached draft ACF response to the OIG Memorandum a€ceSafety Incidents Related to Unaccompanied Children under the care of the Office of Refugee Resettlement and its Grantees§€ □ is ready for Steve Wagner's review and approval. I have revised the memo to Joanne M. Chiedi, the Principal Deputy Inspector General , regarding the Safety Incidents Related to UC and would like your approval on the revision. I also have several questions that I hope you can help me with. (b)(5) Thanks for your help. Please let me know ifl need to clarify my questions. Mary Mary Akers Management Analyst Executive Secretariat Administration for Children and Families U.S. Department of Health and Human Services 330 C Street, SW. Washington , DC 20201 202-401-6965 Mary .Akers@acf.hhs.gov Sender: White, Laura {ACF) "Bena, Anna Marie {HHS/OGC){ACF) "; Recipient: "Lloyd, Scott (ACF) " Sent Date: 2017/09/06 09:29:32 Delivered Date: 2017/09/06 09:29:38 /\MERICAi\ pVERSIGHT EXT-18-248-C-000127 From: Bena,Anna Marie (HHS/OGC)(ACF) To: "ORRSenior Leadership"; "Wynne, Maggie (HHS/IOS)" Subject: ORRWeekly Litigation Update Date: 2017/09/07 16:03:58 Priority: Normal Type: Note I have attached the weekly litigation update. UAC litigation. In Gomez (habeas case), the parties held a Case Management Conference to resolve discovery issues on 9/1, and filed a Proposed Order on 9/6. In Flores (bond hearings) , the government appellants filed a USDHS Mediation Questionnaire with the 9th Circuit on 9/5. In "Nash" (FOIA litigation regarding JRP program), the parties held an interim pre-trial conference on 9/6. Refugee litigation. There were no substantive updates to refugee litigation this week. Bond Hearings. • To date , there have been 27 bond hearings: o 3 hearing s leading to IJ decisions (all agreed with ORR recommendations) o 14 UACs who reque sted bond hearings who subsequently withdrew their requests (either before or during their hearings) o 10 UACs who requested bond hearings but no longer require them because they are no longer in ORR custody (e.g., because they were subsequently reunified with a sponsor, were ordered removed, aged out, etc.). • There are 19 outstanding bond requests in the process of filing and sched uling. Sender: Bena,Anna Marie (HHS/OGC)(ACF) "ORRSenior Leadership"; Recipient: "Wynne, Maggie (HHS/IOS)" Sent Date: 2017/09/07 16:03:54 Delivered Date: 2017/09/07 16:03:58 /\MERICAi\ pVERSIGHT EXT-18-248-C-000128 From: Bulletin Intelligence To: "HHS@bulletinintelligence.com" Subject: HHS News Briefing for Wednesday, September 13, 2017 Date: 2017/09/13 07:34:47 Priority: Normal Type: Note HHS NEWS BRIEFING This document and searchable archives are avai lable at hhs.bulletinintelligence.com. TO: THE SECRETARY AND SENIOR STAFF DATE: WEDNESDAY, SEPTEMBER 13, 2017 7:30 AM EDT TODAY'S TABLE OF CONTENTS LEADING THE NEWS: + Census Data Show US Uninsured Rate Fell To 8.8% In 2016. + Pelosi Declines To Endorse Sanders' "Medicare For All" Bill. THE SECRETARY IN THE NEWS : + Price Discusses Relief, Recovery Efforts Following Hurricane Irma . + House Dems Urge Price, Verma To Provide Funding For ACA Navigator Programs. + WPost: Price Undermined Test Of New Medicare Payment Model Meant To Save Government Money. + Opinion: Opposition To Medical Treatment For Opioid Abuse Stems From "Lack Of Imagination." + Opinion: Opioid Emergency Must Be Skillfully Managed To Avoid "Money Grabs." + National Science Foundation Awards Georgia Tech Partnership $20 Million Grant For New Engineering Research Center. HHS IN THE NEWS: + Researchers Find Potential Link Between Flu Shot And Miscarriage Early In Pregnancy. + Former CDC Director Frieden Discusses New Global Health Project Focused On Heart Disease, Epidemics . + CDC Warns Employees To Avoid Speaking To The Media . + Philip Morris International To Give $1 Billion To Fund Research. + FDA's 510(k) Review Process Fails To Find Major Glitches In Health Software, Study Finds. + FDA Intends To Close Orphan Drug Loophole Allowing Companies To Avoid Testing Drugs For Children. + Hiltzik: Pharmaceutical Lawsu it Underscores Problems With Industry Regulations. + House , Senate Committees Reject Trump's NIH Budget Cuts. + Opera Singer Discusses How Music Affects Brain Activity. + NIA Committee Issues Recommendations On Alzheimer's Testing. + USPSTF Issues New Draft Guidelines For Cervical Cancer Screening. + USPSTF Offers Updated Recommendations Saying Women Can Choose Pap Smear Or HPV Test For Cancer Testing. + Oklahoma Nursing Facility Reaches Agreement With HHS Over Discrimination Case. + HHS Says ACA Data Not Compromised In Equifax Breach. + Hospital Groups Urge CMS To Withdraw Proposal To Slash 340B Medicare Drug Payments. /\MERICAi\ pVERSIGHT EXT-18-248-C-000129 HEAL TH REFORM: + Alexande r Insists Bipartisan ACA Stabilization Measure Will Preserve Patient Protections . + Alexande r Acknowledges "Significant Differences" Between Dems, GOP Working On ACA Stabilization Measure . + Some Members Of Congress Seek To Shore Up ACA Marketplaces. + GOP Reportedly At Odds About Whether To Stabilize Or Repeal ACA. + Hatch Calls Current Efforts To Stabilize ACA Marketplaces "A Bailout." + "Last-Ditch" ACA Repeal Effort To Be Unveiled Wednesday, Without Leadership Support. + Cassidy Says Latest Effort To Repeal ACA Is Not Supposed To Be Partisan. + Anthem Mulling Exits From More ACA Marketplaces. + Trump Administration Funding Cuts Imperil ACA Navigator Programs In Arizona. + ACA Navigators In Tennessee Resorting To Grassroots Methods Following Trump Administration Funding Cuts. + BCBS Of Illinois Small Business Plan Will Not Be Offered Through The ACA Exchange In 2018. + Insurers Tell Lawmakers How To Stabilize ACA Marketplaces During Senate Committee Hearing . + Sanders Could Frame Single-Payer Plan As Litmus Test Or Starting Point. + Without CMS Decision , Iowa Insurance Commissioner "Less Optimistic " About ACA Stopgap Plan. + Insurer Departures Could Leave 70,000 Virginians Without Individual Coverage Options In 2018 . + HHS IG Report Says Remaining ACA Co-Ops Not Financially Viable . + Handel Overstates ACA Tax Impact. + Virginia Lt. Gov. Candidate Supports Single Payer Healthcare . + Hatch Warns Against ACA "Bailout" Amid Healthcare Reform Negot iations . + Commentary Considers Health Reform. OPIOID NEWS : + Opinion: There Is No Simple Policy Solution To the Opioid Crisis. + Most Amer icans Prefer Non-Drug Pain Treatment, Are Aware Of Opioids' Dangers , Survey Suggests. +Rep.Walden Calls On Congress To Boost Efforts Against Opioid Crisis. + Blog: Treat Opioid Addictio n Like Hospital-Acqu ired Illnesses. + Column: Better Data Needed To Measure True Extent Of Opioid Epidemic. + Senate Committee Examines Marketing Practices Of Op ioid Compan ies At Hearing. + Op inion: President Trump "Dithers" On Opioid Emergency. HEALTHCARE NEWS: + Centene To Buy New York's Fidelis Care For $3.75 Billion. + Oh io Supreme Court Hears Arguments On State's Effort To Close Abortion Clin ic. + Lawyers Petition Trump Administration To Protect Pro-Life Clinics Forced To "Promote Abortion" Under State Laws. HUMAN SERVICES NEWS : + Texas , Foster-Care Providers Evacuated , Monitored Foster Children During Harvey. + DHHS Responds To Maine Lawmakers' Questions About Treatment Of Disabled Adults . MEDICARE : + Healthcare Providers At Odds Over CMS Proposal For Joint Replacements At Surgical Centers . + Provider, Health IT Groups Ask CMS To Waive Restrictions On Telehealth. + Ohio's SummaCare, University Hospitals Agree To Co-Brand Medicare Managed-Care Plans. MEDICAID & CHIP : + Senators Strike Deal To Extend CHIP Program . + Opinion: Blaming Medicaid For The Opioid Crisis May Be Wrong . /\MERICAi\ pVERSIGHT EXT-18-248-C-000130 + Analys is: Trump Continues Funding Of Planned Parenthood By Signing Continuing Resolution . + Op inion: Expanding Medicaid In Maine Will Help Hospitals, Economy . + Candidate For Colorado Governor Proposes Medicaid-For-All Healthcare Plan. + Arizona Supreme Court To Decide Medicaid Expansion Case. + Op-Ed: Medicaid Expansion Could Help The Homeless. HEAL TH & MEDICAL NEWS : +Sen.McCain To Receive Brain Cancer Treatment At NIH While Cont inuing Senate Work . + Menopausal Hormone Therapy Drugs Appear Not To Increase Risk Of Premature Death , Researchers Say. + New Texas School Buses Required To Have Seat Belts . + Extended Breastfeeding Can Help Prevent Endometriosis. + Shulkin: Canine Research Program Benefits Veterans, Needs Senate's Preservation . + Pennsylvania Senator Asks Marijuana Grower To Rescind Lawsuit Over State's Permit Awards. + Healthcare Industry Intrigued By Diagnostic Potential Of Artificial Intelligence. + Brexanolone Fails To Meet Main Goal In Trial For Patients With Super-Refractory Status Epilepticus. + 23andMe Using Customer 's DNA Data To Develop New Drugs. + Major Healthcare Companies Invest In "Electroceuticals" Startup. + Californ ia State Assembly Overwhelmingly Passes Drug Pricing Transparency Bill. + Prostate Cancer Experts Offer Tips On Screening , Treating Prostate Cancer. + Scientists Criticize Study Disputing Anonym ity Of Genome Research. + Microscopic Particles From Tattoo Ink Can Get Into Lymph Nodes, Study Suggests . + At Least 12 Pediatric Heart Patients At New Orleans Hospital Have Infected Incisions , Possibly From Contaminated Equipment. + Forbes Contributor Discusses Study Finding Generic Cherne Will Not Help Bring Down High Cost Of Drugs. + Excess Belly Fat May Increase Risk Of Some Cancers In Older Women, Study Suggests. + HIV Continues To Affect Many, Prompting Calls For Further Testing, Treatment. + Harvard Students Warned About Hand, Foot, And Mouth Disease Outbreak. + Opinion: Train ing Nurses' Aides Could Reduce Home Healthcare Costs. + Hospitals Using Alert Systems To Cut Back On Unnecessary Care Procedures. + Genetic Testing For Parents, Embryos Rising As Prices Fall. + Medical Professionals See Innovation In 3-D Printing For Healthcare. + Many Moisturizers Marketed As "Hypoallergenic " May Contain Chemical Irritants, Study Finds. + Hospitals Implementing Strategies To Reduce ER Wait Times. + Telemedicine Heralded As Means Of Helping Pregnant Women Facing Health Risks. + Labor Ward Culture May Impact Rate Of C-Sections, Researchers Say. + Pregnant Women Exposed To Pesticides May Have Higher Risk of Delivering Preterm Babies, Study Finds. + Florida Assisted Living Facility Houses Patients During Irma Despite Lacking Electricity For Three Days. + Shocked Florida Keys Residents Stunned By Irma's Wreckage. + Therapeutic Vaccines Offer New Progress For Cancer Treatment. + Deaths Due To Cancer Have Fallen But New Diagnoses Expected To Rise, Study Finds. + Hospitals Increasingly Encourage Patients To Practice Mobility Prior To Being Discharged . + Social Media Becomes Hotbed Of Competit ion Among Plastic Surgeons Who May Or May Not Have Licenses . + Texas Calls On Air Force To Spray Insecticides In Effort To Limit Post-Harvey Mosquito Population . + Op-Ed: PBMs Play Essential Role In Lowering Prescription Costs. + Opinion: Electron ic Medica l Records Can Enable Clinical Trials In Physicians ' Offices. + Pharmaceutical Companies Implement Ouctomes-Based Pricing Despite Lack Of Evidence To Show It Lowers Costs. + People Continue To Believe Vaccine Myths Despite Being Presented Facts, Study Finds . + Ohio's Hospitals , Physicians Fight Bill That Would End Flu Vaccine Requirements. /\MERICAi\ pVERSIGHT EXT-18-248-C-000131 + Pitt Researcher To Study Effectiveness of New York's Sepsis Law . + Study Finds Cases Of Hookworm In Alabama . + Loneliness Can Be Hazardous To Health, Experts Say . + Increased Use Of Marijuana By Pregnant Women Spurs Nevada Campaign. + Opinion: Payment Methods For Physicians Are Hurting Healthcare. + San Diego Hepatitis A Outbreak Leads To 16 Deaths, Shows No Signs Of Slowing. + Utah Officials Release Data On Rising Suicide Trend As Part Of Wider Prevention Effort. + Lubbock, Texas Confirms Its First West Nile Virus Case Of The Year. + US House Passes Bill Calling For Study Of Cancer Among Firefighters. + California Bill To Create "Safe Injection Sites" For Drug Users Fails In State Senate. + TMS Treatments For Hard-To -Treat Depression Now Much Easier To Get. + Screening Mothers For Depression During Early Well-Child Visits May Lead To Significantly Fewer Reports Of Depression At Nine Months Postpartum , Study Says. + Experts Puzzled By US Male Infertility Crisis. GLOBAL HEAL TH: + Progress On Global Poverty, Disease At Risk, Gates Says. + France Plans To Legalize Assisted Reproduction For Lesbians Next Year . + Efforts To Contain Northeast Nigeria 's Cholera Outbreak Hampered As Refugees Underreport Illnesses . + Health Officials Concerned About Reemergence Of Sleeping Sickness In The Democratic Republic Of Congo . + UnitedHealth Exploring Bid For Chilean Health Insurer Banmedica . NATIONAL NEWS : + Trump To Travel To Florida Thursday To Survey Hurricane Damage. + Florida Lawmakers Seek Federal Aid For Irma Cleanup . + More Than 2,000 Americans Evacuated From Caribbean. + Florida Pizza Hut Manager Threatens To Punish Employees Evacuating Ahead Of Irma. + British Virgin Islands Prisoners Escape In Irma's Wake. + Mosquitoes, Toxins In Flood Waters A Growing Concern In Texas. + Up To One Million Vehicles Suffered Damage In Harvey , Irma. + Latest Forecast Shows Hurricane Jose To Impact East Coast. + Job Openings At Record High. + Trump To Meet With House Moderates Wednesday. + White House: Investigation Of Corney "Should Be Looked At" By DOJ. + Trump Says Some Writing About Him "Know Nothing About Me & Have Zero Access. " + Study: Network Newscasts ' Trump Coverage 91 % Negative In June , July, August. + Bannon Says He Speaks With Trump Several Times A Week. + Congress Passes Joint Resolution Urging Trump To Denounce Hate Groups. + Gorka: GOP "Did Not Win The Election ," Trump Did. + White House Says Trump "Stands By" Endorsement Of Strange. + White House On Clinton Election Book: Trump "Pretty Well-Versed On What Happened." + Jordan Rips WSJournal Over "Fa lse Story" On House Freedom Caucus. + Zinke Orders Clearing Of Trees To Combat Wildfires . + Interior IG Examining Reassignment Of SES Members. + Lee Blasts Democrats ' Questioning Of Barrett. + Voter Fraud Commission Criticized By Its Democratic Members. + Attorneys Ask Administration to Protect Pro-Life Clinics Forced To Perform Abortions . + Pruitt Denies Icahn Had Excessive Influence In Biofuel Regulation . + Energy Department Announces Obama 's Solar Goal Met Early. + Politico Analysis: Silicon Valley Losing Favor From Both Left And Right. + Rep. Duncan Pushes For Gun Silencer Provision. + Pair Of Women Testify About Menendez 's Alleged Role In Helping Obtain Visas. + At Concert, Kid Rock Denounces Racists, Mum On Possible Senate Run. + Cruz Says Aide Inadvertently Liked Porn Tweet On Senator 's Twitter Account. /\MERICAi\ pVERSIGHT EXT-18-248-C-000132 + Poll Shows Romney Faring Much Better Than Hatch In Hypothetica l 2018 Race . + Political Analyst: GOP House Retirements "Still Below The Historical Average. " + Steyer 's Group Donates $1 M To Virgin ia Immigrant Advocates To Mob ilize Voters . + Speculation Grows About Whether Cordray Will Run For Ohio Governor . + GOP State AG Schuette Enters 2018 Michigan Governor 's Race. + Democrat McCabe Launches 2018 Bid To Oust Gov Walker. + De Blas io Easily Wins Democratic Primary. + Ferguson Drops Charges Against Fred Watson. + DOJ Won't Charge Officers In Freddie Gray Case. + Seattle Mayor Resigns After Fifth Sexual Abuse Allegation. + Loudermi lk, Wife Recovering From Car Accident. + After More Than 20 Years, Newark Expected To Regain Control Of Its Schools. + Nearly 50 Lawsuits Filed Against Equifax. + Same -Sex Marr iage Advocate Edie Windsor Dies At 88. + Milbank: Republicans Will Always Own Trump. + Posner: Trump Could Be Removed For Political Incompetence Under Revised 25th Amendment. + WSJournal's Riley: DeVos Should Scrap Obama-Era School Discipline Guidance. + Ignatius: Media Should Bring Back The Ombudsman . EDITORIAL WRAP-UP: + New York Times . + Washington Post. + Wall Street Journal. THE BIG PICTURE : + Head lines From Today 's Front Pages . LAST LAUGHS : + Late Night Political Humo r. Leading the News: CENSUS DATA SHOW US UNINSURED RATE FELL TO 8.8% IN 2016. The New York Times (9/12, A 1, Appelbaum, Subscription Publication, 13.56M) reports on its front page that according to Census Bureau data which were released on Tuesday , the median househo ld income in the US "was $59,000 in 2016, an increase of 3.2 percent. " The figures also revealed that the percentage of Americans living in poverty decreased. Meanwhile , access to healthcare coverage expanded last year, with data showing that just "8.8 percent of the population lacked health insurance for the full year , down from 9.1 percent in 2015." The Washington Post (9/12, Long , 10.38M) reports that 2016 was the "highest-earn ing year" ever recorded for the middle class . The article adds that the continued drop in the uninsured rate was "largely thanks to expanding coverage under the Affordable Care Act." In contrast , the Wall Street Journal (9/12, Radnofsky, Subscription Publication, 6.45M) reports that the additional decline in the uninsured rate was due to the fact that more Americans reached the age of 65 and became eligible for Medicare. The article says last year's drop is minor compared to larger declines which occurred when the ACA was being implemented. USA Today (9/12, Davidson, 8.62M) reports that the number of uninsured Americans fell by 900,000 to 28.1 million, while those living in poverty dropped to 40.6 million from 43.1 million , "lowering the poverty rate to 12.7% from 13.5% and placing it jus t marginally above the prerecession level." The article says these figures indicate that "in the final two years of the Obama administration, low- and middle-income Americans made noticeable progress after struggling in the early years of the economic recovery ." /\MERICAi\ pVERSIGHT EXT-18-248-C-000133 Politico (9/12, Demko, 3.6M) reports that the continued decline in the US uninsured rate ''further complicat[es] Republican efforts to dismantle Obamacare ." The article says 2016 "marked the third straight year in which the Census Bureau recorded a drop in the share of Americans without health care coverage." It adds that before the ACA was fully implemented, "the uninsured rate stood at 13.3 percent." The Hill (9/12, Weixel, 1.68M) also reports that these data "further complicate GOP efforts to repeal ObamaCare, which have slowed in recent months." The piece adds that the uninsured rate of 8.8 percent is "a record low." Also covering the story are the Los Angeles Times (9/12, Lee, 4.49M), CNBC (9/12, Mangan, 3.48M), The Hill (9/12, Wilson , 1.68M), NPR (9/12, Kennedy, 2.4M) , the Washington Examiner (9/12, Leonard, 465K), Modern Healthcare (9/12, Livingston, Subscription Publication , 238K), and Kaiser Health News (9/12, Galewitz). Additional Coverage. The Houston Chronicle (9/12, Deam, 1.97M) reports that the uninsured rate in Texas fell "to 16.6 percent last year, continuing a downward trend that corresponds with the beginning of the Affordable Care Act, according to U.S. Census data." That rate has fallen by 5.5 percentage points since 2013 . The Dallas Morning News (9/12, Rice, 984K) reports that despite the decline, "Texas still has the highest rate of people lacking health insurance in the country. " The data show "Texas and Alaska were the only two states" with rates higher than 14 percent. The AP (9/12), the San Antonio Express-News (9/12, Stoeltje , 1.18M) and the Texas Tribune (9/12, Arriaga, 13K) also cover the story. The Boston Globe (9/12, McCluskey, 969K) reports the share "of Massachusetts residents without health insurance fell again last year, to a new low of 2.5 percent , the US Census Bureau said Tuesday ." That figure was 2.8 percent in 2015 , and 3.7 percent in 2013. The article adds, "Massachusetts continues to have the smallest percentage of uninsured residents in the country." The Albany (NY} Times Union (9/12, Hughes , 373K) reports the share "of New Yorkers without health insurance dropped to 6.1 percent last year, according to data released by the U.S. Census Bureau on Tuesday." The Bangor (ME) Daily News (9/12, Farwell, 162K) reports the number of uninsured Maine residents "held steady in 2016 , as the national uninsured rate fell to a record low," according to the Census Bureau. Data show 8 percent of Mainers , "or 106,000 people, lacked health insurance last year," which is "down slightly from 8.4 percent in 2015 , though within the report's margin of error." The Beckley (WV) Register-Herald (9/12, Holdren , 59K) reports Census Bureau data show "96,000 West Virginians lacked health insurance in 2016- a decrease of 12,000 from 2015." The state's uninsured rate fell from 14 percent in 2013 to 5.3 percent last year. The Connecticut Post (9/13, Cuda, 199K) reports that according to the Census Bureau, the share "of uninsured people in Connecticut fell from 9.4 percent in 2013 to 4 .9 percent in 2016 ." The Chicago Tribune (9/12, Schencker, 1.98M) reports that the number of uninsured people in Illinois "has dropped again - though some worry that trend is about to reverse amid uncerta inty over the future of Obamacare ." Census Bureau data show some 6.5 percent of residents (817,000 people) were uninsured last year, compared to about 900,000 in 2015, and 1.6 million in 2013 before the ACA was implemented. The Char leston (SC} Post and Courier (9/12, Sausser, 269K) reports despite the fact that South Carolina has not expanded Medicaid under the ACA, the state 's uninsured rate dropped to 10 percent in 2016 from 15.8 percent in 2013. The Winston-Salem (NC} Journal (9/ 13, Craver, 232K) /\MERICAi\ pVERSIGHT EXT-18-248-C-000134 reports that "the rate could be significantly lower if the Republican-contro lled General Assembly approved expanding Medica id coverage to more than 500,000 of the 1.04 million North Carolinians who still lack health insurance ." The Newark (NJ) Star-Ledger (9/12, Raychaudhuri, 1.62M) reports that some 66,000 more New Jerseyans gained access to health coverage in 2016 , thus dropping the state's uninsured rate from 8.7 percent in 2015 to 8 percent in 2016. NJ Spotlight (9/13, Stainton) also covers the story. The Providence (RI) Business News (9/12, Gowdey, 31K) reports data from the Census Bureau show "the percentage of uninsured Rhode Islanders fell from 5.7 percent (59,000 individua ls) in 2015 to 4.3 percent (45,000 individuals) in 2016 ." This means Rhode Island has the sixth lowest uninsured rate in the country . The Quad-City (IA) Times (9/12, Tibbetts , 277K) reports that the number of uninsured Iowans decreased by 23,000 from 2015 to 2016, according to the Census Bureau, which leaves "just 4.3 percent of the state's population without coverage." By compar ison, that figure was 5 percent in 2015. PELOSI DECLINES TO ENDORSE SANDERS' "MEDICARE FOR ALL" BILL. Kelsey Snell and David Weigel write in the Washington Post (9/12, Snell, Weigel , 10.38M) "Power Post" that on Tuesday , House Minority Leader Nancy Pelosi (D-CA) said "single-payer health insurance is not a litmus test for Democrats and that she herself is focused on protecting health-care coverage under the Affordable Care Act. " The article says Pelosi refused to endorse Sen . Bernie Sanders' "Medicare for All" bill, and instead urged "Democrats to release a wide range of proposals to fix and improve" the ACA . Sanders is expected to release his bill later th is week . The Los Angeles Times (9/12, Mascaro, 4.49M) reports Pelosi indicated that her stance has "little to do with " the bill's contents, and more to do with the fact that "she is work ing on more incremental gains to preserve and expand cove rage for as many Ame ricans as possible , despite Republican oppos ition to Obamacare." Pelosi stated, "Right now, I'm protecting the Affordable Care Act. ... None of these other things , whether it's Bernie's [bill], can really prevail unless we have the Affordable Care Act protected ." The AP (9/12) reports Pelosi explained that "wh ile she has long supported the idea the bill captures , of everybody getting health coverage ," her immediate focus is protecting the ACA. Politico (9/12, Kim, 3.6M) reports that Sande r' single-payer proposal "has quickly attracted support from a flock of Democratic senators in the mix for the 2020 presidential race, suggesting that it is rapidly becoming a litmus test among the liberal grass roots." The Hill (9/12, Hellmann, 1.68M) also covers the story. In a separate article, the Washington Post (9/12, 10.38M) reports that the bill is "problematic" for Pelosi because Democrats "need to w in in red territory where government-funded health care is a much , much tougher sell than in a Democrat ic presidential primary. " In a sepa rate article, The Hill (9/12, Carney , 1.68M) reports that Senate Minority Leader Charles Schumer (D-NY) "is staying on the sidelines" where Sanders ' bill is concerned . Schumer said, "Democrats believe that health care is a right for all, and there are many different bills out there. There are many good ones ." He declined to say if he would co-sponsor the measure . Meanwh ile, in yet another article, The Hill (9/12, Lillis, 1.68M) reports that in spite of grow ing support for a single-payer health system , Democratic party leaders have been reluctant to endorse the proposals. The piece says that on Tuesday , Schumer and Pelosi refused "to throw their weight behind" Sanders ' "Medicare for All" bill. Hoyer Says House Democratic Leaders' Focus Is Preserving ACA, Not Supporting Single- /\MERICAi\ pVERSIGHT EXT-18-248-C-000135 Payer Healthcare. The Washington Examiner (9/12, Weaver, 465K) reports that on Tuesday, House Minority Whip Steny Hoyer (D-MD) said "a single-payer or Medicare-for-all healthcare system would have 'significant administrative and other issues' and the priority of House Democratic leadership is to preserve and improve upon the Affordable Care Act." He stated, "Our position is we are for affordable access of all Americans to affordable, quality healthcare. We've made that very clear. Medicare-for-all is one way to get there. " Hoyer added that he is not worried about losing centrist votes in next year's midterms, because there has always been a faction which sought a public option. Gillibrand Endorses Sanders' Single-Payer Bill. USA Today (9/12, Gaudiano, 8.62M) reports that on Tuesday , Sen. Kirsten Gilli brand (D-NY), who is considered by many to be "a potential Democratic presidential candidate," said she would co-sponsor Sanders' single-payer legislation. The article says Gillibrand "is among 10 Democratic senators to publicly announce support for the 'Medicare-For-All Act of 2017,' a move that that strengthens her progressive bona tides if she were to decide to run in a Democratic presidentia l primary." The Washington Times (9/12, Howell, 541 K) reports that in a tweet, Gillibrand stated, "Health care is a right, not a privilege .... This week, I'll proudly join Senator @BernieSanders to cosponsor Medicare for All." The article adds that endorsement of the single-payer idea "is emerging as a key test for Democrats ahead of the 2018 midterms and campaign to defeat President Trump , even though that contest is three years away ." The Hill (9/12, Sullivan, 1.68M) also covers the story . Nearly 25% Of Senate Dems Have Expressed Support For Sanders' Single-Payer Bill. The Washington Post (9/12, Weigel , 10.38M) reports that Sanders' "Medicare for All" bill has the "backing of at least 15 Democratic senators - a record level of support for an idea that had been relegated to the fringes during the last Democratic presidency." The Wall Street Journal (9/12, Armour, Hackman, Subscription Publication , 6.45M) reports that Republicans were quick to criticize Democrats' support as a shift towards government overreach. The AP (9/12, Fram) reports that Sen. Bill Cassidy (R-LA) said of the bill, "It's laughable." Jeff Stein writes in a Vox (9/12, 1.54M) piece that so far, 11 of the 48 Democrats in the Senate have "decided to co-sponsor Sen. Bernie Sanders ' single-payer health care bill - just two years after Sanders could find zero co-sponsors for his legislation. " Stein adds that most of these supporters "tend to hail from blue states or are rumored 2020 presidential candidates." He also says this growing support illustrates "a stunning shift among Democrats to embrace single-payer legislation - which was once circumscribed to the party's far-left fringe ." Despite Skepticism, Manchin Urges Senate To Explore Single-Payer System. Bloomberg News (9/12, Kapur, 4.52M) reports that on Tuesday, Sen. Joe Manchin (D-WV), "the most conservative Democrat" in the Senate, said "Congress should consider adopting a single-payer health-care system , a sign of how fast politics are shifting on what was once seen as a fringe issue on the left." According to Manchin, the idea "should be explored. " The Hill (9/12, Beavers, 1.68M) reports Manchin explained that "he is 'skeptical' of a single-payer healthcare system , saying that he simply supports digging into the complex details of the idea to see if it has potential." Manchin added that despite his skepticism, he is convinced "the Senate should carefully consider all of the options through regular order so that we can fully understand the impacts of these ideas on both our people and our economy." The Washington Times (9/12, Howell, 541 K) reports that Sen. Thomas Carper (D-DE) suggested, "Before we try it for our country, the idea of trying it for a couple of states seems to be logical." /\MERICAi\ pVERSIGHT EXT-18-248-C-000136 Vox (9/12, Scott, 1.54M), the Allentown (PA) Morning Call (9/12, Olson, 312K) , TIME (9/12, Jenkins, 5.85M) , and the Minneapolis Star Tribune (9/12, Brooks , 1.27M) also cover the story . The Secretary in the News: PRICE DISCUSSES RELIEF, RECOVERY EFFORTS FOLLOWING HURRICANE IRMA. On Fox Business Mornings with Maria (9/12), HHS Secretary Tom Price discussed relief and recovery efforts in the wake of Hurricane Irma. Price said that because a public health emergency was declared for impacted areas, HHS was able to "pre-deploy and get folk on the ground in those areas so that we were able to respond as rapidly as possib le. HHS has over 600 individua ls on the ground right now," providing needed healthcare services, and "evaluating the hospitals and making certain we can get those hospitals back up and online especially in the Keys and in South Florida as rapidly as possible." He said it is critical to be able to address the "acute needs" of hurricane victims. For instance, some people, such as dialysis patients, depend on having access to electricity to survive. Price explained that "HHS has a list of those individuals, " which it is able to share with local communities. Price also criticized Democrats ' growing support for a singlepayer healthcare system, and insisted that it is essential to repeal and replace the ACA. HOUSE OEMS URGE PRICE, VERMA TO PROVIDE FUNDING FOR ACA NAVIGATOR PROGRAMS. On its website , CNBC (9/12, Mangan, 3.48M) reports that on Tuesday , 31 House Democrats urged the Trump Administration "to unfreeze millions of dollars in grants for a program that gives Obamacare customers hands-on help signing up for health insurance." In a letter to HHS Secretary Tom Price and CMS Administrator Seema Verma, the lawmakers wrote , "As of Monday ...grantees have received no update on when they should expect to receive this essential funding .... Disturbing ly, we have heard reports that some Navigators have already been laid off because of CMS's highly unusual action." The lawmakers added that navigators are crucial to the ACA open enrollment process, and they warned that "discouraging enrollment could weaken the market and drive up premiums." The Hill (9/12, Weixel , 1.68M) reports that the lawmakers were led by Rep. Carol Shea-Porter (DNH) . The article adds that the Trump Administration recently "announced it was slashing the grant money for navigators by nearly 41 percent, or $23 million." The piece says the groups were "blindsided" by the news. The Washington Examiner (9/12, Leonard, 465K) also covers the story. WPOST: PRICE UNDERMINED TEST OF NEW MEDICARE PAYMENT MODEL MEANT TO SAVE GOVERNMENT MONEY. The Washington Post (9/ 12, 10.38M) editorializes that Health and Human Services Secretary Tom Price's decision to stop or scale back potentially cost-saving "bundled payment" experiments the Obama administration had begun "was disheartening but no surprise." Researchers found that applying the Medicare program nationwide "would save the government $2 billion annually," so HHS was poised to expand the program, but "HHS officials now and Mr. Price last year argue that the government should test new payment models but that experiments should be voluntary ," resulting in self-selection that undermines the experiments. OPINION: OPPOSITION TO MEDICAL TREATMENT FOR OPIOID ABUSE STEMS FROM "LACK OF IMAGINATION." Rep. Pau l Tonka (D-NY), who represents New York's 20th District and is a member of the Energy and Commerce Committee, writes in The Hill (9/13 , 1.68M) to call for "evidence-based" medical treatment in an effort to curb the opioid epidemic. He suggests that progress in reducing the spread of the epidemic is hindered by "old stereotypes and a lack of imagination" about treatment options, noting that Health and Human Services Secretary Tom Price has "attacked medication-assisted treatment , claiming , 'If we're j ust substituting one opioid for another, we're not moving the dial much." ' According to Tonka, "Secretary Price is missing the point" that medication-assisted treatment, when "backed by appropriate counseling and support," can help opioid abusers find "the truest path back to a normal productive life." He also references CDC data showing that "more than 64,000 family members, friends and neighbors died from drug /\MERICAi\ pVERSIGHT EXT-18-248-C-000137 overdoses last year, an astonish ing 21 percent increase from 2015 ." OPINION: OPIOID EMERGENCY MUST BE SKILLFULLY MANAGED TO AVOID "MONEY GRABS." Former Maryland governor Robert L. Ehrlich, Jr . and public policy consultant Jim Pettit write in a Baltimore Sun (9/12 , Ehrlich, Pettit, 706K) op-ed that President Trump should "identify specific goals" for his opio id "national emergency" in order "to avoid the mission creep often associated with government programs ." As an example , the authors point to Health and Human Services Secretary Tom Price's grant awards under the "21st Century Cures Act" as "a refreshing attempt to strike a balance between an urgent spending priority and a process for tracking results." The authors conclude that "a productive fight aga inst the opioid scourge should be less about federal funding and lawsuit-induced money grabs and more about governing during a crisis. " NATIONAL SCIENCE FOUNDATION AWARDS GEORGIA TECH PARTNERSHIP $20 MILLION GRANT FOR NEW ENGINEERING RESEARCH CENTER. The Atlanta JournalConstitution (9/12, Stirgus, 1.16M) reports the National Science Foundation awarded a $20 million grant for a "new engineering research center at Georgia Tech that will work closely with several other institutions, such as Emory University and the University of Georgia, and the private sector." The grant comes as Georgia Tech and other state research colleges and univers ities "have raised concerns about possible reductions in research funding by the Trump administration . Leaders of the institutions wrote a joint letter in July to former Georgia congressman Tom Price ..warning him of the potential impact of some cuts to the National Institutes of Health and other biomedical research awards." HHS in the News: RESEARCHERS FIND POTENTIAL LINK BETWEEN FLU SHOT AND MISCARRIAGE EARLY IN PREGNANCY. The Washington Post (9/13, Sun, 10.38M) reports that invest igators "study ing the impact of the flu vaccine in pregnancy have found a possible link between miscarriage early in pregnancy in women who received the flu vaccine two years in a row." Amanda Cohn, senior adviser for vaccines at the Centers for Disease Control and Prevention, which funded the research , said, "I think it's really important for women to understand that this is a possible link, and it is a possible link that needs to be studied and needs to be looked at over more [flu] seasons ." Cohn added, "We need to understand if it's the flu vaccine , or is this a group of women [who happened to receive flu vaccines] who were also more likely to have miscarriages ." The Post adds, "The CDC , the America n College of Obstetricians and Gynecologists and the study authors continue to recommend that pregnant women get a flu vaccine during any stage of pregnancy because of the danger influenza poses to women and their develop ing babies." The AP (9/13) reports that the CDC "has reached out to ...the Amer ican Congress of Obstetricians and Gynecologists to warn them the study is coming out and help them prepare for a potential wave of worry from expectant moms, CDC officials said." The findings were published in Vaccine. STAT (9/13, 43K) also covers the story . FORMER CDC DIRECTOR FRIEDEN DISCUSSES NEW GLOBAL HEAL TH PROJECT FOCUSED ON HEART DISEASE, EPIDEMICS. The Was hingto n Post (9/12, Sun, 10.38M) reports that Tom Frieden , who led the Centers for Disease Control and Prevention for "seven years" under President Obama, is spearheading a new globa l health initiative focused on "cardiovascular disease and epidemics ." The "$225 million initiat ive , called Resolve ...aims to reduce the global burden of heart disease and stroke, the world's leading causes of death," and will assist "low- and middle-income countries fight infect ious disease epidem ics" through improved technology and tra ining. The New York Times (9/12, Belluck, Hoffman, Subscription Publication, 13.56M) provides "a condensed and edited version " of its "conversat ion" with Frieden about the Resolve initiative. In /\MERICAi\ pVERSIGHT EXT-18-248-C-000138 particular, Frieden states he is "focusing on sodium reduction, trans fats and blood pressure control," and says, "Hands down, blood pressure control is the most important thing you can do in health care." The Wall Street Journal (9/12, McKay, Subscription Publication, 6.45M) reports that Frieden will work with the CDC and other organizations worldwide in his effort to improve countries' epidemic response capabilities. The Journal says Frieden's initiative is financially supported by several of the world's most prominent philanthropists, including Michael Bloomberg, Mark Zuckerberg , and Bill and Melinda Gates. Reuters (9/12, Steenhuysen) quotes Frieden as saying , "The Ebola epidemic revealed how vulnerable we are to threats, and was a stark reminder of the human and economic costs caused by the absence of strong public health systems." Resolve's infectious disease "effo rts will focus on building disease tracking systems , laboratory networks and disease detectives" for quick identification of threats. The Huffinqton Post (9/12, Weber, 5.74M) reports that Frieden's goal is to save "100 million lives over 30 years." The Campaign for Tobacco-Free Kids is among a number of organizations Resolve will work with to implement its programs . The article says Dr. Anthony Fauci, the director of the Nationa l Institute of Allergy and Infectious Disease , "has worked with Frieden to address outbreaks" and "said Resolve could have a major positive impact." Fauci "highlighted the initiative's ample resources and having control over an organization without the constraints of governmental bureaucracy," adding, "I'm really looking forward to working with him in the coming years . It'll be interesting to see what we can do when he's on the outside and I'm on the inside." Also covering the story are The Hill (9/12, Bowden , 1.68M), NPR (9/12, Cole, 2.4M), STAT (9/12, Branswell, 43K), the Washington Examiner (9/12, Leonard, 465K), The Guardian (UK) (9/12, Boseley , 3.39M), and the Atlanta Business Chronicle (9/12, Hensley, Subscription Publication, 967K). CDC WARNS EMPLOYEES TO AVOID SPEAKING TO THE MEDIA. The Hill (9/12, Sullivan, 1.68M) reports that the Centers for Disease Control and Prevent ion issued an internal email "warning employees not to talk to reporters unless they are cleared by the communications office." According to the Hill, the email was written by "public affairs officer Jeffrey Lancashire" and read in part, "Effective immed iately and until further notice, any and all correspondence with any member of the news media, regardless of the nature of the inquiry, must be cleared through CDC's Atlanta Communications Office . This correspondence includes everything from formal interview requests to the most basic of data requests." The email was "obtained by Axios." The Atlanta Journal-Constitut ion (9/12, Judd, 1.16M) "Watchdog Blog"also covers the story . PHILIP MORRIS INTERNATIONAL TO GIVE $1 BILLION TO FUND RESEARCH. Bloomberg News (9/13, Mulier, 4.52M) reports that Philip Morris International announced that it will commit around $1 billion to setting up a foundat ion to reduce smoking and research "smoke-free alternatives, measure progress toward eliminating smoking and consider ways to prepare tobacco farmers for reduced demand." PMI has applied to the US Food and Drug Administration for approval to market its IQOS device as a "product that may reduce the risk of smoking-related diseases ." The piece added that Mitch Zeller , director of the FDA's Center for Tobacco Products, will speak at a nicotine conference on Wednesday to introduce the foundation. The Financial Times (9/12, Jack, Subscription Publication, 1.34M) also covers the story. FDA'S 510(K) REVIEW PROCESS FAILS TO FIND MAJOR GLITCHES IN HEALTH SOFTWARE, STUDY FINDS. STAT (9/12, Ross, 43K) reports that a study published in Milbank Quarterly finds "that 11 of the 12 software devices subjected to the highest-risk recalls between 2011 and 2015 went through a streamlined review process, known as 501 (k), that didn't require /\MERICAi\ pVERSIGHT EXT-18-248-C-000139 testing for safety and efficacy, " with the other one "completely exempted from review." The recalls "included life-susta ining equipment such as ventilators and infusion pumps, as well as a clinical decis ion support software used to flag adverse drug events during surgery ." In response, FDA spokesperson Stephanie Caccomo said , "FDA's traditiona l approach to medical devices is not well-su ited to these products . A new pragmatic approach must recogn ize the unique characterist ics of digital health technology and the marketplace for these tools, so we can continue to promote innovation of high-quality , safe , and effective dig ital health devices." FDA INTENDS TO CLOSE ORPHAN DRUG LOOPHOLE ALLOWING COMPANIES TO AVOID TESTING DRUGS FOR CHILDREN. STAT (9/12, Silverman, 43K) reports that Food and Drug Administration Commissioner Dr. Scott Gottlieb acknow ledged that some drug companies are using orphan drug designations "as a way to sidestep other important public health goals set out by Congress ." He said the FDA intends to close a loophole allowing drugmakers who receive an orphan designation to dodge a requirement to study drugs for children , which Gottlieb considers a "loophole that is in direct opposit ion to what Congress intended." HILTZIK: PHARMACEUTICAL LAWSUIT UNDERSCORES PROBLEMS WITH INDUSTRY REGULATIONS. Los Angeles Times (9/12, 4.49M) columnist Michael Hiltzik writes that Allergan's lawsuit against San Diego "compounding" company lmprimis centers on Allergan "trying to close off a compet itive strategy that could cost it customers and money over time." Allergan alleges lmprim is is "creating , patenting, trademarking, marketing and selling standardized , mass-manufactured unapproved new drug ...under the false guise of 'compounding. "' Hiltzik writes that Allergan has pointed to lmprimis as being on the receiving end of "a handful of regulatory initiatives" implemented by the FDA, although lmprimis CEO Mark L. Baum said the lawsuit comes "because we're having success ." Hiltzik observes that Baum has not denied "that his company is market ing drugs wit hout obtain ing FDA approval for them ," but rather "just says FDA approva l isn't necessary for its formu lat ions." Baum said that for some formulations that can be personalized but which stem from three or four original formulas , "we don't need to go through the FDA" for approval. Hiltzik says the suit "underscores the ridiculous complexity of U.S. pharmaceutical regulations, which are full of loopholes and wormholes that can be routinely explo ited by nimble drug companies. " HOUSE, SENATE COMMITTEES REJECT TRUMP'S NIH BUDGET CUTS. GenomeWeb (9/12) reports in continuing coverage that both houses of Congress have rejected President Trump 's proposed 20 percent cut to the NIH budget for fiscal year 2018. The Senate Appropr iations Committee approved a bill last week that allocates NIH $36.1 billion for fiscal year 2018 , wh ile the House Appropriations Committee approved a $35.2 billion budget. Lawmakers also rejected Trump's plan to cut overhead payments from the agency to universities and research institutes. Sen. Roy Blunt Receives Award For Advocating Increased NIH Funding. The St. Louis PostDispatch (9/12, Raasch, 831K) reports Sen. Roy Blunt (R-MO) received the "National Distinguished Advocacy Award" Tuesday by the Amer ican Cancer Society Cancer Action Network, an advocacy arm of the American Cancer Society , for "pushing for increased federal funding for cancer research." The president of the organization giving Blunt the award said he "has made tremendous strides for Missouri and the rest of the nation by cons istently authoring significant annual increases in federa l cancer research funding ." Increased NIH Funding Would Help Cleveland's Health Institutions. The Cleveland Plain Dealer (9/ 12, Koff, 927K) reports the Senate Appropriatio ns Committee last week approved spending $36.1 billion for the NIH next fiscal year, a $2 billion increase over this year's allotment. The funding includes a $169 million increase for the National Cancer Institute. According to the Plain Dealer, the move will help Cleveland-based institut ions with research funding, such as Case Western Reserve University , University Hospitals and the Cleveland Clinic . The NIH "awarded $734.2 million to Ohio universit ies and research centers in 2016 , and $654.7 million so far th is year, with the Cleveland area getting the state's biggest share." /\MERICAi\ pVERSIGHT EXT-18-248-C-000140 OPERA SINGER DISCUSSES HOW MUSIC AFFECTS BRAIN ACTIVITY. The Deseret (UT) News (9/12, Johnson, 381 K) reports opera diva Renee Fleming to ld a large audience as part of a lecture series Monday afternoon that she participated in a study earlier this year at the National Institutes of Health to explore how the brain processes music. The brain scan revealed "that compared to speaking, more areas of the brain were active when Fleming was either singing or imagining that she was singing." During her lecture, Fleming also recalled attending a tense dinner party with NIH Director Francis Collins and Supreme Court Justices Anthony Kennedy, Ruth Bader Ginsburg, and Antonin Scalia two years ago that saw Collins break the ice by taking out a guitar and having an "impromptu sing-along." NIA COMMITTEE ISSUES RECOMMENDATIONS ON ALZHEIMER'S TESTING. The Wall Street Journal (9/12, Wang, Subscription Publication, 6.45M) reports the National Institute on Aging and the Alzheimer's Association recently convened a committee to issue recommendations on how healthcare professionals diagnose Alzheimer's disease. The committee issued a report recommending researchers use tests for biological markers of Alzheimer's such as brain imaging and substances in a patient's cerebrospinal fluid when gathering study participants. Supporters suggest that the recommendations could ensure experimental treatments are tested on the appropriate population, which would promote more effective and meaningful researc h. USPSTF ISSUES NEW DRAFT GUIDELINES FOR CERVICAL CANCER SCREENING. The AP (9/12, Neergaard) reports that cervical cancer screening "isn't one-size-fits-all: Millions of women may soon have to decide between a routine Pap or a newer test that detects if they have a cancer-causing virus." Draft guidelines from the US Preventive Services Task Force (USPSTF) "for the first time say either option is reasonable for certain women - those ages 30 to 65." The USPSTF's proposal would allow these women to "choose an HPV test by itself every five years or a Pap every three years instead." The NPR (9/12, Haelle, 2.4M) "Shots" blog reports that "the draft recommendations update the 2012 USPSTF recommendations." USPSTF OFFERS UPDATED RECOMMENDATIONS SAYING WOMEN CAN CHOOSE PAP SMEAR OR HPV TEST FOR CANCER TESTING . Reuters (9/12, Seaman) reports the US Preventive Services Task Force issued a draft recommendation saying women between the ages of 30 and 65 can choose to undergo a Pap test every three years or a human papillomavirus test every five years. The USPSTF updated its recommendations based on "new evidence," and said the tests "offer a reasonable balance between benefits and harms." The American College of Obstetrician and Gynecologists (AGOG) recommends Pap testing alone or in conjunction with HPV testing, according to Dr. Linus Chuang, professor of obstetrics, gynecology and reproductive science at the Icahn School of Medicine at Mount Sinai in New York. Dr. Chuang said, "I don't think this will make American obstetricians and gynecologists change practice, because they will look at AGOG as gold standard .... But this will challenge it." OKLAHOMA NURSING FACILITY REACHES AGREEMENT WITH HHS OVER DISCRIMINATION CASE. The Oklahoman (9/ 12, Wingerter, 443K) reports HHS' Office for Civil Rights announced on Friday that Heritage Hills Living and Rehab ilitation Center, a McAlester, Oklahoma, nursing facility, has agreed to implement changes after the facility discharged a patient for having HIV. Employees said they were unaware of the discharge, and a news release discussing the matter "offered few details" except that the female patient was very ill at the time of being discharged. OCR director Roger Severino in a news release called the matter "heartwrenching." HHS SAYS ACA DATA NOT COMPROMISED IN EQUIFAX BREACH. Fierce Healthcare (9/12, Sweeney, 146K) reports the data breach at Equifax which involved "143 million people did not include information about consumers that purchased health insurance on the Affordable Care Act marketplaces, according to the Department of Health and Human Services." The article says Equifax has "a $329 million contract with HHS to verify incomes of individuals buying insurance /\MERICAi\ pVERSIGHT EXT-18-248-C-000141 on the exchanges, but an HHS spokesperson told Bloomberg that data was not compromised in the massive data breach ." HOSPITAL GROUPS URGE CMS TO WITHDRAW PROPOSAL TO SLASH 340B MEDICARE DRUG PAYMENTS. Fierce Healthcare (9/12 , MacDo nald, 146K) reports that the Amer ican Hospital Assoc iation (AHA) and 3408 Health wrote a letter to CMS Administrator Seema Verma in opposition to a proposal to cut Medicare drug payments to hospitals under the drug discount program. 3408 Health wrote on behalf of its 1,300 public and private nonprofit hosp ita ls in the program that the proposal would "violate both the 3408 and Medicare statutes " and asked CMS to continue to reimburse hospitals at "6% more than the average sales price" of drugs. The AHA , which represents nearly 5,000 hospitals , expressed similar concerns , saying "CMS lacks statutory authority to impose such a drastic reduction in the payment rate for 3408 drugs, effectively eviscerating the benefits of the program ." On the other hand, the Community Oncology Alliance supports the proposal, pointing out that it will "reduce drug costs for seniors by an est imated $180 million per year" and curb "outrageous hospital abuses" of the program. Health Reform: ALEXANDER INSISTS BIPARTISAN ACA STABILIZATION MEASURE WILL PRESERVE PATIENT PROTECTIONS. USA Today (9/12, Collins, 8.62M) reports that on Tuesday , Sen. Lamar Alexander (R-TN ), chairman of the Senate Health, Education , Labor and Pensions Committee, said a proposal which aims to stabilize ACA marketplaces "would not strip away key patient protections enacted under the Affordable Care Act. " Alexander explained that he wants to preserve "a provision guaranteeing that anyone can buy an insurance policy and other protect ions that bar insurers from rescinding coverage , charging higher rates to patients with preexisting conditions and imposing annual or lifetime limits on health benefits." But he said states must be allowed "more flexibi lity to offer a larger variety of health insurance plans w ith more benefits and payment options. " ALEXANDER ACKNOWLEDGES "SIGNIFICANT DIFFERENCES" BETWEEN OEMS, GOP WORKING ON ACA STABILIZATION MEASURE. The Hill (9/12, Weixel, 1.68M) reports that on Tuesday , Senate Health Comm ittee Chairman Lamar Alexander (R-TN) indicated that Republica ns and Democrats are still not close to "finding a path to a comprom ise bill to stabilize ObamaCare ." He "said Repub licans want to make it easier for states to waive certain coverage protect ions, and Democrats will need to accept such changes if they want fund ing for insurers to help prevent an insurance premium spike ." Alexander warned, "I would caution members that there are still significant differences to deal with. " Modern Healthcare (9/12, Meyer, Subscription Publication , 238K) reports that Alexander and ranking member Sen. Patty Murray (D-WA) "courteously clashed ...over how much freedom Congress should give states to modify the Affordable Care Act's benefit rules in order to make individual coverage more affordab le." In response to Alexander's comments , Murray stated, "It would be deeply disappointing if another partisan debate over Trumpcare erupted and derailed our efforts at this stage." The Washington Examiner (9/12, King, 465K) also quotes Murray as saying , "Democrats will reject any effort to use this discussion as a way to erode the guardrails and protections that so many patients and fam ilies rely on." Fierce Healthcare (9/12, Minemyer, 146K) reports that as the negotiations continue , "Democrats are worried that Republicans' requests might jeopardize their ability to strike a speedy deal." Accord ing to one aide, Republicans seem "to be pulling the negotiations in a more partisan direction from their side by pushing changes that Democrats have made clear from the start they wouldn 't agree to - like rolling back protect ions for patients w ith pre-existing conditio ns." SOME MEMBERS OF CONGRESS SEEK TO SHORE UP ACA MARKETPLACES . Reute rs /\MERICAi\ pVERSIGHT EXT-18-248-C-000142 (9/12, Cornwell} reports that congressional lawmakers were "wrestling with healthcare again on Tuesday , as lawmakers from both parties considered some approaches beyond simply repealing and replacing Obamacare ." The article says this new-found cooperation "appeared unlikely to yield dramatic changes soon , but marked a shift from the long-running , Republican effort to gut 2010's Patient Protection and Affordable Care Act." The piece adds that members of the Senate HELP committee from both parties "want to stabil ize the Obamacare individua l insurance market by protecting its 'cost-sharing subsid ies."' Kaiser Health News (9/12, Bluth) also covers the story . GOP REPORTEDLY AT ODDS ABOUT WHETHER TO STABILIZE OR REPEAL ACA. Politico (9/12, Everett, Haberkorn , 3.6M) reports , "Republicans are paralyzed over what to do about health care, caught between a bipartisan effort to shore up Obamacare and the opportunity to take one last swing at their years-long promise to repeal the law." The article says those leading both efforts have less than three weeks to accomplish their goals, because spec ial "procedural powers for the GOP to repeal the law expire on Sept. 30, and insurance companies desperate for certainty have until Sept. 27 to decide whether to participate in Obamacare markets next year." HATCH CALLS CURRENT EFFORTS TO STABILIZE ACA MARKETPLACES "A BAILOUT." The Hill (9/12, Hellmann, 1.68M) reports that on Tuesday, Senate Finance Committee Chairman Orrin Hatch (R-UT} "derided bipartisan efforts to shore up ObamaCare 's insurance market as a 'bailout. "' He stated , "At th is point, it's pretty clear that the parties will need to work together if any of this is going to improve . That said, I am concerned that many of the proposals for a bipartisan solution wou ld amount to little more than a bailout of the current system," which "would be a mistake ." "LAST-DITCH" ACA REPEAL EFFORT TO BE UNVEILED WEDNESDAY, WITHOUT LEADERSHIP SUPPORT. The Hill (9/12 , Sullivan, 1.68M) reports that on Tuesday , Sens. Bill Cassidy (R-LA) and Lindsey Graham (R-SC) met with Senate Majority Leader Mitch McConnell (R-KY) "to discuss their last-ditch ObamaCare repeal bill." Following the meeting, "Cassidy said the leader's message was that Graham and Cassidy need to find 50 votes for the bill on their own ." The article says the bill "faces long odds ," and party leaders are not endorsing the effort. The piece adds that Cassidy and Graham intend to unveil the measure on Wednesday. The Washington Examiner (9/12, Ferrechio , 465K) reports that Graham and Cassidy will be joined by Sen. Dean Heller (R-NV) and a fourth co-sponsor , Sen. Ron Johnson (R-WI) , when they unveil the bill on Wednesday. The measure "would provide the $1.2 trillion for Obamacare 's Medicaid expansion and tax credits to states in an attempt to get the states to develop their own healthcare programs ." Steve Benen writes in an MSNBC (9/ 12, 7.73M) piece that it appears "the Republican health care crusade has already run its course, " but on Wednesday, "four GOP senators will make one lastditch effort to get it back on track ." He argues that the plan has "profound flaws." Benen adds that while it is not completely "impossible" for the plan to succeed, "even the most ambitious Republicans should concede this is a steep cliff to climb ." Similarly, Dylan Scott writes in a Vox (9/12 , 1.54M) piece that GOP senators who are making one last attempt to repeal the ACA have less than three weeks to accompl ish their task . He adds , 'The path forward is improbably narrow . Almost every seaso ned Washingto n observer believes it can't be done ," however , there is a slight possibility of success . The Baton Rouge (LA) Advocat e (9/ 12, Stole , 72K) and the Daily Inte lligencer (NY) (9/12, Kilgore, 519K) also cover the story . CASSIDY SAYS LATEST EFFORT TO REPEAL ACA 15 NOT SUPPOSED TO BE PARTISAN. The Washington Examiner (9/12, King, 465K) reports that last week , Sen. Bill Cassidy (R-LA) /\MERICAi\ pVERSIGHT EXT-18-248-C-000143 "said a last-dash effort to repeal Obamacare isn't meant to be partisan and that he is reaching out to Democrats." He stated, "We are actually trying to be bipartisan by allowing a blue state and a deep red state come up with a solution that works best for their folks." According to the article, Cassidy said he has asked 10 Democratic senators to support the bill. ANTHEM MULLING EXITS FROM MORE ACA MARKETPLACES. Bloomberg News (9/12, Tracer , Edney, 4.52M) reports that on Tuesday , Anthem, Inc. said it may exit more Affordable Care Act marketplaces "even as U.S. lawmakers debate steps to shore up the health law." The company "is in talks with officials in some states ahead of deadlines later this month to decide whether to sell coverage in 2018, Chief Executive Officer Joseph Swedish said." The article adds that Anthem intends to fully or partially exit nine of the 14 states where it currently offers ACA plans. Reuters (9/12, Humer) reports that according to Swedish, "the company has been reposit ioning itself in states with an eye to re-entering when appropriate if Congress and the White House stabilize the individual markets." TRUMP ADMINISTRATION FUNDING CUTS IMPERIL ACA NAVIGATOR PROGRAMS IN ARIZONA. The Arizona Republic (9/ 12, Alltucker, 968K) reports, "The Trump administration's decision to cut funding for a program that helps people sign up for Affordable Care Act health insurance has left some Arizona organizations facing budget shortfalls, reduced hours and possible layoffs ." The article says HHS has cut funding for ACA navigator programs by more than 40 percent for this fiscal year. This means "two Arizona entities that received navigator grants the Arizona Alliance for Community Health Centers (AACHC) and the University of Arizona don't know if, or how much, they'll receive to pay for these positions during the coming enrollment period." ACA NAVIGATORS IN TENNESSEE RESORTING TO GRASSROOTS METHODS FOLLOWING TRUMP ADMINISTRATION FUNDING CUTS. The Tennessean (9/12, Fletcher, 499K) reports that Affordable Care Act navigators in Tennessee are "devising a last minute, grassroots strategy to let people know when and how they can buy individual health insurance." The article says that in the last four years, "national TV ads have beamed enrollment dates," but with "the federal budget slashed from $100 million to $10 million ," navigators are turning to alternative ways, such as Facebook, local newspapers, and community bulletin boards, to spread the word about open enrollment. BCBS OF ILLINOIS SMALL BUSINESS PLAN WILL NOT BE OFFERED THROUGH THE ACA EXCHANGE IN 2018. The Chicago Sun-Times (9/12, Armentrout, 742K) reports, "Blue Cross and Blue Shield of Illinois will no longer offer group plans for small businesses through the Affordable Care Act health insurance exchange, the company announced this week." Modern Healthcare (9/12, Schorsch, Subscription Publication, 238K) reports that small businesses with a Blue Cross & Blue Shield of Illinois plan purchased through the ACA exchange will have to look for alternatives, because that plan will not be offered in 2018. The article says this means small businesses in Illinois will have only one other option: Health Alliance. The piece adds that "the so-called Small Business Health Options Program, or SHOP, where small businesses nationwide can buy coverage on the federally -run online marketplace HealthCare.gov, never gained steam for a host of reasons." INSURERS TELL LAWMAKERS HOW TO STABILIZE ACA MARKETPLACES DURING SENATE COMMITTEE HEARING. Carolyn Y. Johnson writes in the Washington Post (9/12, 10.38M) "The Health 202" that insurers are testifying before the Senate Health , Education, Labor and Pensions Committee, and it is these "compa nies that will truly determine the success or failure of the Obamacare exchanges by providing the plans and health coverage choices for millions of Americans." She adds that "insurers are going on the record with lawmakers. And they have their own demands and deadlines following the failure of the Repub lican-led Congress to /\MERICAi\ pVERSIGHT EXT-18-248-C-000144 pass its repea l-and-replace plan ." SANDERS COULD FRAME SINGLE-PAYER PLAN AS LITMUS TEST OR STARTING POINT. Jonathan Cohn writes fo r the Huffington Post (9/12, Cohn , 5.74M) that Sen. Bernie Sanders (1Vt.) will unveil a new version of his "Medicare-for-all" proposal on Wednesday , which he could present as "a litmus test" that "Democrats pledge fealty to" or "he could present...more as a concept , someth ing he expects progressives to spend the next few years refining." Cohn writes that if Sanders presents his bill as a finished product, Democrats "would need to explain how they intend for this transition to work " and how to mitigate the negative effects . As a starting point, Sanders could emphasize that a conversat ion "will take place among politicians and activ ists and wonks over the course of many years ." WITHOUT CMS DECISION, IOWA INSURANCE COMMISSIONER "LESS OPTIMISTIC" ABOUT ACA STOPGAP PLAN. The AP (9/12, Rodriguez) reports Iowa Insurance Comm issioner Doug Ommen to ld state lawmakers on Tuesday that he is "less optimistic" the Centers for Medicare and Medicaid Services will approve a stopgap measure for the state's individual insurance market to lower some people's premiums. Ommen "indicated he had expected a decision amid a loom ing deadline on open enro llment for ACA coverage." The plan, first submitted in June and final ized last month, wou ld be in effect for 2018 and "also develops a program to help carriers with high-cost patients ." The Des Moines (IA) Register (9/12, Leys , 324K) quotes Ommen as test ifying that he is hopeful CMS official will approve the plan, saying, "If they don't, we will be in much worse shape next year ." The article says Medica has proposed raising premiums by 58 percent for individual health insurance plans in Iowa next year and Ommen told legislators that Wellmark Blue Cross & Blue Shield "has told him it would propose 2018 rates that would be about half of Medica's if federal officials approve Iowa's 'stopgap ' proposal." Without the proposed changes , Wellmark has indicated it would stop selling new policies next year. INSURER DEPARTURES COULD LEAVE 70,000 VIRGINIANS WITHOUT INDIVIDUAL COVERAGE OPTIONS IN 2018. The Roanoke (VA) Times (9/ 12, Rife, 176K) reports that the Affordable Care Act exchange "is collapsing in Virginia" with the exit of Optima Health "leaving about 70 ,000 people without the ability to purchase health insurance for 2018." Virg inia Secretary of Health Bill Hazel said Tuesday that Washington had created this crisis. 'They are the ones who have to fix it," he said. "Our hands are all but tied." The article notes that Aetna and Anthem left the marketplace this spring. HHS IG REPORT SAYS REMAINING ACA CO-OPS NOT FINANCIALLY VIABLE. The Daily Caller (9/12, Pollock, Barton , 521 K) reports the remaining six nonprofit health insurance co-ops established under the Affordab le Care Act do not "appear to be financially viable and susta inable ," according to the Department of Health and Human Services Inspector Genera l. The six remaining co-ops "reported net losses and had drawn down nearly all ava ilable CO-OP loan amounts as of December 31, 2016" and "Medical claims costs exceeded premiums for three of the six CO-OPs," the report said. The article notes that the Centers for Medicare & Medicaid Services placed 10 of the 11 co-ops on "corrective act ion" or "enhanced overs ight plans" in 2015 and 2016 , and the IG report says oversight "did not prevent the CO-OPs from ceasing or planning to cease operatio ns." HANDEL OVERSTATES ACA TAX IMPACT. The Atlanta Journal-Co nstit ution (9/12 , Greenberg , 1.16M) fact-checks the claim by newly elected Rep. Karen Handel (R-GA) that the Affordable Care Act "is the single largest tax increase in my lifetime history. You can't repair a tax . You have to repeal it." The article rates the claim as false because, since Handel was born in 1962, six of 28 tax increases examined were higher relative to the size of the economy. VIRGINIA LT. GOV. CANDIDATE SUPPORTS SINGLE PAYER HEALTHCARE . The Newport News (VA ) Daily Press (9/12, Ress, Subscription Publication, 170K) reports Justin Fairfax , thee /\MERICAi\ pVERSIGHT EXT-18-248-C-000145 Democratic candidate for lieutenant governor of Virginia supports the Affordable Care Act, Medicaid expansion, and favors "Medicare for all." The article highlights the limited power of the office to implement any such policies, but says that lieutenant governors should "take a position on state legislative issues on which there's a chance they'd be a tiebreaking vote," although the General Assembly is "adamantly opposed." HATCH WARNS AGAINST ACA "BAILOUT" AMID HEALTHCARE REFORM NEGOTIATIONS. The Deseret (UT) News (9/12, 381 K) reports Sen. Orrin Hatch "decried" potential healthcare legislation that would provide a "bailout" for the Affordable Care Act. Hatch said Tuesday "its pretty clear that the parties will need to work together," but "many of the proposals for a bipartisan solution would amount to little more than a bailout of the current system." Hatch also said Tuesday that he wants lawmakers to curb individual and employer mandates. COMMENTARY CONSIDERS HEALTH REFORM. Several outlets offer opinions on health reform. The New York Times (9/13, Subscription Publicat ion, 13.56M) says in an editorial that "President Trump clearly inherited an economy on the upswing," but it remains to be seen "whether his administration and the Republican-controlled Congress will sustain the momentum, or even reverse it." The Times explains that despite the economy's improvement, "broad prosperity remains elusive," and "Republican policy makers seem determined to undo the progress that has been made." The Times adds that new Census Bureau data show "the ranks of the uninsured fell last year by 900,000 people, to an all-time low of 8.8 percent of the population. The decline is a result of the Affordable Care Act." William A. Galston writes for the Wall Street Journal (9/12, Subscription Publication, 6.45M) spotlighting Vermont Gov. Peter Shumlin's failed attempt to shift his state to a single-payer healthcare system. Despite successfully campaigning on the issue, Shumlin never persuaded a majority and the economic costs were projected to be too high. Galston frames the case as a cautionary one for Democratic presidential aspirants endorsing Sen. Bernie Sanders ' national single-payer plan. Adjunct professor of Internal Medicine at the University of Utah, Margaret Battin, writes for TIME (9/12, 5.85M) that the Veterans Affairs healthcare system offers a model for a "comprehensive, universal, effective and cheap" civilian healthcare system. Battin outlines the approach, which was first proposed a decade ago by public policy expert Phillip Longman . In an editorial, the Los Angeles Times (9/12, 4.49M) writes that Senate Republicans should "stop flirting with yet another partisan proposal to 'repeal and replace' the Affordable Care Act, and start focusing instead on steps to make coverage more affordable." The Times calls a proposal floated by Sens. Bill Cassidy (R-LA), Lindsey Graham (R-SC), and Dean Heller (R-NV) "irresponsible" as the Senate Health, Education , Labor, and Pensions Committee works toward a bipartisan fix. The Los Ange les Times (9/12, 4.49M) editorializes that Medi-Cal provider directories are unnecessary wastes of paper. Three California health plans have asked the California Department of Health Care Services for permission to take advantage of a new federal rule allowing them to stop automatically sending the phonebook-sized directories, but they "are still waiting for approval," which the Times says "seems like a no-brainier." Robert Pearl writes for Forbes (9/12, 5.11 M) recapping the ongoing debate over the Affordable Care Act, framing it as "more like a Shakespearean play than a matter of policy." In his description, Pearl writes "this production features three acts, several twists, and an ending that will likely prove predictable only in retrospect." Faris Harton, president of the Southeastern NC Central Labor Council, writes for the Wilmington /\MERICAi\ pVERSIGHT EXT-18-248-C-000146 (NC) Star News (9/12, 138K) that "when Americans understand that the prohibitive cost of health care is due to the inefficiency of our for-profit system itself," they will demand a single-payer Medicare-for-all system . Harton says that "over 25 percent of our health care dollars go to administrative costs" while other costs stem from "outrageous salaries and benefits of medical insurance and pharmaceut ical industry CE Os and other top execut ives." Lori Lodes, former director of the office of commun ications for the Centers for Medicare & Medicaid Services , writes for Vox (9/12, 1.54M) that the Trump Administrat ion's "decision to cut funding for advertising and in-person assistance " is "is nothing less than sabotage." Lodes writes that "vague awareness that the ACA exists is a lot different from knowing how to enroll ," and "in truth most peop le don't know the open enrollment dates , and they don't know that the deadline this year is December 15 - not January 31, like last year." Politico Magazine (9/12, 3.55M) contributing editor Bill Scher writes that wr ites that in addition to Sen . Kirsten Gillibrand , other potential 2020 candidates including Sens. Cory Booker , Kamala Harris, Jeff Merkley, and Elizabeth Warren "have signed on" to Sanders' bill. The Democratic Party is now "the party of single-payer health insurance. Big mistake." Democrats, Sher argues , are "committing themselves to years more of treacherous health care debate , at a time when there are more pressing issues to confront, " and they are "emulating Donald Trump's penchant for quick-fix, bumper-sticker solutions that prove to be, in his own words , more 'complicated' once in power." Tyler Cowen writes for Bloomberg View (9/12, 4 .52M) that the major Democratic presidential candidates for 2020 "will end up endors ing some version of single-payer health care, " but an "obvious problem" is that "most people with private health insurance are pretty happy with their current arrangements ." Cowen says that single-payer systems in Europe and As ia "were instituted while health-care costs were still fairly low, and then kept down by government fiat ," but the US is not in such a position. Sowen also argues that "the Medicare for All movement is more about easing everyone 's access and boosting the usage of health-care resources," not reducing use as in other single-payer systems. Ken Herman , president of medical technology company Smith & Nephew, writes for the Austin (TX ) American Statesman (9/12, Subscription Publication, 431K) that Congress "should seize the existing opportun ity to score a bipart isan legislative victory - for patients, jobs and innovation by permanently repealing the jobs-killing medica l dev ice excise tax" enacted under the Affordable Care Act. The 2.3-percent tax on medical devices has meant "less capital was available to invest in growing our business and developing the next generation of pioneering advanced medical devices." If Congress doesn't act, medical technology companies "will be hit with a $20 billion tax increase at the end of the year. " Diamond Naga Siu writes for Politico (9/12, 3.6M) that the Democratic Socialists of America finds itself with "unprecedented political potential ," but it is "struggling with an identity crisis as members scrap over whether to focus on national or local issues." The organization grew fivefold with Sen . Bernie Sanders ' "meteoric " rise as "a self-descr ibed democrat ic socialist," but the growth in recent years "still amounts to only 25,000 members total." Wh ile many members want to focus at the loca l level, "others see a rare opportunity to leverage the Sanders wave and its existing power at the local level to influence nationa l politics , namely the health care debate. " Dr. Dana Goldman, is director of the Leonard D. Schaeffer Center for Health Policy & Economics at the University of Southern California, writes for STAT (9/12, 43K) that Sen. Bernie Sanders' universal healthcare bill set to be released Wednesday is "bold and simple" but "only gets it half right." Goldman warns that turning Medicare into a single-payer system would supplant private insurers at "an enormous price tag," arguing that "universal catastrophic coverage" is a better way that "borrows from both progressive and conservative playbooks." Goldman explains that from the perspective of insurers, "the new system would look like Medicare's prescription drug plan." /\MERICAi\ pVERSIGHT EXT-18-248-C-000147 Opioid News: OPINION: THERE IS NO SIMPLE POLICY SOLUTION TO THE OPIOID CRISIS. Two professors of economics at Princeton University , Anne Case and Angus Deaton, write in the Washington Post (9/12, 10.38M) that there is no "simple policy solution" to the opioid epidemic. They make four points about the crisis to "correct the record." First, Medicaid is neither the problem nor the solution. Second, even if opioids are better controlled, there would still be deaths from suicide and liver diseases because of the "underlying depression," arguing opioids "are like guns handed out in a suicide ward ." Third , the crisis has hit both men and women equally and fourth , it is not one for rural Americans alone . They conclude that the "long-run solution" is "higher wages and better jobs for working peop le" and that is a ''far more difficult goal to attain ." MOST AMERICANS PREFER NON-DRUG PAIN TREATMENT , ARE AWARE OF OPIOIDS' DANGERS, SURVEY SUGGESTS. TIME (9/12, Sifferlin, 5.85M) reports that a new survey of "about 6,300 adults " showed that "nearly two thirds" indicated suffering "neck or back pain so great they sought a health care provider for relief, and 54% said they had neck or back pain for at least five years ." However, "78% said they preferred to try" alternative methods of pain management "before taking drugs." The study's authors wrote that the "findings suggest that Amer icans are aware of the dangers associated with opioid misuse and are open to drug-free alternatives for pain management ," adding , "These deve lopments could be a sign of a future where patients and healthcare professionals alike are trying drug-free treatment options before relying on opioids. " REP. WALDEN CALLS ON CONGRESS TO BOOST EFFORTS AGAINST OPIOID CRISIS. The Hill (9/ 12, Roubein, 1.68M) reports that House Energy and Commerce Committee chairman Rep. Greg Walden (R-OR) "wrote in a Morning Consult op-ed published Tuesday" that "it is of utmost importa nce we in Congress kick our work into high gear" to stem the opioid epidemic. The article says the committee will hold an opioid crisis hearing "the week of Oct. 23" where "lawmakers will receive an update on the implementation of the Comprehensive Addiction and Recovery Act," and "agency officials helping address the epidemic at the federa l level will also provide an update on their efforts ." BLOG: TREAT OPIOID ADDICTION LIKE HOSPITAL-ACQUIRED ILLNESSES . Paige Minemyer writes for the Fierce Healthcare (9/12, Minemyer , 146K) that "hospitals must treat add iction like other hosp ita l-acquired conditions" in order to better address the opioid crisis. Minemyer says multiple physicians recently contributed to a Health Affa irs blog post stating that "hospitals and health systems will need to mobilize resources much like they did to improve antibiotic stewardship to reduce opioid overprescribing and change the approach to pain management. " The blog post also offers several "steps hosp ita l leaders can follow to change the conversation around opioids. " COLUMN: BETTER DATA NEEDED TO MEASURE TRUE EXTENT OF OPIOID EPIDEMIC . In his "Quick Study" column, Evan Horowitz of the Boston Globe (9/12, Horowitz , 969K) writes that death statistics are a flawed measure of the extent of the opioid crisis . For example , Horowitz says more individuals are surviving overdoses because of "the wide deployment of naloxone ," which "in theory" could "lower the opioid-related death rate even if heroin and fentany l are still expanding their reach." Horowitz concludes that to better "address the addiction crisis , we need timely, reliable information that reaches beyond mortality ." SENATE COMMITTEE EXAMINES MARKETING PRACTICES OF OPIOID COMPANIES AT HEARING. The Philadelphia Inquirer (9/12, Sapatkin , 1.71M) reports on a Senate Homeland Security and Governmenta l Affairs Committee hearing on Tuesday on the marketing practices of the pharmaceut ical industry in connection with opioids . The committee released a report last week entitled "Fueling an Epidemic: lnsys Therape utics and the Systemic Manipulation of Prior Authorizat ion" examining the behavior of lnsys Therapeutics , wh ich made an opioid believed to have played a role in the death of a Philadelphia-area woman last year . Her mother and others /\MERICAi\ pVERSIGHT EXT-18-248-C-000148 affected by the opioid crisis testified at the hearing . OPINION : PRESIDENT TRUMP "DITHERS " ON OPIOID EMERGENCY . Renee Graham writes in the Boston Globe (9/12, Graham, 969K) that a month after announcing that he would declare the opioid crises "a national emergency, " President "Trump 's actions don't reflect this issue's gravity. " Specifically , Graham points out that Trump has yet to "officially declare" the national emergency , but has "found time to pardon racist former Arizona sheriff Joe Arpaio; threaten with deportation undocumented immigrants brought to this country as chi ldren ; and move to ban transgender men and women from serving in the military." Graham concludes , "If there's a plan, he needs to unveil it; meanwhi le, as Trump dithers , people die, families mourn, and communities buckle under the weight of add iction and the agony of its government's inexplicab le inaction." Healthcare News: CENTENE TO BUY NEW YORK 'S FIDELi$ CARE FOR $3.75 BILLION . The Wall Street Journal (9/12, Mathews, Aremental , Subscription Publication , 6.45M) reports that Centene Corp. announced Tuesday that it will buy nonprofit health insurer Fidelis Care in a $3.75 billion deal. The deal adds 1.6 million members in New York to Centene . Centene is a leader in Medicaid managed care business and Medicare , and is also active in Affordable Care Act exchange plans. The deal is expected to close in the first quarte r, accord ing to the Journal. Reuters (9/12 , Mukhopadhyay) reports that Centene said the deal "would significant ly improve the company's earn ings per share" and its stock rose 6.7 percent in aftermarket trading on Tuesday . Forbes (9/12, Japsen, 5.11M) reports that unlike its competitors Aetna , Anthem , UnitedHealth Group, and Humana, Centene is expanding into new markets and "has been able to successfully manage the costs of sick uninsured Americans buying individual policies on the ACA's public exchanges." Centene had nearly 1.1 million customers enrolled in ACA marketplaces as of June 30 this year, compared to 617,700 at this time last year. Fidelis, the article says, is "an established player in New York 's Obamacare, Medicaid and Medicare Advantage markets ." Fierce Healthcare (9/12, Small , 146K) reports that Centene's CEO Michael Neidorff said, "Centene 's entrance into the state of New York marks a significant step in our strategy to continue to be the national leader in government-sponsored healthcare ," and , when completed, Centene will have a "leadership position " in the US' four largest managed care states: California , Flor ida, Texas , and New York. Buffalo (NY) Business First (9/12 , Drury, Subscription Publication, 839K) reports that the sale will also result in the "creation of a private charitable foundat ion that will be focused solely on New York and centered on the health and welfare of poor, low-income, elderly, disabled and underserved individ uals and families throughout New York state." Modern Healthcare (9/12, Livingston, Subscription Publication, 238K) also covers the story . OHIO SUPREME COURT HEARS AR GUMENTS ON STATE 'S EFFORT TO CLOSE ABORTION CLINIC. In continuing coverage, the AP (9/12) reports that the Ohio Supreme Court on Tuesday heard arguments in a dispute over "the state Health Department's order to shut down Toledo 's last abortion clinic ." The health department ordered the clinic to close in 2014 because it "didn't have a patient-transfer agreement with a local hospital," as mandated by "restrictions Ohio lawmakers passed in 2013." The clinic , however, "sued and won in the lower courts, " and has been permitted "to continue operating as the legal dispute" continues. LAWYE RS PETITION TRUMP AD MINISTRATION TO PROTECT PRO-LIFE CLINICS FORCED TO "PROMO TE ABORT ION " UNDER STATE LAWS . The Washington Times (9/12, Richardson , 541 K) reports that attorneys for the Alliance Defending Freedom filed a comp laint on /\MERICAi\ pVERSIGHT EXT-18-248-C-000149 Monday with the US Department of Health and Human Services "asking the agency to protect the free speech rights of pro-life doctors and women 's health clinics" from state laws which they say are "trying to force them to promote abort ion." Laws in Illinois and Hawaii require pro-life physicians and pregnancy centers to "tell their patie nts about the ava ilability of state-spo nsored abortions" or to post signs in their offices directing patients to a state agency that provides abortion referrals. The petition argues that such laws violate federal law and the US Constitut ion. Human Services News: TEXAS, FOSTER-CARE PROVIDERS EVACUATED, MONITORED FOSTER CHILDREN DURING HARVEY. The AP (9/12, Garrett) reports Texas Child Protective Services announced on Monday that Hurricane Harvey fo rced them to "evacuate more than 400 foste r kids in institutions ... and, probably, hundreds more who lived in foste r homes along the Gulf coast." Accord ing to the AP , "CPS workers in about 55 affected count ies made timely initial checks on nearly 96 percent of youngsters named in child maltreatment tips of the most serious kind between the night of Aug. 24 , just before Harvey made landfall, and Monday," DHHS RESPONDS TO MAINE LAWMAKERS' QUESTIONS ABOUT TREATMENT OF DISABLED ADULTS. The Portland (ME) Press Herald (9/12, Gallagher, 191K) reports that the Maine Department of Health and Human Services sent a 21-page written response on Tuesday to the Legislature's Health and Human Services Committee seeking details about a "recent federal audit that found the department failed to proper ly report and monitor incidents involving abuse or deaths of disabled people in the care of community -based providers. " Among others, the committee had asked why the agency had failed to invest igate the deaths of 133 disabled adults according to the report by the Office of Inspector General of the US Department of Health and Human Services released on August 10. The committee plans to release the letter after its members reviewed it , either late Tuesday or on Wednesday . Medicare: HEALTHCARE PROVIDERS AT ODDS OVER CMS PROPOSAL FOR JOINT REPLACEMENTS AT SURGICAL CENTERS. Modern Healthcare (9/12, Dickson, Subscription Publication, 238K) reports that healthcare providers take both sides of a CMS proposal that would allow surgical centers to perform knee replacements. Some in the medical commun ity contend that the proposal could put patient safety at risk because Medicare beneficiar ies tend to be older and sicker than non-Medicare beneficiaries - nearly 50 percent of them "live with four or more chronic conditio ns." On the other hand , those in favor of the proposa l say "not all Medicare beneficiaries need the leve l of care provided at acute-care hospitals following a joint replacement " and outpatient settings may be a less costly alternative. CMS is expected to release the final 2018 outpatient pay rule in November . PROVIDER, HEAL TH IT GROUPS ASK CMS TO WAIVE RESTRICTIONS ON TELEHEAL TH. Fierce Healthcare (9/12, Sweeney , 146K) reports provide r and health IT groups "are gene rally pleased with a proposal issued by federal officials to expand Medicare coverage for telehealth services under the 2018 physician fee schedule, but severa l are pushing for even more flexib ility to integrate connected health technology ." In comments subm itted to the agency , the American Medical Association and Healthcare Information and Management Systems Society (HIMSS) "say CMS can do more to remove payment restrictions. " In particu lar, AMA "wants CMS to utilize its waiver authority to provide better care at a lower cost and raised concerns that the proposed codes for remote monitoring were too general." OHIO'S SUMMACARE, UNIVERSITY HOSPITALS AGREE TO CO-BRAND MEDICARE MANAGED-CARE PLANS. The Akron (OH) Beacon Journal (9/12, Lin-Fisher, 235K) reports that SummaCare w ill add the University Hospitals name to its Medicare managed-care plans, so that the plans will be known as University Hospitals Medicare Advantage from SummaCare. /\MERICAi\ pVERSIGHT EXT-18-248-C-000150 SummaCare is the largest Medicare managed-care insurer in Summ it County and "has room to grow " in other counties . The co-brandi ng is seen as a way for the Akron-based insurer to grow its network in Portage, Cuyahoga , Geauga , and Lorain County where the Cleveland-based University Hospitals health system has hospitals . Financial terms of the deal were not disclosed . Medicaid & CHIP: SENATORS STRIKE DEAL TO EXTEND CHIP PROGRAM . The New Yo rk Times (9/12, Pear, Subscr iption Publication , 13.56M) reports top senators on the Senate Finance Committee announced on Tuesday night "that they had reached agreement on a plan to prevent the imminent exhaustion of federal funds for the Children 's Health Insurance Program," wh ich is set to expire at the end of th is month . Finance Committee Chairman Orrin G . Hatch and ranking Democrat Ron Wyden struck an agreement that would funds the program for five additio nal years . Reuters (9/12 , Beech) reports that in a statement Hatch said, "I am hopeful we can move forward swiftly to ensure no lapse in care for our nation's most vulnerable children, " calling the agreement "a good first start." The AP (9/12, Fram) reports the program "provides health coverage to around 8 million lowincome children and pregnant women" and is "a wide ly supported initiative." The Hill (9/12, We ixel , 1.68M) , Politico (9/12, Pradhan, 3.6M), and the Wash ington Exam iner (9/12, King, 465K) also report. OPINION: BLAMING MEDICAID FOR THE OPIOID CRISIS MAY BE WRONG. Aaron Carroll , professor of pediatrics at Indiana University School of Medicine , and health economist Austin Frakt challenge the theory that Medicaid expansion is "fueling" the opioid crisis in an op-ed in the New York Times (9/12, Subscription Publication , 13.56M). They argue that it may be "conven ient" argument for opponents of the Affordable Care Act , but "substantial evidence" suggests that it is not true . They cite the Department of Health and Human Service 's statement which says, "Correlation does not necessar ily prove causation ," and examine research showing that opioid use was already on the rise before Medicaid expansio n. They also argue that the rising opioid use may have caused states to expand Medicaid, rather than the ot her way around . The autho rs conclude , "To use a theoretical Medicaid-opioid connection (for which the evidence is weak anyway) to justify scaling back Medicaid ignores the larger picture - that it is a crucial aspect of our safety net, providing access to health care and financial protection that many low-income Amer icans could not otherwise obtain. " ANALYSIS: TRUMP CONTINUES FUNDING OF PLANNED PARENTHOOD BY SIGNING CONTINUING RESOLUTION. The Daily Caller (9/ 12, Carr, 521K) reports that by signing the continuing resolution on Friday, President Trump contin ued current funding of Planned Parenthood until at least December 8, despite his promises to the contrary during the campaign . The Daily Caller adds that the Administration did "stop all fu nding to abortion providers via Medicaid and Title X programs" and has said that Trump 's budget will prohibit funding for entit ies that provide abortions , including Planned Parenthood. OPINION: EXPANDING MEDICAID IN MAINE WILL HELP HOSPITALS, ECONOMY. James Myall writes in the Portland (ME) Press Herald (9/12, 191K) that the ballot measure to expand Medicaid will help more than 70,000 low-income Mainers working in low-wage jobs get access to affordable healthcare. Myall criticizes Maine Gov. Paul LePage (R) and his "series of false or misleading statements " opposed to expansion. He argues that expansion w ill provide over $500 million in new federal funds every year to the state's hospitals and health centers, and concludes that the "evidence is overwhelming ly in favor of Medicaid expansion , so opponents rely on alternative facts, distortions and misrepresentations . It won't work ." /\MERICAi\ pVERSIGHT EXT-18-248-C-000151 CANDIDATE FOR COLORADO GOVERNOR PROPOSES MEDICAID-FOR-ALL HEALTHCARE PLAN. The Denver Post (9/12, Frank, 817K) reports that Colorado gubernatorial candidate Cary Kennedy is proposing a "Medicaid-for-all" healthcare system for Colorado . Under the proposal, anyone on the individual market could j oin the Medicaid system or the state employee healthcare plan. Those individuals would "pay the full cost of their coverage with premiums" but she could not provide what that estimated cost would be. The piece adds that other states are considering similar plans, like Nevada which passed a Medicaid-for-all bill this year but it was vetoed by the governor. The Post also discusses the plans of other contenders as well as criticisms from Repub licans who want to reduce the size of Medicaid. ARIZONA SUPREME COURT TO DECIDE MEDICAID EXPANSION CASE. The AP (9/ 12) reports that the Arizona Supreme Court will hear a challenge from Republican lawmakers to the Medicaid expansion who argue that a hospital assessment that pays the state costs is unconstitutional. The lawmakers say the assessment is a tax that requires a two-thirds supermajority to pass. Both the trial court and the court of appeals held the hospital assessment to be constitutional, ruling against the Republican state lawmakers who are represented by the Goldwater Institute. OP-ED: MEDICAID EXPANSION COULD HELP THE HOMELESS. Public health student Stephanie Burdick writes in an op-ed in the Deseret (UT) News (9/12, 381 K) that "Medicaid expansion can provide the much-needed funding and affordable health care to address the needs of our homeless friends and the tens of thousands of other low-income Utahns left uninsured ." Burdick discusses five ways Medicaid expansion can help, includ ing increasing access to primary care providers and treatment for mental health and opioid abuse . Health & Medical News: SEN. MCCAIN TO RECEIVE BRAIN CANCER TREATMENT AT NIH WHILE CONTINUING SENATE WORK. The Wash ington Post (9/12, Sullivan, 10.38M) "PowerPost " reports Sen. John McCain (R-AZ) will undergo treatment for brain cancer at the National Institutes of Health as he continues to attend to his duties in the Senate, his office said Tuesday . In a statement, his office said McCain received an MRI at the NIH in Bethesda on Monday . "Following the advice of his doctors , Senator McCain will continue to receive targeted radiation and chemotherapy treatments at NIH while maintain ing a regular work schedule in the United States Senate ," the statement said . The AP (9/12) reports the 81-year-old senator "disclosed his diagnosis in July , and returned home for treatme nt after casting the decisive vote to kill Republican legislation to repeal and replace the Obama health law." McCain said in a weekend CNN interview that he is confident about defeat ing brain cancer, but also said , "Every life has to end one way or another. " Also covering this story are USA Today (9/12, Estepa, 8.62M), CBS News (9/ 12, 4.42M), Arizona Republic (9/12, 968K), The Hill (9/12, Carney, 1.68M), Roll Call (9/12, Williams, 134K), and Washington Examiner (9/12, 465K). MENOPAUSAL HORMONE THERAPY DRUGS APPEAR NOT TO INCREASE RISK OF PREMATURE DEATH, RESEARCHERS SAY. In "Well," the New York Times (9/ 12, Bakalar , Subscription Publication , 13.56M) reports , "The largest and longest clinical trials to date of menopausa l hormone therapy have found that the drugs do not increase the risk of premature death ," researchers reported. In the Journal of the American Medical Association , Endocrine Society member and study lead author JoAnn E. Manson , MD, DrPH, FACE, "chief of the division of preventive medicine at Brigham and Women's Hospital ," and colleagues "reported the results of two randomized trials ." In one trial , "16,608 women took either a placebo or a combination of estrogen and progesterone for an average of 5.6 years ." In the second trial "10,739 women took either a placebo or estrogen alone for an average of 7.2 years . The women were 50 to 79 years old ." /\MERICAi\ pVERSIGHT EXT-18-248-C-000152 NBC Nigh tly News (9/12, story 7, 2:05, Holt, 16 .61 M) NBC : Menopause-Hormone T herapy Safety . (story 7, 2:05 Ho lt 09/12) reports that the study concludes that "women who choose" hormone therapy drugs "are no more likely to die years later than those who do not. " T he AP (9/12, Tan ner) reports, 'The new resu lts are reassuring and support current advice: Hormones may be appropr iate for some women when used short-term to relieve hot flashes and other bothersome menopause symptoms," the study concluded . Dr . Manson said, "It's the ultimate bottom line." When a pat ient wants "to know ' is th is medication going to kill me ' ...the answer appears to be no , she said ." According to MedPage Toda y (9/12, Minerd , 60K), the author of an accompanying editorial (9/12 , 745K) wrote , "This information will be he lpfu l in counse ling women considering whet her to start ho rmone therapy and hopefully will alleviate concerns that many patients and physicians have about the initiation of hormone therapy ." T he study received its funding from the National Institutes of Health . Also covering the story are Reuters (9/12, Rapaport), Los Angeles Times (9/12, Hea ly, 4.49M) and TIME (9/12, Park, 5 .85M), TODAY (9/12 , Fox , S ilverman, 1.25M) . NEW TEXAS SCHOOL BUSES REQUIRED TO HAVE SEAT BELTS. The Dallas Morn ing News (9/12, Email , 984K) reports that as of this month , all 2018 and later mode l schoo l buses in Texas must be equipped with "three-po int" shoulder lap belts for each passenger . School districts may opt of the requirement, but on ly afte r conducting an open vo te follow ing a public hearing . T he Amer ican Academy of Pediatrics and Nat iona l Safety Counc il have "long endorsed seat belts in school buses ." The National Highway Safety Traffic Associa tion, "in a bellwether sw itc h," also endorsed seat belts on buses in late 2015 . EXTENDED BREASTFEEDING CAN HELP PREVENT ENDOMETRIOSIS . Reute rs (9/12 , Harding) reports in cont inuing coverage that a new st udy suggests women who nurse their babies are less likely to develop to endometriosis. The longer they breastfeed , the study found , the lower the risk. Study co-author Dr. Les lie V. Farland of Harvard Med ical School said, "For women who are interested in reducing the ir risk for endometriosis , breastfeeding is one potential modifiable way that women can reduce their risk ." SHULKIN: CANINE RESEARCH PROGRAM BENEFITS VETERANS, NEEDS SENATE'S PRESERVATION . U.S . Secretary of Veterans Affairs David J. Shulkin writes in a USA Today (9/12, 8 .62M) op-ed that legis lation recently tacked on "to an unre lated spending bill passed by the House of Representatives would el iminate " the VA 's "canine research program ." Shulkin says the legislation , if approved by the Senate , "wou ld stop potential VA canine research-related medica l advancements that offer ser iously disab led veterans the hope of a better future." Shu lkin calls on the Senate to "take a stand and preserve humane and carefully supervised can ine research at VA. " The Wa shingt on Exam iner (9/12, Kasperowicz, 465K) reports that the "language banning most dog testing at the VA passed in an easy voice vote in the House , but opposition to it has grown since then ." T he article says the Senate 's vote could take place "in the coming weeks ." PENNSYLVANIA SE NATOR ASKS MARIJUANA G ROWER TO RESCIND LAWSUIT OVER STAT E'S PERMIT AWARDS. The Pittsbu rgh Tr ibun e-R eview (9/12 , Schm itt , 236K) reports that marijuana grower Keystone ReLeaf LLC fi led a lawsuit against Pennsylvan ia on Friday after the company fa iled to win a permit "to grow and process marijuana in the state." Keystone ReLeaf alleges "bias and favoritism " in the state 's permit selections and "has asked the court to rescind all awarded perm its and start again from scratch." State Sen. Daylin Leach wrote a letter asking the company to withdraw its case, say ing, "If the entire program is delayed , people will be forced to needlessly endure excruciat ing pain , agony, and , in some cases, death. " /\MERICAi\ pVERSIGHT EXT-18-248-C-000153 HEALTHCARE INDUSTRY INTRIGUED BY DIAGNOSTIC POTENTIAL OF ARTIFICIAL INTELLIGENCE. The Wall Street Journal (9/12, Parmar , Subscription Publication , 6.45M) reports that deep-learni ng artificia l intelligence has the potential to greatly increase the accuracy of medical diagnoses, and many companies throughout the healthcare industry are attempting to develop the technology. Researchers Working On Various Ways To Improve Diagnoses. In a separate article, the Wall Street Journal (9/12 , Landro, Subscription Publication, 6.45M) details several of the most encouraging ways researchers are attempt ing to minimize misdiagnoses , including establish ing computerized tracking systems and large-scale information sharing networks. BREXANOLONE FAILS TO MEET MAIN GOAL IN TRIAL FOR PATIENTS WITH SUPERREFRACTORY STATUS EPILEPTICUS. Reuters (9/12, Grover) reports that Sage Therapeutics ' brexanolone "failed to meet the main goal of a key trial" in "patients with super-refractory status epilepticus (SRSE) whose seizures persisted despite earlier treatments. " Accord ing to Reuters, the failure raises "concerns about the future of the study." STAT (9/12, Feuerstein, 43K) reports that the drug failed to cause a statistically significant benefit over the placebo. Sage "continues to study brexanolone in other neuropsychiatric diseases , including a phase 3 clinical trial of women with severe postpartum depression. " Results from that study "are expected later this year ." Fierce Biotech (9/ 12, Adams) reports that brexanolone "essentially matching a dummy treatment (43.9% vs 42.4%; p=0.8775) when added to standard-of-care ." Additional coverage is provided by Forbes (9/12 , Herper , 5.11M) and the Boston Business Journal (9/12, Seiffert , Subscription Publication , 896K). 23ANDME USING CUSTOMER'S DNA DATA TO DEVELOP NEW DRUGS. CNN Money (9/12, O'Brien, 3.59M) reports that genetic test ing startup 23andMe is leveraging consumer data "for disease research and developing drug therapies." The company "is current ly running research programs dedicated to a range of areas, like oncology, skin, and cardiovascu lar disease " and is using the data "to help academic and pharmaceutical partners develop new therapies for diseases like Parkinson's, irritable bowel syndrome , and lupus." MAJOR HEALTHCARE COMPANIES INVEST IN "ELECTROCEUTICALS" STARTUP. STAT (9/12, Piller , 43K) reports that "electoceut icals" startup SetPoint Medical raised $30 million in another round of investment , with major companies like Medtron ic, Boston Scientific , and GlaxoSmithKline investing . The field of "electoceuticals " is premised on the idea that "narrowly targeted electrica l pulses could - in theory - prove a benign way to treat an array of condit ions from asthma to arthritis to incontinence , without the need for prescription drugs ." The article mentions that the National Institutes of Health "has poured tens of millions into studying the concept." However, electroceutica ls remains a "nascent industry," with companies like SetPoint "still in the early days of trying to turn an intriguing concept into a proven medical product." CALIFORNIA STATE ASSEMBLY OVERWHELMINGLY PASSES DRUG PRICING TRANSPARENCY BILL. STAT (9/12, Silverman , 43K) reports that Califo rnia's state Assembly "overwhe lmingly passed" a bill that would require drugmakers "to report and justify price hikes." The bill "has been vociferously fought by the pharmaceutical industry" and "could become one of the most comprehensive state efforts to address pricing transparency ." PROSTATE CANCER EXPERTS OFFER TIPS ON SCREENING , TREATING PROSTATE CANCER. The Wilmington (DE) News Journal (9/12, Newman , 424K) features tips from prostate cancer experts concerning what "men need to know about the disease ," in honor of Prostate Cancer Awareness Month. The News Journal reports that the US Preventat ive Services Task /\MERICAi\ pVERSIGHT EXT-18-248-C-000154 Force did not make a final recommendation concerning best screening methods for prostate cancer; however, in April they did recommend men between ages 55 and 69 "talk to their doctors about the benefits and harms of [prostate-specific antigen] screening ." Experts also warn that prostate cancer symptoms typically do not emerge until the disease reaches an advanced stage, making early detection even more important; for treatment , both chemotherapy and hormonal therapies are options. SCIENTISTS CRITICIZE STUDY DISPUTING ANONYMITY OF GENOME RESEARCH. The San Diego Union-Tribune (9/12, Fikes, 668K) reports a study finding that the identity of people who donated genomes for genomic research could be deduced is generating blow-back from genomic researchers who "anonymize genomes and follow health privacy laws," and insist genomic information cannot be tied to their individual. According to geneticist Mark Shriver, "I don't think this paper raises those risks, because they haven't demonstrated any ability to individuate this person from DNA." MICROSCOPIC PARTICLES FROM TATTOO INK CAN GET INTO LYMPH NODES, STUDY SUGGESTS. AFP (9/12) reports that research suggests "microscopic particles from tattoo ink can migrate into the body and wind up in lymph nodes." These "tiny particles ...include molecules from preservatives and contaminants such as nickel, chromium, manganese and cobalt." The findings (9/12, 177K) were published in Scientific Reports. AT LEAST 12 PEDIATRIC HEART PATIENTS AT NEW ORLEANS HOSPITAL HAVE INFECTED INCISIONS, POSSIBLY FROM CONTAMINATED EQUIPMENT. The AP (9/12, Mcconnaughey) reports that at least 12 kids who underwent "heart surgery at Children's Hospital in New Orleans during the summer have infected incisions, apparently from contaminated equipment. " The FDA "reported last October that a certain model of bypass machines' heatercooler units had been linked to infections with a related germ, Mycobacterium chimaera ." The same "model was used at Children's Hospital." CBS News (9/12, 4.42M) reports that the hospital "sent out 55 letters to patients who potentially could have been infected." FORBES CONTRIBUTOR DISCUSSES STUDY FINDING GENERIC CHEMO WILL NOT HELP BRING DOWN HIGH COST OF DRUGS. Forbes (9/12, 5.11 M) contributor Arlene Weintraub writes that "the drop in capecitabine 's price isn't enough to support the notion that encouraging generic competition will help bring down the high cost of drugs ...argue" the authors of a study published in JAMA Internal Medicine. Weintraub continues, "If 'similar modest price decreases are observed for other orally administered anticancer drugs following generic entry, generic competition alone may not be sufficient to curb oncology spending ,' they conclude in the paper." EXCESS BELLY FAT MAY INCREASE RISK OF SOME CANCERS IN OLDER WOMEN, STUDY SUGGESTS. The Atlanta Journal-Constitution (9/12, 1.16M} reports that research suggests women with an "apple-shape" may be linked to a higher risk of certain cancers. Health Day (9/12, Preidt, 11K) reports that investigators "followed nearly 5,900 Danish postmenopausal women for up to 12 years and found that abdominal fat was a bigger factor than body weight when it came to the risk of lung and gastrointestinal cancers ." The research was presented at a European Society for Medical Oncology meeting . HIV CONTINUES TO AFFECT MANY, PROMPTING CALLS FOR FURTHER TESTING, TREATMENT. The Huffington Post (9/12, Almendrala, 5.74M) reports that while antiretroviral therapy has made HIV a manageable condition for many patients, the disease has still claimed many lives, with 6,721 Americans dying from HIV-related causes and 12,333 Americans with HIV dying of any cause in 2014. Although treatment is available, many people do not seek it out because they are unaware of funding assistance , or they do not know they have HIV. The article profiles CDC data showing US populations with the highest rates of HIV, and offers /\MERICAi\ pVERSIGHT EXT-18-248-C-000155 recommendations on prevent ing further diagnoses and deaths . HARVARD STUDENTS WARNED ABOUT HAND, FOOT, AND MOUTH DISEASE OUTBREAK. The Boston Globe (9/12, Meyers, 969K) reports Harvard University administrators have issued warnings to students about a recent outbreak of hand , foot, and mouth disease. A university spokesman said cases have been isolated to certain on-campus residences , "although he did not name the specific residences affected." OPINION: TRAINING NURSES' AIDES COULD REDUCE HOME HEALTHCARE COSTS. Paul Osterman, author and professor at the MIT Sloan Schoo l of Management , writes in an op-ed in the Wall Street Journal (9/12, Subscription Publication , 6.45M) about the high costs of home healthcare services, wh ich stem in part from requiring registered nurses to perform tasks such as administering eyedrops. Some healthcare experts have suggested home health aides could present a remedy for the rising costs, saying that with add itional training , they could take on more tasks now performed by nurses. HOSPITALS USING ALERT SYSTEMS TO CUT BACK ON UNNECESSARY CARE PROCEDURES. The Wall Street Journal (9/12, Evans, Subscription Publication , 6.45M) reports hospitals are turn ing increasingly to digital alert systems that require physicians to reconsider treatment options in an effort to reduce instances of unnecessary care procedures . A 2014 study in JAMA Internal Medicine found costs for such procedures tota l $1.8 billion each year. The Amer ican College of Cardio logy has recommended a system to prevent physicians from performing unnecessary cardiac imaging tests , suggesting they do not perform them on new patients unless the patie nts present other issues that put them at risk. GENETIC TESTING FOR PARENTS, EMBRYOS RISING AS PRICES FALL. The Wal l Street Journal (9/12, Wallace , Subscr iption Publication , 6.45M) reports on the increasing prevalence of genetic testing in parents and embryos as costs for testing have fallen. Nearly half-a-dozen companies are offering testing for much less than the nearly $5,000 screenings offered about a decade ago. Tests also have increased in accuracy, helping lead more parents to seek them as a form of family planning. MEDICAL PROFESSIONALS SEE INNOVATION IN 3-D PRINTING FOR HEALTHCARE. The Wall Street Journal (9/12, McConnon, Subscription Publication, 6.45M) reports medical professiona ls are turning to 3-0 printing for treatment research and development as well as surgery planning and medication creation . Research institutions such as the Mayo Clin ic are relying on 3-0 printing as manufacturers develop healthcare-specific technology to support medical researchers' needs. MANY MOISTURIZERS MARKETED AS "HYPOALLERGENIC" MAY CONTAIN CHEMICAL IRRITANTS, STUDY FINDS. Reuters (9/12, Rapaport) reports a study published in JAMA Dermatology found that many skin moisturizers touted as being able to remedy issues such as eczema and that are labeled as being "hypoallergenic" or "fragrance-free " may contain chemica l irritants. Researchers surveyed Amazon , Target , and Wa lmart for their top 100 best-selling body moisturizers sold onl ine, find ing that during an assessment of the products ' ability to moisturize skin, whethe r they cause allergic reactions , and how much they cost, only 12 percent "of the 174 individual products tested were free of allergens ." HOSPITALS IMPLEMENTING STRATEGIES TO REDUCE ER WAIT TIMES. The Wall Street Journ al (9/12, Kincaid, Subscript ion Publication , 6.45M) reports on efforts by hospitals to reduce emergency room wa it times, saying many are reworking or eliminating triage, slimming management processes by cutting down on waste time , addressing minor patient issues quickly , and scheduling elective surgeries more evenly. TELEMEDICINE HERALDED AS MEANS OF HELPING PREGNANT WOMEN FACING HEALTH RISKS. The Wall Street Journal (9/12, McKay, Subscription Publicat ion, 6.45M) reports /\MERICAi\ pVERSIGHT EXT-18-248-C-000156 on the expanded use of telemed icine for women with high-risk pregnancies or who may be at risk of such pregnanc ies. Some medical professionals say telemed icine offers women in rural or isolated areas better access to specialized healthcare . Amer ican Cong ress of Obstetricians and Gynecologists president Haywood Brown said the expansion of telemedicine for prenatal care and labor and delivery is a priority for the organizat ion, adding that it leads to improved care quality and reductions to healthcare costs. The organ ization has formed a task force to establish standards for telemedicine use. LABOR WARD CULTURE MAY IMPACT RATE OF C-SECTIONS, RESEARCHERS SAY. The Wall Street Journal (9/12, Marcus , Subscription Publication , 6.45M) reports researchers are working to reduce the number of Cesarean section deliveries by targeting the labor ward culture. One recent study suggested that hospitals with management that often proactively worked to lessen the difficulty of challenges before they arise had higher rates of C-sections. PREGNANT WOMEN EXPOSED TO PESTICIDES MAY HAVE HIGHER RISK OF DELIVERING PRETERM BABIES, STUDY FINDS. Reuters (9/12, Cohen) reports a study published in the journal Nature Communications found that pregnant women exposed to the highest number of agricultura l pestic ides in California 's San Joaquin Valley had a higher risk of giving birth prematurely and del ivering babies with low birth we ights. Mothers who lived closest to areas with the highest percentage of pesticides "had an 11 percent increased probab ility of preterm delivery and a 20 percent increased probability of having a low birth-weight baby." Researchers found "women exposed to the top 25 percent of pesticide loads in the San Joaquin Valley had babies with no detectable effect," although "those in the top 5 percent of exposures had increases in the range of 5 to 9 percent in adverse outcomes. " FLORIDA ASSISTED LIVING FACILITY HOUSES PATIENTS DURING IRMA DESPITE LACKING ELECTRICITY FOR THREE DAYS. The Wash ington Post (9/12, Sullivan, 10.38M) reports on Cape Coral Shores, a Florida assisted care facil ity that housed 20 patients during Hurricane Irma and lost power for three days "as elderly patients suffered in the rising heat." The facility kept the patients during Irma due to "an agreement with state and local officials because the emergency shelters it would normally use in Fort Lauderdale and Sarasota were both evacuated ." The Post reports neighboring homes and businesses regained power days before the facility, which saw its indoor temperature reach "the mid-80s Tuesday morning." Facility CEO Dan Nelson said the utility company did not list Cape Coral Shores as a medical provider, or it would have restored power sooner. SHOCKED FLORIDA KEYS RESIDENTS STUNNED BY IRMA'S WRECKAGE. Reuters (9/13, Sullivan) reports on evacuees who returned to their homes on Wednesday morning to find their homes and workplaces destroyed. The piece discusses the aftermath in the Florida Keys, where some roads are beginning to open up to allow residents to survey the damage caused by Hurricane Irma. The storm destroyed 25 percent of homes and 65 percent suffered damage , according to Federal Emergency Management Agency administrator Brock Long , and 5.8 million Floridians remain without power. THERAPEUTIC VACCINES OFFER NEW PROGRESS FOR CANCER TREATMENT. The Wall Street Journal (9/12, Gormley , Subscr iption Publication , 6.45M) reports therapeutic vacc ines for cancer offer a new type of treatment that addresses cancers by prompting immune cells to attack the disease and do not cause the side effects associated with treatme nts such as chemotherapy . Much like conventional vaccines, the therapeutic treatments instruct the immune system to target specific dangers, specifically tumor cells bearing the biomarker called antigens . The Journal reports on several compan ies developing vaccines. DEATHS DUE TO CANCER HAVE FALLEN BUT NEW DIAGNOSES EXPECTED TO RISE, STUDY FINDS. STAT (9/13, Th ielking , 43K) reports a study released Wednesday by the Amer ican Associatio n for Cancer Research found that the number of cancer deaths in the US has fallen by 25 percent for adults and 35 perce nt for children since 1991. Despite th is, researchers /\MERICAi\ pVERSIGHT EXT-18-248-C-000157 anticipate cancer to grow in prevalence , with the number of new cancer diagnoses expected to rise from 1.7 million in 2017 to 2.3 million in 2030 due to a large aging population, high rates of obesity , and a large number of people who are not physically active . STAT ment ions Congress ' recent move to provide the NIH with $36.2 billion in funding for the next fiscal year. HOSPITALS INCREASINGLY ENCOURAGE PATIENTS TO PRACTICE MOBILITY PRIOR TO BEING DISCHARGED. The Wall Street Journal (9/12, Ward, Subscription Publicat ion, 6.45M) reports many hospitals are encouraging patients to practice mobility prior to being discharged despite facilities ' earlier fears of causing falls . Some medical experts say that remaining immobilized for several days can lead to permanent declines in bodily function , making it challenging for patients to return home and resume ordinary activities . Nearly 40 hosp itals and health systems , supported by CMS' Center for Medicare and Medicaid Innovation and its Mobility Action Group, have initiated pilot programs to encourage patients to leave their beds and become more mobile. SOCIAL MEDIA BECOMES HOTBED OF COMPETITION AMONG PLASTIC SURGEONS WHO MAY OR MAY NOT HAVE LICENSES. The Wall Street Journal (9/12, Rubin, Subscription Publication, 6.45M) reports plastic surgeons are using social media sites such as lnstagram and Snapchat to compete for clients. The shift also has attracted the presence of some plastic surgery practitioners who are not qua lified in plastic surgery. According to one study , fewer than 18 percent of the most popular plastic surgery-related lnstagram posts came from surgeons licensed by the American Board of Plastic Surgery , and many others were posted by physicians with expertise in other fields who did not have the specialized training to perform the procedure . Health experts comment ing on the phenomenon said the trends could leave patients at risk of injuries . TEXAS CALLS ON AIR FORCE TO SPRAY INSECTICIDES IN EFFORT TO LIMIT POSTHARVEY MOSQUITO POPULATION. Reuters (9/12 , Kumar) reports Texas is beginning "aerial attacks on mosquitoes " that have covered coastal areas impacted by Hurricane Harvey , prompt ing state authorit ies to use USAir Force C-130 cargo planes to spray "insecticides over three eastern Texas counties over the weekend ." The effort will expand to other locations throughout the next two weeks, with nearly 1.85 million acres having been treated as of Tuesday , according to officia ls from the Texas Department of State Health Services. The state has confirmed "441 human cases of West Nile virus and 21 deaths since the start of 2016" and 342 Zika cases during the same period. OP-ED: PBMS PLAY ESSENTIAL ROLE IN LOWERING PRESCRIPTION COSTS. Edmund J. Pezalla , MD, MPH, consultant on payer strategy for pharmaceutical and device manufacturers and scholar-in-residence at the Duke-Margolis Center for Health Policy , writes in an op-ed in The Hill (9/12 , 1.68M) that with "so much rancor and finger pointing these days over prescription drug prices," consumers can rely on pharmacy benefit managers (PBMs) to advocate for lower prescription treatment prices. According to Dr. Pezalla, PBMs are in the unique position "to reduce drug costs by negotiating for rebates and discounts from big drug companies and drugstores. " Dr. Pezalla says that because PBMs are involved direct ly in the process of reviewing medical evidence for FDA-approved treatments, assisting in manag ing treatment side effects , and supporting in creating formularies for patients to "stay on their drug regimens and out of the hospital," they also help reduce medication "costs for patients and the entire health care system ." OPINION: ELECTRONIC MEDICAL RECORDS CAN ENABLE CLINICAL TRIALS IN PHYSICIANS' OFFICES. In an op-ed for the Wall Street Journal (9/12, Subscriptio n Publication , 6.45M), Dr. Amy Abernethy , chief medical officer and chief scientific officer at Flatiron Health, and Dr. Sean Khozin, an acting associate director in the FDA's Onco logy Center of Excellence and founding director of the agency 's Information Exchange and Data Transformation Program, write that electronic medica l records are paving the way for modern clinical drug trials using real-time, detailed data collected at the point of care, in physicians offices. The authors write that such trials are not yet common practice due to impediments such as a lack of technical and organizationa l /\MERICAi\ pVERSIGHT EXT-18-248-C-000158 infrastructure, which prevent them from meeting the higher standards of convent ional trials . PHARMACEUTICAL COMPANIES IMPLEMENT OUCTOMES -BASED PRICING DESPITE LACK OF EVIDENCE TO SHOW IT LOWERS COSTS . The Wall Street Journal (9/12, Loftus, Subscr iption Publication , 6.45M) reports pharmace utica l compa nies increasing ly are ty ing part of their reimbursements from insurers to how well treatments perform in patients in an effort to lower costs for consumers . This practice , known as value-based or outcomes-based pricing , is becoming more popu lar and has attracted the attention of legislators and is even the subject of a White House executive order that would require federa l health programs to implement such contracts . Despite this, many compa nies and insurers say there is a dearth of evidence to suggest the contracts have lowered prescription prices . PEOPLE CONTINUE TO BELIEVE VACCINE MYTHS DESPITE BEING PRESENTED FACTS , STUDY FINDS. The Wall Street Journal (9/12, Dizik, Subscription Publication, 6.45M) reports a study published in the journa l PLOS One examining the prevalence of belief in myths about vaccines found that those who believed that certa in vaccines have harmful effects on children maintained their beliefs or said their beliefs were stronger after being shown facts correcti ng the misinformation. Researche rs found that many people may continue to believe such statements because they are more familiar w ith them than they are with new, correct information. While many study participants were unable to remember the source of the information they received or whether it was valid, they recalled parts of what they heard, researchers said. OHIO 'S HOSPITALS, PHYSICIANS FIGHT BILL THAT WOULD END FLU VACCINE REQUIREMENTS . The Columbus (OH) Dispatch (9/12, Siege l, 456K) reports that a bill passed out of a House committee in the Oh io legislature that would "'empower Ohioa ns' to refuse a flu vaccine without placing their jobs in jeopardy ." Hospitals , physicians , and "essentially all of the state's largest health care associatio ns" are opposed to the bill because they see it as "threatening employers ' rights to enforce safety precautions in their workplaces ." Supporters, howeve r, argue that employer-mandated flu vacc ines are an "egreg ious violation of personal freedom, " and that the shot has a "low rate of effectiveness " and can cause side effects . The Ohio Chapter of the America n Academy of Pediatrics says influenza is the leading cause of vaccinepreventab le deaths in the nation . The Centers for Medicare and Medicaid Services includes flu vaccines as part of its reporting requirements for quality measures . PITT RESEARCHER TO STUDY EFFECTIVENESS OF NEW YORK 'S SEPSIS LAW. The Pittsburgh Tribune-Review (9/12, Vente icher, 236K) reports that a University of Pittsburgh researcher, Dr. Jeremy Kahn, is launching a four-year study of New York state's regulations on sepsis to examine the policy's effectiveness and whether there were any "unintended negative consequences. " New York's law requires hospitals to speed up treatment and follow protocols of "tak ing blood cultures to guide diagnosis and treatment , analyzing lactate levels that can signify septic shock and admin istering flu ids and antibiot ics." According to the National Institutes of Health , seps is "contributes to as many as half of all hospital deaths ." The study will also compare New York's clinical outcomes to those in other states , including Pennsylvania, Massachusetts , Wash ington, and Florida. STUDY FINDS CASES OF HOOKWORM IN ALABA MA. NPR (9/12 , Whitehead, 2.4M) reports that a new study published th is month has uncovered a community in one of the poorest counties in the US, Lowndes County, Alabama , where 19 of the 55 individuals tested were positive for hookworm . Hookworm remains common in deve loping nations , but was thought to be eradicated in the US betwee n 1950 and 1980. The parasite is transm itted when an infected person defecates outside and, after the eggs hatch in the soi l, the worms can latch on to bare feet and burrow to the small intestine. Dr. David Diemert, a hookworm expert at George Wash ington University, said , "I was very surprised by this . ... There has not been any documentation of people being infected in the U.S. for the past couples of decades ; we thoug ht there was no more local transm ission in the U.S." /\MERICAi\ pVERSIGHT EXT-18-248-C-000159 LONELINESS CAN BE HAZARDOUS TO HEALTH , EXPERTS SAY. The Wall Street Journa l (9/12, Holland, Subscription Publication, 6.45M) reports that medical experts are calling for a public health campaign to address loneliness and social isolation based on research showing they can lead to an early death . The article examines some senior living facilities' programs to address social isolation, including setting up child care services, adopting co-housing where homes are near each other surrounding a common shared space, hotlines, and intergenerational social activities. INCREASED USE OF MARIJUANA BY PREGNANT WOMEN SPURS NEVADA CAMPAIGN . The Las Vegas Review-Journal (9/12, Harasim , 458K) reports that Nevada officials are preparing a public information campaign airing TV and radio ads to address the increasing rates of marijuana use in the state after recreational use was legalized. The ads will highlight the potential harm to the fetus. However , Nevada's chief health officer Dr. John DiMuro says "there is no definitive research about pot's effects on the fetus" because the "[r]esearch is not consistent. " Studies have shown, he adds, that the "strongest consensus" is that exposure to the drug could cause developmenta l delay for elementary school-aged children . OPINION : PAYMENT METHODS FOR PHYSICIANS ARE HURTING HEALTHCARE. Howard Forman, a Yale University professor of radiology, writes in the Wall Street Journal (9/12, 6.45M) that Medicare's reimbursemen t system causes compensation to be higher for specialists than it is for internists, pediatricians, and family medicine physicians. Forman points to an emphasis on the number of procedures and volume, rather than on prevention and outcomes . He urges government and private payers to continue to move towards reimbursement premised on outcomes, not volume of services . SAN DIEGO HEPATITIS A OUTBREA K LEADS TO 16 DEATHS, SHOWS NO SIGNS OF SLOWING . The San Diego Union-Tribune (9/12, Sisson, 668K) reports that Tuesday's update from the San Diego County Health and Human Services Agency confirms that the hepatit is A outbreak "shows no signs of slowing," as the death toll rose to 16 and the number of confirmed cases increased to 421, up 23 since last week. The county declared a public emergency on September 1 which included an ongoing vaccination campaign and the installation of handwashing stations for the homeless, "who have been hit hardest by the outbreak." Mayor Kevin Faulconer has a scheduled news conference on Wednesday to discuss a plan to build temporary shelters for hundreds of those living on the streets which will provide beds, showers , restrooms and hand-washing stations . UTAH OFFICIALS RELEASE DATA ON RISING SUICIDE TREND AS PART OF WIDER PREVENTION EFFORT. The Salt Lake (UT) Tribune (9/13, Ramseth, 337K) reports that the Utah Department of Health released numbers showing that Utah's suicide rate so far in 2017 remains "roughly on pace to meet or surpass last year's preliminary one-year record of 638 suicide deaths," placing Utah as the state with the fifth-highest suicide rate in the country. The article adds that health, education , and other experts are "attacking the problem on several fronts," including pushing mental health "first aid" and suicide intervention training, firearm awareness programs, and the release of this data, as well as the state Board of Education's hiring of an "education specia list to work on suicide issues ." LUBBOCK , TEXAS CONFIR MS ITS FIRST WEST NILE VIRUS CASE OF THE YEAR. The Houston Chronicle (9/12, Ramirez, 1.97M) reports that city officials in Lubbock, Texas, confirmed the first case of West Nile virus of 2017 in the city. The state now has reported 71 cases. Last year, Texas officials counted 370 human cases and 18 fatalities . US HOUSE PASSES BILL CALLING FOR STUDY OF CANCER AMONG FIREFIGHTERS . The Buffalo {NY) News (9/12, Zremski, 362K) reports that the US House of Representatives unanimously passed the Firefighter Cancer Registry Act on Tuesday, which would authorize $2 million in funding for a Centers for Disease Contro l and Prevention registry of firefighters who are diagnosed with cancer. The bill was seen as the first step towards bolstering federal research into /\MERICAi\ pVERSIGHT EXT-18-248-C-000160 the health effects on firefighters because of their work. Rep. Chris Collins (R-NY) sponsored the bill and referenced the continued loss of 9/11 first responders from "ongoing health effects" of the attacks . CALIFORNIA BILL TO CREATE "SAFE INJECTION SITES" FOR DRUG USERS FAILS IN STATE SENATE . The Los Angeles Times (9/12 , Mason, 4.49M) reports that the California Senate rejected a "controversial proposal to allow certain California counties and cities to establish sites where people could inject drugs without legal consequences" on Tuesday night. The injection centers would permit users of heroin and other intravenous drugs a setting with "clean needles and under the supervision of trained staff' to prevent overdose. Opponents warned that the centers "would enable illegal activity." The bill came up two votes short and may come up again before the Legislature adjourns later this week. TMS TREATMENTS FOR HARD-TO-TREAT DEPRESSION NOW MUCH EASIER TO GET. The Boston Globe (9/12, Freyer, 969K) reports that transcranial magnetic stimulation (TMS) treatments for hard-to-treat depression have "become much easier to get." Now TMS is "covered by Medicare and most health insurers, which will pay roughly $10,000 or more for a course of ' the treatment, "provided three or four medications and psychotherapy have failed." Consequently , "it's feasible for private psychiatric practices to purchase the machines and for TMS-only clinics to spring up." The Globe points out that the Food and Drug Administration "cleared the first TMS device for depression in 2008." SCREENING MOTHERS FOR DEPRESSION DURING EARLY WELL-CHILD VISITS MAY LEAD TO SIGNIFICANTLY FEWER REPORTS OF DEPRESSION AT NINE MONTHS POSTPARTUM, STUDY SAYS. In continuing coverage, CNN (9/12, Scutti , 33.59M) reports, "Screening mothers for depression during early we ll-child visits led to significantly fewer reports of depression at nine months postpartum ," researchers found after studying some 3,000 women in the Netherlands. The study revealed that only "3% of the screened mothers experienced minor or major depression at nine months postpartum, compared with 8.4% of the mothers who weren't screened during the visits." The findings were published online Sept. 12 in Pediatrics. EXPERTS PUZZLED BY US MALE INFERTILITY CRISIS . Newsweek (9/12, Walsh, 991 K) reports researchers suspect environmental toxins, "specifically, endocrine-disrupting chemicals found in compounds like bisphenol A (BPA) and phthalates ," can cause reduction in male sperm counts. The production of sperm is "tightly regulated by the body's hormones, and so any interference with those hormones - say, through exposure to endocrine-disrupting chemicals could make itself felt first through damage to sperm quantity or quality." Several Endocrine Society members are quoted in the article, including University of Texas toxicologist Andrea Gore. Global Health: PROGRESS ON GLOBAL POVERTY, DISEASE AT RISK, GATES SAYS. Reuters (9/13, Kelland) reports philanthropist Bill Gates warns that proposed US budget cuts threaten "great progress in reducing poverty and disease" and could lead to 5 million more AIDS deaths. The Bill and Melinda Gates Foundation released its global health report on Wednesday, co-authored by Gates and the Institute for Health Metrics and Evaluations at the University of Washington, which analyzed progress against diseases such as malaria, HIV/AIDS, and tuberculosis and tracked rates of poverty, maternal and infant death, access to contraception, sanitation, and other development issues. For example, the report said a 10 percent cut in "global donor funding for HIV treatment" could cost more than 5 million deaths by 2030 . President Trump has proposed cutting global health programs by 24 percent , but both Democrats and many Republicans have "blasted his plan." FRANCE PLANS TO LEGALIZE ASSISTED REPRODUCTION FOR LESBIANS NEXT YEAR. Reuters (9/12) reports that France intends to legalize access to assisted reproduction for lesbian /\MERICAi\ pVERSIGHT EXT-18-248-C-000161 couples and single women in 2018 . France 's minister for gender equa lity, Marlene Sch iappa , called it "a matter of social justice " and "a campaign promise" that "will be honored ." Schiappa "said a bill would likely pass through parliament" next year . EFFORTS TO CONTAIN NORTHEAST NIGERIA'S CHOLERA OUTBREAK HAMPERED AS REFUGEES UNDERREPORT ILLNESSES. Reuters (9/12) reports that individua ls in northeast Nigeria "are failing to report suspected cases" of cholera to health officials, hindering efforts to contain the outbreak, according to the United Nations. The artic le says "the number of suspected cholera cases had jumped to 1,626 as of Sept. 11," resulting in 40 deaths so far . Reuters states the rainy season has contributed to the disease's spread "in dense ly populated [refugee] camps " plagued by "unsanitary conditions. " HEAL TH OFFICIALS CONCERNED ABOUT REEMERGENCE OF SLEEPING SICKNESS IN THE DEMOCRATIC REPUBLIC OF CONGO. The Huffington Post (9/12, McNeish, 5.74M) reports public health experts are concerned that rates of Afr ican trypanosom iasis, commonly known as sleeping sickness , may be on the rise in rural areas of the Democratic Republic of Congo. Accord ing to Crispin Lumba la, the DRC's director of the Ministry of Health's National Programme for Seeping Sickness Control, "The real problem right now is a resurgence of the disease because we don't have a well-supported and effective surveillance program." Part of the issue is a decline in the number of mobile medical units capable of find ing and treating sleeping sickness in the country, from 200 such units in the 1960s to only 30 today. Part of the issue is a decline in the number of mobile medical units capable of finding and treating sleeping sickness in the country , from 200 such units for a population of 12 million in the 1960s to only 30 today for a population of 80 million. UNITEDHEAL TH EXPLORING BID FOR CHILEAN HEALTH INSURER BANMEDICA. Forbes (9/ 12, Japsen , 5.11 M) reports UnitedHealth Group is in talks to buy Chile-based insurer and hospital operator Banmedica , which could be part of the insurer's grow ing interest in global healthcare markets where they can grow their business in emerging markets rather than the mature US market. According to Leerink Partners analist Ana Gupte, "Banmedica is very similar to [the UnitedHealth-owned ] Amil, wh ich is the largest Brazilian insurance company with a strong asset base that encompasses both owned and contracted hosp itals, and a leading network of physicians and outpatient clinics . ... While the Brazilian deal with Amil for ~$5 B has not been without challenges, it offers [UnitedHealth] diversification into a new geography ." National News: TRUMP TO TRAVEL TO FLORIDA THURSDAY TO SURVEY HURRICANE DAMAGE. USA Today (9/12 , Jackson , 8.62M) reports the White House announced that President Trump will travel to Florida on Thursday to survey the damage from Hurricane Irma. Press secretary Sarah Huckabee Sanders told reporters, ''The president and the entire administration continue to monitor the situation in Puerto Rico, the United States Virgin Islands, Florida, Texas and all areas affected by Hurricanes Irma and Harvey." She also said that "details of the trip - including the exact location - are still being worked out." The Hill (9/12, Fabian, 1.68M), however, reports that the FAA "posted a travel advisory Tuesday that covers Fort Myers, on Florida 's west coast," which "typ ically issued before the president travels to a destination in the US." Jim Acosta said on CNN's Situat ion Room (9/12 , 959K), "We're hearing through our sources that it appears at th is point that [the President] will be in the Ft. Myers area , that part of southwest Florida that was so hard hit. ... This will obviously be another test for the President when he arrives on the ground down there." NBC Nightly News (9/12, lead story, 3:10, Holt , 16.61M) and the CBS Evening News (9/12, lead story , 2:50 , Mason, 11.17M) both briefly mentioned the President's trip in their lead stories , and Reuters (9/12) also reports briefly on the announcement by Sanders . The White House also tells NBC Nightly News (9/12, story 4, 2:40, Holt, 16.61 M) that the President "is looking into possibil ity, /\MERICAi\ pVERSIGHT EXT-18-248-C-000162 down the line, of making a trip [to the US Virgin Islands], but at a time when it won't imperil those relief efforts." The New York Post (9/12, Rachman, Fears, 4.31M) reports Virgin Islands Gov. Kenneth Mapp "said late Monday night" that Trump is planning to visit "within the next six or seven days." On its front page, the Washington Post (9/12, A 1, Faiola, 10.38M) likewise reports on Mapp said in a telephone interview that "Trump ...called him Monday and was due to survey the Virgin Islands damage this week. He would find , the governor said, an efficient response." The Atlanta Journal-Consti tution (9/12, Dupree, 1.16M) notes that "this would be the second trip in recent weeks to an area hit hard by a tropical system: Mr. Trump made two trips to the Gulf Coast, stopping in Texas and Louisiana, to get a look at damage and recovery efforts after Hurricane Harvey." The New York Post (9/12, Perez, 4 .31 M) similarly notes that the President, jo ined by First Lady Melania Trump , made two visits to Texas last month following Hurricane Harvey. "My concern continues for all impacted by the hurricanes," the first lady tweeted Tuesday . "Will fly to #Florida on Thursday w @potus to survey the damages from #Hurricanelrma." Politico (9/12, Nelson , 3.6M) reports that shortly after Sanders' announcement, Stephan ie Grisham, a spokeswoman for Melania Trump , tweeted, "@flotus will trave l to #F lorida w POTUS on Thurs to survey aftermath of #Hurricanelrma." Administration Earns "Bipartisan Praise." The Washington Post (9/12, Nakamura , 10.38M) reports that "facing off against a pair of historic storms," the Trump Adm inistration "has earned bipartisan praise for coord inating the federal response with state and local officials , avoiding the type of catastrophe that marked the Bush administrat ion 's response to Katrina." Wh ile the pair of storms "wreaked widespread destruction that will take years and billions of dollars to recover from," the Post says that "for a Trump administration whose first eight months has been marked by internecine squabb les and a lack of legislative accomplishments , the initial competence in manag ing the sto rms represented a relief - and a rare chance to take credit." Overall, "emergency management veterans said, Trump and his team deserve acknowledgment for gett ing through the first phase of the crisis in a way that inspired public confidence." Virgin Islands Delegate Stacey Plaskett said on CNN's Situat ion Room (9/12, 959K) that Irma "hit us almost direct impact while it was a Category 5 .... So St. Thomas and St. John have been tremendously affected by it. ... But I have to say we've had great support from FEMA, from the Department of Defense. Our governor has been working very closely with the federal government , along with our local emergency management agencies , first to prepare for this and now in the aftermath." NBC Nightly News (9/12, story 4, 2:40, Holt, 16.61M) reported that a Coast Guard cutter loaded up with supplies traveled to St. Thomas on Tuesday. Also on board, TSA officers "with the critical goal of getting airport back up and running." Without mentioning the Trump Adm inistration, the New York Times (9/12, A 1, Fausset , Subscription Publication , 13.56M) reports on its front page that Hurricanes Harvey and Irma "may have revealed a largely unnoticed truth often buried under the news of unfolding tragedy: The United States appears to be improving in the way it responds to hurr icanes, at a time when climate scientists say the threats from such storms, fueled by warming oceans , are grow ing only more dire." The Times says the 9/11 attacks "revolutionized the way Amer ican government coordinated disaster response ," and Hurricane Katrina "stimu lated a new and robust conversat ion about the power of natural disasters , and, more specifically , forced Americans to rethink the growing threats from floodwater." Politico Analysis: Democrats Refrain From Using Storms To Criticize Trump's Climate Policies. Politico (9/12, Holden , Schor , 3.6M) reports Hurricanes Harvey and Irma have "handed Democrats their most potent opportun ity in half a decade to hammer Republicans on climate change - with the massive storms giving tens of millions of Americans an up-front glimpse of the /\MERICAi\ pVERSIGHT EXT-18-248-C-000163 types of devastatio n the world faces if the warm ing planet spawns a surge in extreme weather. But instead , they' re mostly keeping quiet." For now, Democrats "appear to be heeding the warnings of Trump appo intees" like EPA Administrator Pruitt, who said last week that it's "very, very insensitive to the people in Florida" to talk about climate change now. Sen . Sheldon Whitehouse (D-RI), "said he doesn't view the immed iate aftermath of Harvey and Irma as heightening the sense of urgency to talk about global warming ." WPost Analysis: Trump's Praise Of Coast Guard Gives Service "Much-Needed" Boost. The Washington Post (9/12, Horton, 10.38M) reports that on Sunday, President Trump "singled out the Coast Guard for its sudden ly high profile amid dueling catastrophic hurricanes, first during Harvey in Texas and now its early work providing assistance in the Florida region" in the wake of Hurricane Irma. The Post says Trump's "praise for the Coast Guard is a much-needed confidence boost for the service, which was roiled by early Trump administration proposals to cut $1.3 billion from its budget to help pay for the planned wall on the US-Mex ico border." USA Today (9/12, Moniuszko , 8.62M) , however, reports that during Late Night on Monday , host Seth Meyers "didn't hold back wh ile making fun of President Trump's comments on the storm," which praised the Coast Guard's "branding." "You'd think applauding the bravery of emergency responders like the Coast Guard would be one of the easiest things a president could do - but even that, it seems, is too much to ask of Donald Trump ," Myers said. "Branding? The Coast Guard doesn't need to improve their brand, they're the Coast Guard. They 're not Arby's." Daily Caller Analysis: Telethon Gets "Political." In a report that was the lead story on Drudge Report Tuesday night , the Daily Caller (9/12 , 521 K) reports Stevie Wonder kicked off Tuesday's "Hand In Hand" telethon to raise money for hurricane recovery "by getting political." Wonder started the telethon , which was broadcast on every major network, by saying , "Anyone who believes that there's no such thing as global warming must be blind or unintelligent." FLORIDA LAWMAKERS SEEK FEDERAL AID FOR IRMA CLEANUP. McClatchy (9/12, Daugherty , 67K) reports that "many members of Florida's congressional delegation couldn't be in Washington for votes on Tuesday , as the state began a massive cleanup after Hurricane Irma. But that hasn't stopped them from pressing colleagues who were spared Irma's wrath to join in their quest for federal help." Rep. Ileana Ros-Lehtinen is "urging Washington to treat her state as it did Texas just a week ago," but her call "will likely meet resistance from conservative Republicans who bristle at any new spending that doesn 't include corresponding cuts elsewhere." Florida Sen. Bill Nelson said on CNN's Situation Room (9/12, 917K) , "Isn't it interesting that 90 members of the House of Representatives voted against the $15 billion package for Texas and Florida that we passed last week. That's only going to last for a few weeks. The massiveness for the storm here , and then what happened in Texas , is going to take a lot more. We are going to run out of money in a few weeks. We are going to have to do th is again in October. Can you believe 90 members of the House of Representatives voted against th is? It boggles my mind." 0MB Director Mulvaney was asked on Fox News' Special Report (9/12, 2.12M) if he knows how much money will ultimate ly be required for hurricane relief. Mulvaney said, "No, and we wo n't know for quite some time . That's w hy we have broken it up into smaller pieces. The amount of money we asked for last week that Congress gave us on a bipartisan basis was enough to get us through basica lly the middle of October . The numbers can change depending upon how substant ial the damage was in Florida . A lot of this is still guesswork . It's early on . But we have enough money to buy time and learn about the damage in Texas, learned about the damage in Florida. But, it could be months before the totals are in." The Orlando (FL) Sentinel (9/12, Shanklin, 603K) reports that the "speed and amount of federal aid that comes to Central Florida depends on everyth ing from the amount of debris that gets carted away to how well counties prepared for the event." Accord ing to the Sentinel, "what was uncertain on Tuesday was whether Orange , Lake, Seminole or Osceo la count ies would become /\MERICAi\ pVERSIGHT EXT-18-248-C-000164 eligible for FEMA's 'individual assistance,' which gives survivors timely access to programs including unemployment assistance and housing assistance." It notes that by Tuesday , FEMA had already "approved 16 counties - mostly coastal - for the assistance." The New York Times (9/12, Bidgood, Cochrane, Goldstein, Subscription Publication , 13.56M) reports Gov. Rick Scott said Tuesday that the state had "shifted its attention to recovery and rebuilding efforts, while working to get water and food to those who needed it and to restore access to fuel." Said Scott, "We've got a lot of work to do, but everybody 's going to come together. We're going to get this state rebuilt." FEMA: One Quarter Of Keys Homes Could Be Destroyed. The AP (9/12, Dearen , Mendoza) reports that search-and-rescue teams "made their way into the Florida Keys' farthest reaches Tuesday , while authorities rushed to repair the lone highway connecting the islands and deliver aid to Hurricane Irma's victims." FEMA Administrator Long "said that preliminary estimates suggested that 25 percent of the homes in the Keys were destroyed and 65 percent sustained major damage. " The Wall Street Journal (9/12, Calvert, Kamp , Bernstein, Subscription Publication, 6.45M) quotes Long as saying, "Basically every house in the Keys was impacted in some way or another. This is why we ask people to leave." Both the CBS Evening News (9/12, lead story , 2:50, Mason, 11.17M) and NBC Nightly News (9/12, lead story, 3:10, Holt, 16.61M) briefly noted Long's assessment in their lead story . CBS said that it remains unclear when residents will be allowed to return their homes in the lower Keys , and NBC said that while the "road to recovery may be longest in the Keys, but those who live here say they are ready to rebuild." ABC World News Tonight (9/12, lead story, 3:30, Muir, 14.63M) reported that "military teams from both the Army and the Air Force, (are] leading the recovery effort" in the Keys. NBC Nightly News (9/12, story 2, 1 :20, Almaguer, 16.61 M) reported that US Navy is also "deploying across the Florida Keys," conducting search-and-rescue missions , and delivering food and water. The New York Times (9/12, Blinder, Santora, Yee, Subscription Publication, 13.56M) reports that on Tuesday, evacuees were "still shut out of the islands" as "rescue teams like the Federal Emergency Management Agency crew from Los Angeles checked on those who had stayed behind." The Washington Post (9/12, 10.38M), meanwhile, reports that satellite images from NASA show that in Key West, "damage is visible , however it appears to be less extensive than the islands in the Caribbean." Millions Still Without Power In Florida. The Orlando {FL) Sentinel (9/12, Harris, 603K) reports Florida officials said Tuesday that "some of the 5.2 million customers statewide could be without power for a week or more. They say it will be the largest restoration process in history." Duke Energy spokeswoman Ann Marie Varga "said it will take time to get the lights back on because it suffered widespread damage to its transmission lines." Similarly , Florida Power and Light (FPL) "said customers who live on the west side of the state may not be restored until Sept. 22 while those on the east coast by Monday ." The South Florida Sun Sentine l (9/12, Davis, 530K) reports that FPL "promised " Tuesday that power "should be back on throughout South Florida by the end of the weekend," and the Naples (FL) Daily News (9/12, Riley, 142K) reports that a "small army of Florida Power and Light employees has been working to restore power in the state ...but customers on the west coast will have to wait longer than others - up to as late as Sept. 22." The CBS Evening News (9/12, story 2, 1:40, Mason, 11.17M) reported FPL alone "has to restore power to 1.5 million homes and businesses in South Florida's three major counties." ABC World News Tonight (9/12, story 2, 2:15, Muir, 14.63M) reported that crews "have restored power to more than two million customers," and according to the Palm Beach (FL) Post (9/12, 273K) , "As /\MERICAi\ pVERSIGHT EXT-18-248-C-000165 of 5 p.m. [on Tuesday] , more than half of FPL's customers in Palm Beach County now have power restored ." NBC Nightly News (9/12 , story 3, 2:10 , Holt, 16.61M) called it "the largest power restoration effort in US history . Local crews and teams from New York, Pennsylvania , even Minnesota , work ing to light up the southeast. " The Washington Post (9/ 12, Achenbach , Berman, 10.38M) reports that the "unprecedented outages ...also unleashed a cascade effect across the region. Millions of people who fled Irma may struggle to return home for weeks as crews try to deal with downed lines , debris and a storm-swamped electrical grid. Electrical power is needed, too, to keep water and sanitation systems operating ." Christopher Krebs, Assistant Secretary for Infrastructure Protection at OHS, said Tuesday morning that "as many as 15 million peop le in Florida lacked power, an astonishing figure that represented three-quarters of the state 's entire population ." Flood Waters Rece de In Downtown Jacksonville. The Florida Times-Union (9/12 , Conarck , 199K) reports that floodwaters "receded by midday on Tuesday, but it was hardly business as usual in downtown Jacksonville, where business owners and electrica l crews were assessing damages." The New Yor k Times (9/12 , Bidgood , Cochrane , Goldstein, Subscription Publication , 13.56M) reports that the extent of the flooding in Jacksonville "shocked " residents and officials alike, Gov. Rick Scott said, adding , "So many areas that you wou ld never have thought have flooded , have flooded. " ABC World News Ton ight (9/ 12, story 13, 1 :25 , Muir, 14.63M) reported that "members of the Coast Guard came from Kentucky, West Virginia , [and] Tennessee to Jacksonville to help those caught in the storm , rescuing more than 100 peop le." WSJournal: Reforms Helped State-Backed Insurer Cover Irma Claims. The Wall Street Journ al (9/12, Board, Subscription Publication, 6.45M) editorial izes that reforms undertaken by taxpayer-backed Citizens Property Insurance Corp. have allowed it to cover all the cla ims from Hurricane Irma. Next , the Journal urges Florida to move on tort reform before the next big hurricane hits the state. Limbaugh, Coulter Face Criticism For Hurrica ne Irma Comm ents. USA Today (9/12, Snider , 8.62M) reports conservative pundits Rush Limbaugh and Ann Coulter are fac ing blowback from their "unusual - some said dangerous - counterpo int to the blunt warn ings booming out of the state's officia l offices" to evacuate . They charged that "the liberal media had cooked up the storm for ratings, retail sales and politics." Critics , however , "assai led them as delivering their own waves of dis informat ion or, at best, poor attempts at humor, ill-conceived when the storm looked likely to take lives and leave millions without power." MORE THAN 2,000 AMERI CANS EVACUATED FROM CARIBBEAN. ABC Wor ld News Tonight (9/12, story 3, 1:35, Muir, 14.63M) reported that "more than 2,000 Amer icans" who were caught in the Caribbean when Hurricane Irma hit "have now made it out onto US military planes and on private cruise ships , as cond itions on those islands continue to deteriorate ." The CBS Evening News (9/12, story 3, 3:00, Mason , 11.17M) reported that the Puerto Rico National Guard evacuated an est imated 300 to 400 Americans from St. Martin. CBS said that while "all the major airports in Florida have reopened ...most are ope rating at about half the normal capacity , and there is still a huge backlog of travelers . More than 17,000 flights in the US and the Caribbean were canceled because of Irma." FLOR IDA PIZZA HUT MANAGER THREATE NS TO PUNISH EMPLOYEES EVACUATING AHEAD OF IRMA . USA Today (9/ 12, Hafner , 8.62M) reports that manager of a Jacksonvi lle, Flor ida Pizza Hut threatened to punish emp loyees who didn't show up for shifts because they evacuated more than one day ahead of Hurricane Irma. The note also said, "in the event of an evacuation, you MUST return within 72 HOURS ." Pizza Hut spokesman Doug Terfehr said in a statement that the memo is an "isolated incident by an employee who showed very poor judgement " and had been addressed by the franch ise's operator. He added, "This is not, /\MERICAi\ pVERSIGHT EXT-18-248-C-000166 whatsoever, a company or franchise policy ." However, in general employers can legally fire storm-fleeing employees . BRITISH VIRGIN ISLANDS PRISONERS ESCAPE IN IRMA'S WAKE. The New York Post (9/12, Fears, 4.31 M) reports that, according to a government memo, "forty 'high risk' inmates escaped from a prison on the British Virgin Islands" following Hurricane Irma. British Junior Foreign Minister Alan Duncan said, according to the Daily Mail, said, "We had a serious threat of a complete breakdown of law and order in the British Virgin Islands"; more than 700 British troops and 50 police officers have been sent to restore peace. MOSQUITOES, TOXINS IN FLOOD WATERS A GROWING CONCERN IN TEXAS. The CBS Evening News (9/12, story 4, 2:20, Mason, 11.17M) reported fro Houston that "what lies beneath the floodwaters is becoming a growing concern. Along with exposure to mold, toxins are floating around, too. Tests of floodwaters conducted by Baylor College of Medicine and Rice University show some neighborhoods are contaminated with lead and arsenic, as well as bacteria like E. Coli - found in one area at levels 135 times what's considered safe." Another concern, according to CBS, "are the mosqu itoes that breed in stagnant pools like this one and also carry West Nile and Zika . Now, ground spraying has started in certain neighborhood where's the water has receded, but in other neighborhoods, they 're going to have to spray by the air ." UP TO ONE MILLION VEHICLES SUFFERED DAMAGE IN HARVEY, IRMA. ABC World News Tonight (9/12, story 5, 1:25, Muir, 14.63M) reported Hurricanes Harvey and Irma delivering "a one-two punch to vehicles from Florida all the way to Texas and north. Up to a million cars and trucks may have spent time soaking in the floodwaters. And some of them may now be headed back to the market." ABC 's Eva Pilgrim warned consumers that "before you buy a used car, get a report on the vehicle and make sure you see a mechanic." LATEST FORECAST SHOWS HURRICANE JOSE TO IMPACT EAST COAST. On ABC World News Tonight (9/12, story 4, 0:55, Muir, 14.63M), Meteorologist Ginger Zee said that Hurricane Jose , on its current track, is likely to bring "high surf and rip currents" to the East Coast in the coming days. JOB OPENINGS AT RECORD HIGH. Reuters (9/12) reports the monthly Job Openings and Labor Turnover Survey (JOLTS) released by the Labor Department Tuesday shows that job openings in the US reached a record high in July, "suggesting a slowdown in job growth in August was an aberration and that the labor market was strong before the recent disruptive hurricanes." Job openings "increased by 54,000 to a seasonally adjusted 6.2 million ," their "highest level since the data series started in December 2000." The report, says Reuters , "showed the labor market continued to tighten amid a scarcity of workers." Gallup Analyst: 80 Percent Of Americans "Satisfied" With Their Standard Of Living. The Washington Times (9/12, Harper , 541 K) reports that Gallup analyst Jim Norman says that "80 percent of the nation say they are 'satisfied' with their current standard of living, and the pollster's complex but revealing 'well-being index' now stands at 54, a record high." According to Norman , 'The percentage of Americans saying their standard of living is getting better has risen from 62 percent in 2016 to 64 percent so far this year, with a corresponding drop in the percentage saying it is getting worse , from 22 percent to 19 percent." Stocks Indexes Close At Record Highs. Reuters (9/12, Carew) reports that the major stock indexes posted record highs Tuesday . The Dow added 61.49 points to close at 22,118.86. The S&P 500 climbed 8.37 points to 2,496.48 and the Nasdaq ended the day 22.018 points higher at 6,454.28. TRUMP TO MEET WITH HOUSE MODERATES WEDNESDAY. In what Politico (9/12, Caygle, Bade, 3.6M) calls "the latest across-the-aisle outreach by the White House to Democrats," President Trump is scheduled to meet Wednesday with a group of moderate House members. /\MERICAi\ pVERSIGHT EXT-18-248-C-000167 Politico cites "multiple sources" who say "members of the bipartisan Problem Solvers Caucus, including its co-chairmen, Reps. Tom Reed (R-NY) and Josh Gottheimer (D-NJ), will attend." Others on the list of invitees include Reps. Henry Cuellar, Kyrsten Sinema, Tom Suozzi, Kurt Schrader, Stephanie Murphy , Glenn Thompson, and Collin Peterson . WHITE HOUSE: INVESTIGATION OF COMEY "SHOULD BE LOOKED AT" BY DOJ. The New York Post (9/12, Moore, 4.31M) reports that during a Tuesday press briefing, White House press secretary Sarah Huckabee Sanders said "that federal prosecutors should investigate ousted FBI Director James Corney, saying it's something that 'should be looked at.' She said it's not President Trump 's role but a decision for the Department of Justice. " Sanders is quoted as saying, "If there's ever a moment where we feel somebody's broken the law , particularly if they're the head of the FBI, that's certainly something that should be looked at." The Hill (9/12, Fabian, Easley , 1.68M) quotes Sanders as saying of Trump's firing of Corney, "The president is proud of the decision that he made. The president was 100 percent right in firing James Corney. He knew it could be bad for him politically and felt he had an obligation to do what was right for the Amer ican people and men and women at the FBI." Sanders continued, "I think there is no secret Corney, by his own self-admission, leaked privileged government information weeks before President Trump fired him. Corney testified that an FBI agent engaged in the same practice would face serious repercussions. His actions were improper. He leaked memos to [The] New York Times. He signaled he would exonerate Hillary Clinton before interviewing her. [Trump] is very happy with the decision he made." The New York Times (9/12, Haberman, Subscription Publication, 13.56M) reports that Trump "has accused Mr. Corney of leaking classified informatio n by furnishing memos about his interactions with the president to a friend, who provided them to a reporter . The friend has said the information was not classified ." The Washington Examiner (9/12, Quinn, 465K) reported that ex-White House strategist Steve Bannon said in an interview with CBS' "60 Minutes," which aired on Sunday, that "he believed firing Corney in May was the biggest mistake made by a president in 'modern political history.' But the White House reiterated both Monday and Tuesday Trump stands by his decision, and said recently revealed information about Corney and his actions justify his dismissal. " Townhall (9/12, Pavlich, 523K) reported that Sanders' remarks came "more than a week after members of the Senate Judiciary Committee, including Chairman Chuck Grassley, revealed Corney made the decision to exonerate ...Clinton months before FBI agents finished their criminal investigation into her repeated mishandling of classified information. The revelation is at odds with testimony Corney gave under oath to Congress about the timing of the FBl's investigation." Bannon: No Doubt Corney Firing Led To Special Counsel In Russia Investigation. Coverage of Bannon 's interview for "60 Minutes" continues, with reporting once again focused on Bannon's criticism of Trump's decision to fire Corney. ABC World News Tonight (9/12, story 7, 1:40, Muir, 14.63M) reported Bannon, in his first interv iew since leaving the Administration, "is now blasting the President's decision to fire ...Comey, calling it the biggest mistake in modern political history.'' Bannon: "I don't think there's any doubt that if James Corney had not been fired , we would not have a special counsel" for the Russia probe . CBS Analysis: Mueller Has "All-Star" Team. Noting Bannon's comments, the CBS Evening News (9/12, story 6, 2:30, Mason, 11.17M) reported Special Counsel Robert Mueller has put together an "all-star" team of prosecutors with "expe rience in long-term investigations, going after organized crime, money laundering, cyber-terrorism , and foreign bribery. Some even speak Russian." One member of Mueller' team is Andrew Weissman, who, in the 1990s, worked in the Justice Department's fraud section on a case "linked to the mafia and Russian organized crime that involved Felix Sater, a Trump business partner who is now of interest to Mueller's investigation." Prosecutor Andrew Goldstein, another member of the team, has handed over to Mueller an investigation into former Trump campaign chairman Paul Manafort that Goldstein led /\MERICAi\ pVERSIGHT EXT-18-248-C-000168 at the US Attorney's office in Manhattan . In addition, James Quar les - one of the "more experienced members" of Mueller's team - served on the Watergate Special Prosecution Task Force . Kremlin-Linked Firm Created Facebook Account To Disseminate Anti-Immigrant Messages. The New York Times (9/12, Shane, Subscription Publication, 13.56M) reports that a "notice went out on Facebook last year, calling citizens of Twin Falls, Idaho, to an urgent meeting about the 'huge upsurge of violence toward American citizens' by Muslim refugees who had settled there. The inflammato ry post, however, or iginated not in Idaho but in Russia. The meeting 's sponsor , an anti-immigrant page called 'Secured Borders,' was one of hundreds of fake Facebook accounts created by a Russian company with Kremlin ties to spread vitriolic messages on divisive issues." The Times adds , "A report by the Russian media outlet RBC last March ...identified the Secured Borders page as the work of the Internet Research Agency, a St. Petersburg firm that employs hundreds of so-called trolls to post material in support of Russian government policies. A Facebook official confirmed that Secured Borders was removed in the purge of Russian fakes ." During Trump Transition, Flynn Promoted "For-Profit" Nuclear Plan, Was Paid By Supporters. Politico (9/12, Dawsey, 3.6M) reported , "As a top official in President Donald Trump's transit ion team, Lt. Gen. Michael Flynn actively promoted a private-sector scheme to build dozens of nuclear reactors across the Middle East known informally in the transition as the 'Marshall Plan.' But he did not publicly disclose that backers of the plan had paid him at least $25,000 ." Politico said that during the transition , Flynn was in communication with supporters "of the for-profit plan, billed as a way of strengtheni ng ties between the US and Arab allies looking to develop nuclear power capabi lity." At the same time, he "expressed his support for the plan with people inside the transition - and discussed its merits with others beyond Trump Tower , according to sources within and close to the Trump team at that time." TRUMP SAYS SOME WRITING ABOUT HIM "KNOW NOTHING ABOUT ME & HAVE ZERO ACCESS." Politico (9/12 , Nelson, 3.6M) reported that President Trump "lashed out Tuesday morning at authors who write about him, posting on Twitter that their books and articles amount to 'fake news' because 'they know nothing about me."' Trump is quoted as tweeting, "Fascinat ing to watch people writing books and major articles about me and yet they know nothing about me & have zero access . #FAKE NEWS!" The President "did not make clear which authors, books or articles he was referring to," but his "tweet coincided with the release of two prominent books related to the 2016 election , Hillary Clinton's campa ign memoir, titled 'What Happened,' and NBC political reporter Katy Tur's 'Unbelievable: My Front-Row Seat to the Craziest Campa ign in Amer ican History."' USA Today Analysis: Trump May Have Been Tweeting About "At Least Three Different Books." In an analysis , USA Today (9/12, Estepa, 8.62M) reports that Trump 's tweet may have been referring to "at least three different books." The "most obvious choice" is "What Happened" by Hillary Clinton , which was released Tuesday. Others could be "Unbelievable: My Front-Row Seat to the Craziest Campaign in American History" by NBC News' Katy Tur, and a yet untitled book project by the New York Times' Maggie Haberman and Glenn Thrush about the "first years of the Trump administrat ion ." STUDY: NETWORK NEWSCASTS' TRUMP COVERAGE 91% NEGATIVE IN JUNE, JULY, AUGUST. The Washington Times (9/12 , Harper , 541 K) reports , "Much of the news media continues to offer coverage wh ich is both hostile and biased aga inst President Trump and his administration, " accord ing to "a wide-reach ing new study from the Media Research Center ," which found "that 91 percent of the recent coverage which aired on ABC, CBS and NBC has been negative. 'Since January 20, Media Research Center analysts have reviewed every ment ion of President Trump and top adm inistration officials on ABC's Wor ld News Tonight , the CBS Evening News and NBC Nightly News, including weekends ,' write research director Rich Noyes and Mike Ciandella , a senior analyst for the conservative press watchdog ." The analysts added, /\MERICAi\ pVERSIGHT EXT-18-248-C-000169 "In June , July and August , broadcast evening news coverage of Trump was 91 percent negative - worse than the astounding 89 percent negative spin we calculated during the first three months of the administration ." BANNON SAYS HE SPEAKS WITH TRUMP SEVERAL TIMES A WEEK. The Wall Street Journal (9/12, Steinberg , Russolillo , Khan, Subscr iption Publication , 6.45M) reports that while meeting privately over lunch on Tuesday with a collection of money managers in Hong Kong, exWhite House chief strategist Steve Bannon said that he still speaks with President Trump several times per week , acco rding to those who attended the gathering. Those peop le said that Bannon indicated his most recent conversat ion with Trump took place the previous night and lasted for about an hour. The Journal adds that White House press secretary Sarah Huckabee Sanders on Monday had said she believed Bannon had conversed with Trump only once since his exit from the Administration. The Hill Analysis: "Mainstream Republicans" Worried About Bannon Primary Attacks. The Hill (9/12 , Easley , 1.68M) reported , "Republicans are fearful about the damage ...Bannon and his allies will inflict on GOP incumbents seeking reelection in the 2018 midterms. Bannon has been meeting with insurgent conservative candidates and is committed to making Breitbart News ... a major player in the" GOP "primaries against cand idates he views as insufficiently loyal to President Trump . Bannon is also in discussions with the pro-Trump outside group Great Amer ica PAC - wh ich has raised and spent tens of millions of dollars in the last two years - about acting as his political arm in targeting " GOP House and Senate incumbents . The Hill added, "Mainstream Republicans are frett ing over the havoc those forces cou ld unleash," expressi ng concern that they "could sink one or two incumbe nts in primaries and hobb le others enough that they lose winnable general election races to Democrats ." Von Drehle: Bannon's "Big Ideas Boil Down To A Residue Of Nonsense." In his Washington Post (9/12, 10.38M) column, David Von Drehle discusses Bannon's interview with "60 Minutes ," writing that he cast Trump - "and himself - as philosop hers and men of principle guided by a few big ideas. " However , "those big ideas boil down to a residue of nonsense. " Von Drehle says Bannon 's "big holey cheese was an idea he called 'popu list economic nationalist ,' wh ich ...turns out to have almost nothing to do with the Trump presidency. " As one example , Von Drehle pointed to the Affordab le Care Act, saying that Bannon "bitterly attacked Republican leaders of Congress for their fa ilure to repeal the law and replace it with a new" measure. However, "health care is one of the least globalized industries we have. And the goal of Obamacare (however unevenly achieved) is to make access to medical care more wide ly available. So why would this be the urgent Job One for a supposed populist economic nationalist?" CONGRESS PASSES JOINT RESOLUTION URGING TRUMP TO DENOUNCE HATE GROUPS. The New Yo rk Times (9/12, Thrush , Subscription Publication , 13.56M) reports the House and Senate on Tuesday unanimously passed a joint resolution "urging President Trump to denounce racist and anti-Sem itic hate groups , sending a blunt message of dissatisfaction with the president's initial, equivocal response to the white nationalist violence in Charlottesville" last month. The resolution may be sent for Trump 's signature "as early as Wednesday." ESPN Issues "Meek" Statement Disapproving Of Anchor Who Called Trump A White Supremacist. The Washingto n Times (9/12, Richardson , 541K) reports that ESPN on Tuesday "issued a meek statement " disapp roving of anchor Jeme le Hill's recent tweets calling President Trump and his supporters "wh ite supremacists ." The statement read, "The comments on Twitter from Jemele Hill regarding the President do not represe nt the position of ESPN .... We have addressed this with Jemele and she recognizes her actions were inappropriate." Bannon To Speak At Berkeley. The New York Times (9/12, Astor, Subscription Publication, 13.56M) reports that Steve Bannon has agreed to speak later this month at the University of California , Berkeley as part of its four-day Free Speech Week event organized by The Berkeley Patriot , a conservative student publicat ion. Conservative speaker Milo Yiannopoulos is also /\MERICAi\ pVERSIGHT EXT-18-248-C-000170 scheduled to appear . The Times highlights that Bannon's visit will come after a year of tensions on campus surrounding events w ith conservat ive speakers. Politico (9/12, Marinucci , 3.6M} reports that UC Berkeley assistant vice chancellor Dan Mogulof told Politico on Tuesday that the Berkeley Patriot "'still has not completed the critical steps' necessary to arrange venues" for its Free Speech Week event later th is month - raising questions about whether the event will still continue. According to Mogulof , the group "has failed to provide requested information needed to provide security for the events , 'nor has it confirmed the list of speakers and when they intend to schedu le events with those speakers ."' Berkeley Police Now Allowed To Use Pepper Spray. The AP (9/12) reports the Berkeley City Council voted Tuesday to allow Berkeley police to use pepper spray to subdue violent protesters "after the City Counci l modified a 20-year ban on officers ' ability to use the weapon." Central Park's Christopher Columbus Statue Vandalized. The New York Times (9/12, Nir, Mays, Subscription Publication, 13.56M) reports that the Christopher Columbus statue inside Central Park was found vandal ized on Tuesday morning, "its hands stained with red paint and its pedestal scrawled with graffiti including the hashtag '#somethingscoming.'" The words "Hate will not be tolerated" had also been written in white spray paint on the pedestal. Lawyer: Americans Should Pause Before Erasing Historical Symbols. In a Wall Street Journ al (9/12, Subscription Publication, 6.45M) op-ed , attorney James Marquardt writes about his experience as the leader of Kalamazoo , Michigan's arts council during a 2006 controversy over whether a city fountai n should have been removed because of its depictions of pioneer settlers removing Native Americans - a controversy that ended with the city deem ing the fountain not offensive . He writes that today the statue is listed on the National Register of Historic Places as an important piece of history documenting the suffering of Native Amer icans, and he argues that Amer icans should pause before erasing symbols of their past. GORKA: GOP "DID NOT WIN THE ELECTION," TRUMP DID. The Los Angeles Times (9/ 12, Tarnopolsky, 4.49M) provides an edited transcript on a recent interview it conducted with exWhite House national secur ity aide Sebastian Gorka. During the interview, says the Times , Gorka "expressed continuing support for President Trump , denounced" GOP "leaders as a greater obstacle to Trump 's success than Democrats, and predicted that the president would soon purge the White House of staffers who are not loyal to his 'Make America Great Again ' agenda. " Gorka is quoted as saying in the interview, "I've said this aga in and again and again: The biggest problem we have isn't the Democrat Party. The biggest near-term obstacle to the president's agenda is the fact that the GOP ...thinks they won the election. They did not win the election. The president was only the Republican candidate by accident. He is the quintessential antiestablishment candidate, as anti-left-wing establishment as he is anti-right-w ing establishment." WHITE HOUSE SAYS TRUMP "STANDS BY" ENDORSEMENT OF STRANGE. The AP (9/12, Thomas) reports that the White House on Tuesday reaffirmed support for appointed Sen . Luther Strange (R-AL), who is battling ex-state Supreme Court Justice Roy Moore (R-AL) in the Sept. 26 GOP runoff in the special election for the former seat of Attorney General Sess ions. The AP says White House legislative director Marc Short "was asked about the race by reporters at a breakfast Tuesday . He said President Donald Trump 'has endorsed Luther Strange and he continues to stand by that endorsement .'" Even so, The Hill (9/12, Kamisa r, 1.68M) reported that Strange "is racing to win more" aid from the President, "as Trump keeps his distance from the intraparty fight. " While Trump "endorsed Strange before Alabama 's Republican primary in August," the President "has hardly lifted a finger since, frustrating the senator's allies ." The Hill added , "With polls suggesting that Strange is behind in the race, time is running out for Trump to boost Strange 's campaign." The senator "has spent the past week trying to tie himself more closely to Trump, backing Trump 's call to end the Senate filibuster and hoping to nudge the president back into the fray." /\MERICAi\ pVERSIGHT EXT-18-248-C-000171 Bannon-Linked Group's Ad Takes Aim At Strange, McConnell. Politico (9/12, lsenstadt , 3.6M) reported, "An outside group linked to Steve Bannon is venturing into the closely watched " GOP contest, launching "a hard-hitting" ad targeting Strange and Senate Majority Leader Mitch McConnell, "Bannon 's nemesis. The spot, from the pro-Trump organization Great America Alliance , describes Strange as a 'big time lobbyist' who was 'appointed by the swamp' and is 'in the pocket of Mitch McConne ll."' In the ad , a narrator says, "It's time to drain the swamp . Take your voice to Washington, and vote for someone to represent you. On Sept. 26, don't let the swamp take over Alabama. " The Hill (9/12, Greenwood, 1.68M) reported that the spot "also includes a clip of former Alabama Gov. Robert Bentley saying that Strange was the 'first person ' mentioned by McConnell to fill the Senate seat vacated by ...Sessions in February. 'I talked with Mitch McConnell, and the first person that he actually mentioned was Luther Strange ,' Bentley, who resigned earlier this year amid a sex scandal, says in the ad. 'So Luther is not a stranger in Washington. "' Foundation 's Back Pay To Moore, Second Mortgage Draw Scrutiny. Alabama Live (9/12, Koplowitz , 608K) reports , "As the Foundation for Moral Law fought - unsuccessfully - a lawsuit against it by a Christ ian fu ndraising operation, the organization with ties to ...Moore took out a second mortgage on its Montgomery building to pay Moore years of back pay, federa l court filings and Montgomery County probate records showed. " Moore, at the time, was president of the foundation , according to the report. Alabama Live says "it remains unclear years later who paid the $465 ,000 judgement against the foundation because the organization has not filed its taxes since 2014 and didn't report the payment in its most recently filed tax returns ." WHITE HOUSE ON CLINTON ELECTION BOOK: TRUMP "PRETTY WELL-VERSED ON WHAT HAPPENED." The AP (9/12) reports that at Tuesday 's press briefing, White House spokeswoman Sarah Huckabee Sanders accused Hillary Clinton "of 'propping up book sales with false and reckless attacks.' " Sanders said "she's unsure if President Donald Trump will be reading 'What Happe ned,' Clinton's account of the 2016 campaign," saying "the president is 'pretty well-versed on what happened .'" Politico (9/12, Nelson , 3.6M) quoted Sanders as saying, "I th ink it's sad that after Hillary Clinton ran one of the most negative campaigns in history and lost and the last chapter of her public life is now going to be defined by propping up book sales with false and negligent attacks." The Washi ngton Times (9/12, Miller, 541K) and USA Today (9/12, Estepa, 8.62M) also report on Sanders' comments on Clinton 's book. Conway Hits Clinton For "Talking About Hillary" On 9111Anniversary. USA Today (9/12, Cummings, 8.62M) reports that counselor to the President Kellyanne Conway on Monday blasted Clinton "for promoting her book on the 16th anniversary of the 9/11 attacks. On the anniversary of that dark day in American history , when the nation is still reeling from Hurricanes Harvey and Irma, 'Hillary is talking about Hillary ,' Conway tweeted." NYPost's Callahan: Clinton Book-Signing Event Simply A Cash-Grab. Meanwhile, in her New York Post (9/12, 4.31 M) column, Maureen Callahan discusses Clinton 's Tuesday booksigning event in New York City, saying that those who turned out were meant "to serve two purposes: To make sure 'What Happened' debuts at No. 1 on the bestseller list and to line Hillary's pockets . (At least she wasn't surcharging $89-$3 ,000 per head, as she is at forthcoming events .) ... Wait for hours, sweat it out, love her all you want - she's popping in for your cash , nothing more.'' JORDAN RIPS WSJOURNAL OVER "FALSE STORY" ON HOUSE FREEDOM CAUCUS. Rep. Jim Jordan was asked on MSNBC's Morning Joe (9/12, 974K) about the Wall Street Journa l's claim that the House Freedom Caucus is contemplating a GOP leadership coup. Jordan said, "Nobody is talking about change in leadership, and frankly, instead of the Wall Street Journal using six unnamed sources to write something that is not accurate - and this is not the first time they have done it - why don't they call us? Do you know how many times I've talked to Paul Gigot /\MERICAi\ pVERSIGHT EXT-18-248-C-000172 this Congress? Zero . You know how many times they've called up [Rep. Mark Meadows (R-NC)] in his entire tenure in Congress? Zero . Why don't you just call us? We'll be happy to give you the truth instead of using six unnamed sources , false story after false story ." ZINKE ORDERS CLEARING OF TREES TO COMBAT WILDFIRES. In "a policy switch that represents a dramatic departure from nearly three decades of hands-off management in the federal forests ," Interior Secretary Zinke on Tuesday moved "to combat the spread of catastrophic wildfires by clearing more trees ," the Washington Times (9/12, Richardson , 541 K) reports . Zinke "released a department-wide memo calling on supervisors and managers to 'think about fire in a new and aggress ive way' by clearing the dead and dying trees and vegetation that have overrun the federa l forests and heightened wildfire danger. " Zinke said in a statement, 'This Administration will take a serious turn from the past and will proactively work to prevent forest fires through aggress ive and scientific fuels reduction management to save lives, homes, and wildlife habitat." INTERIOR IG EXAMINING REASSIGNMENT OF SES MEMBERS. The Wash ington Post (9/12, Davidson, 10.38M) reports that "in response to a request from eight Democrats on the Senate Energy and Natural Resources Committee ," the Interior Department's Office of Inspector General "is exam ining the extraord inary and politically suspect reassignment of dozens of Senior Executive Service (SES) members. " The Democrats' request came "after one Interior senior executive , Joel Clement , wrote a Washington Post article that said he was reassigned and 'retaliated against for speak ing out publicly about the dangers that climate change poses to Alaska Native communities ."' On Monday , Sen . Maria Cantwell , one the Democrats seeking a probe , "welcomed the review , saying 'there are serious questions that need to be answe red about the treatment of public servants who have dedicated their careers to the Department of the Interior ."' LEE BLASTS DEMOCRATS' QUESTIONING OF BARRETT. Sen. Mike Lee was asked on Fox News Tucker Carlson Ton ight (9/ 12, 2.76M) if Democrats ' questioning of judicial nominee Amy Barrett amounted to a religious test. Lee said, "It certa inly felt that way to me ...and as a religious minority myself, I am someone whose ears perk up very quick ly when I start hearing questions into someone 's religious belief and saying that they are of a concern to my colleagues." Lee added , "Can you imagine someone asking this of a Muslim or someone who is Jewish or a Hindu or a Sikh? Any other religion. Anyone who worships other than in a Catholic or a Christ ian or a Mormon background I can't even imagine how that would ever be tolerated for a moment. " WSJournal: Grassley Should Suspend Al Franken's Blue Slip. In an editorial , the Wall Street Journal (9/12, Subscription Publication, 6.45M) reports that in light of Sen. Al Franken's (D-MN) recent announcement that he w ill refuse to return his blue slip on the nomination of a judge to the Eight Circuit , Judiciary Chairman Chuck Grassley should suspend Sen. Franken's blue slip. The Journa l contends that Grassley has full author ity to suspend the blue slip tradition on a case-bycase should senators obstruct the nomination process . VOTER FRAUD COMMISSION CRITICIZED BY ITS DEMOCRATIC MEMBERS. The New York Times (9/12, Wines, Subscr iption Publication , 13.56M) reports that as President Trump 's voter fraud commission met in New Hampshire Tuesday "to discuss what members characterized as declining confidence in elections," the "most telling discussions of the session add ressed declining confidence in the commission itself." Democrat ic commiss ion membe r New Hampshire Secretary of State William M. Gard ner "warned that 'the specter of extreme political partisanship' threatened to undermi ne whatever work it was doing ," and Maine Secretary of State Matthew Dunlap , "another Democrat on the commission, dressed down the commiss ion's Republican vice chairman for what he called reckless statements about supposed voter fraud in New Hampshire ." Bloomberg News (9/12, Harris, 4.52M) reports that commission chairman, Kansas Secretary of State Kris Kobach "was lambasted" by Gardner and Dunlap "for an opinion piece he wrote in a Breitbart.com last week" claiming that "New Hampshire laws allowed people with out-of-state /\MERICAi\ pVERSIGHT EXT-18-248-C-000173 identification to vote there and election results were likely tipped illegally in favor of Democrats ." The Washington Post (9/12, Wag ner , 10.38M) says Kobach "largely defended an article published Friday in which he pointed to statistics showing that more than 6,000 people had voted in a close elect ion [in New Hampshire] using out-of-state driver 's licenses to prove their identity ," and "suggested that was evidence of people taking advantage of New Hampshire's same-day registration and head ing to the Granite State to cast fraudulent votes. " Experts Tell Commission Voting Machines Are Susceptible To Hacking. The Washi ngton Times (9/12, Dinan, 541 K) reports that computer experts told the comm ission Tuesday that the nation's voting machines "are susceptible to hacking, which could be done in a way so that it leaves no fingerprints , making it impossible to know whether the outcome was changed." MIT professor Ronald Rivest told the panel , that "hackers have myriad ways of attacking voting machines." Said Rivest, "You don't want to rest the election of the president on, 'Maybe the Wi-Fi was turned on when it shouldn't have been ."' Princeton professor Andrew Appel "said it would be easy to write a program that cheats on election results and deletes evidence of the hack as soon as the results are reported. " ATTORNEYS ASK ADMINISTRATION TO PROTECT PRO-LIFE CLINICS FORCED TO PERFORM ABORTIONS. The Was hington Times (9/12, Richardson , 541 K) reports attorneys have filed complaint with HHS "asking the agency to protect the free speech rights of pro-life doctors and women's health clinics from states governments trying to force them to promote abortion ." The Alliance Defending Freedom , which "has filed state and federal lawsuits challenging such laws," said the Trump Administration can "take action to ensure the First Amendment rights of pro-life medical practitioners are upheld ." ADF legal counsel Elissa Graves said in a statement, "Government officials shouldn't be allowed to force anyone to provide free advertising for the abortion industry .... Furthermore , federal law simply doesn't allow it. States that compel pro-life doctors and staff to act contrary to their conscience do not qualify for federal funds . We have filed these complaints to inform HHS of what is happening so that it can take action. " PRUITT DENIES ICAHN HAD EXCESSIVE INFLUENCE IN BIOFUEL REGULATION. Reuters (9/12, Volcovici) reports that EPA Administrator Pruitt said in a letter dated September 11 to Sen. Sheldon Whitehouse (D-RI) that investor Carl Icahn never had excess ive influence on US biofuels policy during his time as President Donald Trump's adviser on regulation. The letterwhich was a response to lawmakers' repeated requests for information on lcahn's "dual role" as a regulatory adviser and a majority stakeholder in the refining company CVR Energy - said that Icahn "was 'one of many' of Trump's advisers that he met during his confirmation process ." ENERGY DEPARTMENT ANNOUNCES OBAMA'S SOLAR GOAL MET EARLY. Bloomberg News (9/12, Natter, 4.52M) reports the Energy Department announced Tuesday that former President Obama's goa l of "slash ing" the cost of solar power down to 6 cents per kilowatt hour "has been achieved early, taking credit for" a "milestone even though the new admin istration is skeptical of renewable power." The department also "announced $82 million in new funding for solar research ." POLITICO ANALYSIS: SILICON VALLEY LOSING FAVOR FROM BOTH LEFT AND RIGHT. In an analysis , Polit ico (9/12, Scola, 3.6M) reports Silicon Valley 's technology companies "are increasingly drawing attacks from both the left and the right," with Democrats "condemn ing" Facebook for permitti ng "fake news" and "Russia-linked ads" and with conservatives accus ing Google of censor ing right-leaning viewpoints . Politico highlights major critics and observes that heightened crit icism is placing the tech sector at risk for tighter regulat ions . REP. DUNCAN PUSHES FOR GUN SILENCER PROVISION . Politico (9/ 12, Bresnahan , 3.6M) reports that Rep. Jeff Duncan (R-SC) "is renewing his controversial push" to ease restrictions on the purchase of gun silencers by including a silencer provision in the House's "Sportsmen Heritage and Recreational Enhancement Act." Duncan "argues that silencers are used by hunters /\MERICAi\ pVERSIGHT EXT-18-248-C-000174 and target shooters to limit potential hearing loss from gunfire ," but gun contro l groups argue the provision "is opposed by many police organizations ." Politico adds that there is "very little chance" Duncan 's bill would pass the Senate , given Democratic oppos ition . Poll: Americans See Gun Policy As A Top Issue. The Wash ingto n Free Beacon (9/12, released Thursday found that 35 Gutowski, 158K) reports a Wall Street Journal/NBC News QQ.U percent of respondents "listed gun rights or gun control as the top issue they considered important enough to have an impact on their voting ." The poll, wh ich surveyed 1,200 adults between August 5 and 9, found that respondents "picked gun policy as important to their vote more often than any other issue surveyed ," including environmental policy (30 percent), immigration (28 percent), and abortion ( 17 percent). PAIR OF WOMEN TESTIFY ABOUT MENENDEZ'S ALLEGED ROLE IN HELPING OBTAIN VISAS. Several reports today focus on the third day of the federa l corruption trial of Sen. Bob Menendez (D-NJ) and his longtime friend and political donor, Florida eye doctor Salomon Melgen. The AP (9/12, Porter) reports, 'The alleged former Dominican girlfriend of ' Melgen "testified Tuesday that her visa application was initially den ied and then approved exped itiously after" Melgen "told her he would 'fix it' by reaching out to 'the senator.' Rosiell Polanco-Suera testified ...Melgen said he was 'going to fix it' by talking to Menendez. She said that at the first visa interview in 2008 , she and her sister, who also sought a visa, waited for hours and were treated abruptly . At the second interview , she said, they had little or no wait and the visa was approved that day.'' Drawing from the AP dispatch , The Federalist (9/12, Payton, 88K) also reported on Polanco-Suera 's testimony. Politico (9/12, Friedman , 3.6M) reported that "forme r [Melgen] girlfriend " Svitlana Buchyk, "who was in her early 20s when prosecutors say Menendez alleged ly helped her secure a visa to visit the" US, also test ified Tuesday. Buchyk, "who was born in the Ukraine and grew up in Spain, was one of four women - three of them 20-someth ing girlfriends to the 63-year-old married Melgen for whom Menendez ...allegedly pressured officials to get visas in exchange for vacations , private jet flights and political donations. " Buchyk "said she met Menendez ...during her first visit to the US, over dinner at a Miami restaurant with him and Melgen . Prosecutor Peter Koski asked her if Melgen said anything at the dinner 'about the role that Senator Menendez played in helping you get your visa ."' Buchyk replied , in part , that "it was nothing but 'this is the person that helped you with your visa. "' The New York Times (9/12, Corasaniti , Subscription Publication , 13.56M) reports, "Before the two women took the stand, the government introduced an email sent by Mark E. Lopes, a former senior policy adviser to Mr. Menendez, to Danny O' Brien, a former chief of staff , in November 2009 , descr ibing how Mr. Menendez was 'helping secure visas in the DR for Sal M."' The Times adds , "In a portion of the email that was read aloud by Judge William H. Walls without the jury present during a discussion about whether it should be admitted as evidence, Mr. Lopes said that Mr. Menendez should not be calling ambassadors 'about stuff like th is.' The email also began, 'Danny, taking this thread offline and removing RM."' AT CONCERT, KID ROCK DENOUNCES RACISTS, MUM ON POSSIBLE SENATE RUN. The Detroit News (9/12, Rahal , Hicks, Williams , 725K) reports , "Hometown rocker Kid Rock took the stage Tuesday " in Detroit at the open ing of the new Little Caesars Arena , delivering "a profanity laced campaign- like speech marked by blasting the government for offering financial support for people 'who can't take care of themselves ' yet have '(explet ive) kid after kid."' He "also denounced racists, saying: 'Stay the hell away .'" Kid Rock said, "Struggli ng single parents are an issue close to my heart. We should not reward those who can't take care of themselves but keep having kid after (expletive) kid. Of course, of course we should help them out. Let's do it with child care, child training and find them a (expletive) place to work." Kid Rock later added, "Nazis, (expletive) bigots and again the KKK , I say (expletive) all you racists, stay the hell away" The Detroit Free Press (9/12, Gray, 1.07M) reports that Kid Rock, whose given name is Robert /\MERICAi\ pVERSIGHT EXT-18-248-C-000175 Ritchie, made no announcement as to his plans of a potential 2018 challenge to Sen. Debbie Stabenow (D-MI), despite having hinted "for the last seve n weeks that he was headed in that direction ." The Free Press adds that during the concert, Kid Rock "obliquely addressed the controversy surround ing black activists critical of his act. 'I do believe we are all created equal. I'll say it once and say it again , I love black people. And I love white people, too,' he said. 'But neither as much as I love red white and blue." Kid Rock Denied Press Credentials To Detroit Free Press. The Hill (9/ 12, Greenwood, 1.68M) reported that the Detroit Free Press was "denied a media credential for [the] Kid Rock concert Tuesday night." The Hill said Kid Rock's publicist , Kirt Webster, told "the newspaper that the decision to deny its reporters credentia ls was based on a negative column about the musician that the Free Press had published earlier this month. 'You guys wrote a f----- up story and allowed it to be published,' Webster told the Free Press over the phone on Monday." Kirt added, "To be published without doing any fact checking on what Kid Rock has done for the city of Detroit? We don't condone bad behavior. We won 't reward bad behavior." The Hill added , "The column, authored by Free Press editoria l page editor Stephen Henderson, call[ed] the decision to book Kid Rock as the inaugural performance at Detroit's new Little Caesars Arena a 'middle finger to Detroiters. "' CRUZ SAYS AIDE INADVERTENTLY LIKED PORN TWEET ON SENATOR'S TWITTER ACCOUNT. The AP (9/12, Tay lor) reports that Sen. Ted Cruz (R-TX) on Tuesday said "an aide was responsible for the 'like' that caused a pornograph ic post to briefly appear on Cruz 's Twitter feed overnight. " Cruz said "severa l aides have access to the account and that one inadvertently posted the pornography . Cruz to ld reporters that 'it was a staffing issue and it was inadvertent. It was a mistake . It was not a deliberate action ."' Cruz declined to "say whether he'll fire the staff aide or deny the aide access to his social media accounts , though he noted that the aide did not act maliciously ." The Washington Post (9/12, O'Keefe , Selk, 10.38M) reports that Cruz "woke up Tuesday to find his name trend ing on Twitter - linked overnight to a certain video from the 'Milf Hunter' series, perhaps unfairly , perhaps irrevocably. " Speaking with reporters , Cruz "said 'a number of people' in his office had access to account. " Cruz was asked a couple of times "if he himself was the liker. 'No ,' Cruz said quietly as he finally walked away." Politico (9/12, Nelson, Everett, 3.6M) quoted Cruz as saying , 'There are a number of people on the team who have access on the account. It appears that someone inadvertently hit the like button. When we discovered the post, which was I guess an hour or two later, we pulled it down ." Cruz added, "It was a staffing issue. And it was inadvertent , it was a mistake. It was not a deliberate act. We're dealing with it internally , but it was a mistake. It was not malicious." USA Today (9/12, Estepa , 8.62M) reported , "By early Tuesday, the tweet was removed from" Cruz's "likes and reported to Twitter by staff, according to his senior communications adviser . The offensive tweet posted on @tedcruz account earlier has been removed by staff and reported to Twitter,' adviser Catherine Frazier said on Twitter . Still, the damage was done. Screenshots of the tweet appearing in Cruz's like were already taken, and the senator was trending on Twitter later that morning." Rolling Stone Profiles Cruz's Democratic Challenger, O'Rourke. Meanwhile , writing for Rolling Stone (9/ 12, Stuart , 4.66M), Tessa Stuart profiled Rep. Beto O'Rourke (D-TX) , w ho is seeking to unseat Cruz in 2018 , sayi ng that before enter ing the contest , the Democrat "was a fairly low-profile member of the House. Few people knew of his crusade to combat gang vio lence by legalizing marijuana , or the years he spent playing bass w ith Cedric Bixler-Zavala (now a member of the Mars Volta and At the Drive-In) in their old punk band Foss . That started to change last summer , after Speaker Paul Ryan ordered C-Span cameras turned off during Democrats ' 25-hour sit-in to protest inaction on gun control, and O'Rourke launched his own broadcast on Facebook Live." Stuart added, "Besides supporting limits on guns, O'Rourke , who is /\MERICAi\ pVERSIGHT EXT-18-248-C-000176 44 , is pro-choice and a vocal advocate for comprehensive imm igration reform ." POLL SHOWS ROMNEY FARING MUCH BETTER THAN HATCH IN HYPOTHETICAL 2018 RACE. Utah Policy (9/11 , Webb , Schott) reported that a Dan Jones & Assoc iates poll of 608 Utah voters, taken Aug . 30-Sept. 5, shows that Mitt Romney (R) "runs much stronger than other Republican candidates against" Salt Lake County Councilwoman Jenny Wilson (D-UT) in hypothetical 2018 Senate match ups. Accord ing to the poll, Romney leads W ilson 64%-26 %; Rep. Chris Stewart (R-UT) leads Wilson 34%-30% ; Wilson leads Utah Valley Univers ity President Matt Holland (R) 30%-23%; and Wi lson leads Sen. Orrin Hatch (R-UT) 45%-34%. The poll was commissioned by Utah Policy. Hatch has yet to say whether he'll seek reelection next year. The other Repub licans tested in the poll have either indicated or are reportedly consider ing bids, if Hatch opts to retire. Wilson, the Democrat, is an announced candidate. The Salt Lake (UT) Tr ibune (9/11, Burr, Gehrke, 337K) reported that Hatch's "office dismissed the poll as old news , noting the senator has yet to say whether he will seek another term. 'As much as we love to support our local med ia outlets , this is the th ird or fourth time we have seen this same report without any new sources or any new informat ion,' said Hatch spokesman Matt Whitlock. 'Nothing has changed. Senator Hatch is focused on the critical work of the Senate , and he plans to make a final decisio n by the end of the year." ' POLITICAL ANALYST: GOP HOUSE RETIREMENTS "STILL BELOW THE HISTORICAL AVERAGE." Unde r the head line "GOP Retirements May Open Door For Democ rats In 2018,'' the Washington Times (9/12, Persons, 541 K) reports , "A slew of Republican House retirements in recent weeks has left the GOP wondering whether it wi ll be able to defend open seats in swing districts - and Democrats saying President Trump has poisoned the upcoming election for vulnerable Republicans ." In recent days , Reps . Charlie Dent (R-PA) , Dave Reichert (R-WA), and David Trott (R-MI) have announced they won 't seek reelection next year . Those "retirements follow other announcements by a series of senior Republicans ": Reps. John Duncan Jr. (R-TN) , Sam Johnson (R-TX), and Ileana Ros-Leht inen (R-FL). However , political analysts "said the retirements are normal. 'By the numbers we 're still below the histor ical average , so until we get close to exceed ing that number, it's tough to draw a grander conclusion, "' Inside Elections editor Nathan Gonzalez told the Times. Targeted GOP Members Push Back On Speculation They Won't Seek Reelection. The Hill (9/12, Marcos , 1.68M) reported that several GOP House members "expected to be heav ily targeted by Democrats in next year's midterm elections pushed back Tuesday on speculation that they might retire." Rep. Pete Sessions ' (R-TX) "campaign tweeted Tuesday that he is '[h]onored to represent #TX32. To my friends who think I'm hanging it up, as we say in #TX, Come and Take It. Rumors are comp letely false ."' Rep. Ed Royce (R-CA) "meanwhile , 'is 100 percent running for reelection ,' an aide told The Hill." And Rep. Leonard Lance (R-NJ) "also told The Hill last week that he plans to run for reelect ion." STEYER'$ GROUP DONATES $1M TO VIRGINIA IMMIGRANT ADVOCATES TO MOBILIZE VOTERS. The Washington Post (9/12, Olivo, 10.38M) reports that billionaire environmentalist Tom Steye r "is giving $1 million to imm igrant advocates in Virginia to mobilize voters in November 's state elect ions." The donation "by Steyer 's super PAC, NextGe n Amer ica, aims to tap into voter resentment over President Trump 's imm igration policies , in particular the travel ban aga inst immigrants from six Mus lim-majority countr ies and plans to phase out an Obama administration program that protected from deportation 800 ,000 undocumented immigrants who arrived here illegally as children . It follows a $2 mill ion effort announced by the group last month to" boost Lt. Gov . Ralph Northam (D-VA) in this fall's race to succeed term-l imited Gov. Terry McAuliffe (D-VA) "by target ing millennial voters and emphasizing climate change as an issue." SPECULATION GROWS ABOUT WHETHER CORDRAY WILL RUN FOR OHIO GOVERNOR. In a report on the 2018 race to succeed term-l imited Gov. John Kasich (R-OH) , The Hill (9/12, Lane , 1.68M) focused on what it described as "a guessing game in Wash ington: Is Richard /\MERICAi\ pVERSIGHT EXT-18-248-C-000177 Cordray running or not? The director of the controversial Consumer Financial Protection Bureau (CFPB) is said to be mulling a" run "and could announce his plans at any moment. But there's a catch . Federal law prevents Cordray, a Democrat , from campaigning while he serves as director of the CFPB ," leaving "lawmakers , reporters and industry lobbyists to scrounge for clues about his intentions. Leaders of congressional committees and trade groups that interact frequently with Cordray speculate that his relaxed demeanor in recent meetings indicates he's headed out the door." At the same time, "Republicans and business groups that have long sought to rein in Cordray and the CFPB are convinced a recent uptick in bureau act ion shows the director is trying to finish up several high-profile rules before he steps down. " GOP STATE AG SCHUETTE ENTERS 2018 MICHIGAN GOVERNOR'S RACE. The AP (9/12 , Eggert) reports that state Attorney General Bill Schuette (R-MI) on Tuesday launched a 2018 run to succeed term-limited Gov. Rick Snyder (R-MI) , "entering as the Republican front-runner' ' with a vow "to be a 'jobs governor ' who will cut income taxes and high auto premiums and not accept that Michigan 's best economic days are in the past." Schuette joins state Sen. Patrick Colbeck (R-MI) and Dr. Jim Hines (R) in the GOP primary . Lt. Gov. Brian Calley (R-MI) "is weighing a bid." The Detroit Free Press (9/12, Egan, 1.07M) reports that in announcing his run, Schuette vowed "that if elected he wou ld cut state income taxes , push Congress to repeal the Affordable Care Act , and bring the state more and better-paying jobs." Schuette "said the November 2018 election will present Michigan voters with a choice of continuing economic recovery or a return to the 'lost decade' of the lengthy recession that ended late in 2009, which" he "associated with the leadership of former Democratic Gov . Jennifer Granholm. 'We must have a governor who won 't accept the fate ass igned to us by the liberal elite, who look down on manufacturing,' Schuette said ." DEMOCRAT MCCABE LAUNCHES 2018 BID TO OUST GOV WALKER. The AP (9/12 , Bauer) reports that "political activist " Mike McCabe (D) on Tuesday announced that he will seek to oust Gov. Scott Walker (R-WI) in 2018 , "cast ing himself as an outsider from the left who will shake up the establishment. " McCabe, who joins state Schools Superintendent Tony Evers (D-WI) , businessman Andy Gronik (D), and state Rep. Dana Wachs (D-WI) in the Democratic primary , "said in an interv iew that as governor he would restore collective barga ining rights lost under ...Walker, push for a publ ic option state-run health insurance program for all and advocate for as close to a $15 minimum wage as possible." The Milwaukee Journal Sentinel (9/12, Marley, 628K) reports that McCabe "is staking out turf on the left end of the Democratic spectrum, campaigning for 'a living wage for every worker, health care for all , debt-free education and job training, and high-speed internet to every doorstep.' For 15 years , McCabe was the face of the Wisconsin Democracy Campaign, a group that lobbies for having taxpayers finance political campaigns to reduce the influence of special interests ." He "left the Democracy Campaign in 2015 and founded Blue Jean Nation , a group aimed at helping everyday people challenge the political establishment." DEBLASIO EASILY WINS DEMOCRATIC PRIMARY. On its front page, the New York Times (9/12, Neuman, Subscription Publication, 13.56M) reports that New York City Mayor Bill de Blasio (D) "coasted to a decisive win on Tuesday in the Democratic primary.'' moving "closer to securing a second term . Facing a group of underfinanced, little-known riva ls, Mr. de Blasio received 74 percent of the vote .'' He "will now focus on the general election, on Nov. 7 , when he will face " Assemblywoman Nicole Malliotakis (R) and ex-police detective Bo Dietl, who is "running as an independent." FERGUSON DROPS CHARGES AGAINST FRED WATSON. The New York Times (9/12, W illiams, Subscription Publication, 13.56M) reports the city of Ferguson this week "abruptly dropped its prosecution" against Fred Watson, the man whose arrest and story "was detailed in a Department of Justice report on Ferguson 's criminal justice system that followed the 2014 fatal police shooting of Michael Brown. " The city's decision to drop charges came "without explanat ion" /\MERICAi\ pVERSIGHT EXT-18-248-C-000178 after "five years of pursuing a host of minor charges " against Watson . DOJ WON'T CHARGE OFFICERS IN FREDDIE GRAY CASE. The Baltimore Sun (9/12 , Rector, 706K) reports the Justice Department issued a statement Tuesday that it will not bring charges aga inst Baltimore police officers "in connection with the death of 25-year-old Freddie Gray from injuries sustained in police custody in 2015 ." The statement said the department reached its decis ion after "an extensive review of this trag ic event, conducted by career prosecutors and investigators ." SEATTLE MAYOR RESIGNS AFTER FIFTH SEXUAL ABUSE ALLEGATION. The Seattle Times (9/12, Brunner, Beekman , 1.08M) reports that Seattle Mayor Ed Murray resigned Tuesday hours after a fifth man, a cousin of the mayor, "made public allegations Murray molested him when he was a child." In his resignation statement, Murray said , "While the allegat ions against me are not true, it is important that my personal issues do not affect the ability of our City government to conduct the public's business." LOUDERMILK, WIFE RECOVERING FROM CAR ACCIDENT. The Atlanta Journal-Const itution (9/12, Hallerman , 1.16M) reports Rep. Barry Loudermilk 's office said he and his wife are, in the Journa l-Const itution's words, "recovering from non-life-threatening injuries after" their car was rear ended, "which caused their car to veer off the road and flip multiple times. " AFTER MORE THAN 20 YEARS, NEWARK EXPECTED TO REGAIN CONTROL OF ITS SCHOOLS. The New York Ti mes (9/12 , Chen, Subscription Publication, 13.56M) reports the New Jersey State Board of Education "is expected on Wednesday to approve a plan that would ultimately give Newark control again over its public schools with their almost $1 billion budget and 55,000 students ." If the plan is approved, the dec ision would come more than 20 years after the state seized contro l of Newark public schools after a judge warned that "nepot ism" and "cronyism " had caused "abysmal" student performance. NEARLY 50 LAWSUITS FILED AGAINST EQUIFAX. NBC Nightly News (9/12, story 5, 2:25, Holt , 16.61M) reported that "nearly 50 lawsuits " already have been filed in federal court against Equifax over its data breach , "including a multi-b illion dollar class action suit." Additionally , 36 senators on Tuesday "called for federal investigations into three Equifax executives who sold stock before the breach went public although the company has said they didn't know of the breach." The CBS Evening News (9/12, story 5, 2:10, Mason, 11.17M) reported that Eva Velasquez of the nonprofit Identity Theft Resource Center is telling concerned individua ls that the "best option" to help stop immediate identity theft is a credit freeze. She said, "The credit freeze will lock the criminals out of opening financial accounts in your name .. .. It really is worth that little bit of inconvenience in order to basically lock it down and keep the thieves out." SAME-SEX MARRIAGE ADVOCATE EDIE WINDSOR DIES AT 88. USA Today (9/12, Wolf, 8.62M) reports "Edie Windsor, the New York octogenarian whose Supreme Court victory in 2013 forced the federal government to recognize same-sex marriage and led to its legalization two years later, died Tuesday " at the age of 88. "Before and particularly after her court victory," USA Today says, "Amer icans came to learn about Windsor and Thea Spyer's long march toward matrimony , encumbered by Spyer's 30-year battle with multiple sclerosis and culminating in their unlikely weddi ng trip to Canada in 2007 ." MILBANK: REPUBLICANS WILL ALWAYS OWN TRUMP. In his Washington Post (9/12, 10.38M) column , Dana Milbank writes that Republican frustrat ion with President Trump 's decision to craft a debt ceiling agreement with Democrats comes after Republicans have tolerated what Milbank describes as many indefens ible things, including Trump's firing of FBI Director Corney "in an effort to thwart the FBl's Russia probe," boasting about "groping women ," attacking racial and religious minorities and labeling women "all manner of vulgarit ies." Milbank concludes that even /\MERICAi\ pVERSIGHT EXT-18-248-C-000179 "if Republicans disown Trump now, they still own all the previous Trump actions over which they failed to break with him in any meaningful way ." POSNER: TRUMP COULD BE REMOVED FOR POLITICAL INCOMPETENCE UNDER REVISED 25TH AMENDMENT. In a Washington Post (9/12, 10.38M) op-ed, University of Chicago Law professor Eric Posner writes that President Trump's presidency "has exposed a defect in our constitutional system" in that a president cannot be removed from office, under the current understanding of the 25th Amendment , if he "has lost the confidence of the public because of a failure of temperament, ideology or ability ." Posner argues that the 25th Amendment "should be enlarged so as to provide authority to address this problem, through creation of a Presidential Oversight Council empowered to recommend removal of the president on political rather than medical grounds. " WSJOURNAL'S RILEY: DEVOS SHOULD SCRAP OBAMA-ERA SCHOOL DISCIPLINE GUIDANCE. In his Wall Street Journal (9/12, Subscription Publication, 6.45M) column, Jason L. Riley writes that in addition to addressing campus sexual assault policy , Education Secretary DeVos also should discard another Obama-era policy that targets schools that have racially disparate results in their student discipline cases. Riley argues that the policy, stemming from a 2014 Education Department guidance letter, is causing chaos in classrooms as schools struggle to handle unruly students. IGNATIUS: MEDIA SHOULD BRING BACK THE OMBUDSMAN. In his Wash ington Post (9/12, 10.38M) column, David Ignatius writes that news organizations can address flagging public trust in the media by bringing back an "in-house ombudsman or public editor to represent readers and viewers ." Ignatius argues that ombudsmen - however burdensome to media outlets- provide a check against biased report ing by second-guessing editors , challenging particular coverage , and advocating "ideas of fairness that some people think are outmoded ." Editorial Wrap-Up: NEW YORK TIMES. "Senators In Search Of A Foreign Policy." In an editorial , the New York Times (9/13, Board , Subscription Publication , 13.56M) outlines a "range of problems facing the United States abroad, " and laments "a robust foreign policy led by a reinvigorated State Department that right now is suffering from presidential neglect, poor leadership and an absence of professiona l firepower in pivotal positions ." The Times says Sens. Lindsey Graham and Patrick Leahy, two lawmakers who "understand the urgency of helping" the State Department "recover from the damages inflicted by" President Trump, have "won unan imous comm ittee approval for a $51 billion bill for the State Department and foreign aid , about $11 billion more than the administration requested. " Because there "is no sign that Mr. Trump and his team understand its core mission and its importance in a turbulent world, " the Times argues , 'The rest of Congress should ensure that a strong version of it becomes law." "How Not To Sustain Prosperity." Citing the 2016 Census report, a New York Times (9/13, Subscription Publication , 13.56M) editorial says "President Trump clearly inherited an economy on the upswing," but "The question is whether his administration and the Republican-controlled Congress will sustain the momentum, or even reverse it." The Times explains that despite the economy's improvement, "broad prosperity remains elusive ," but "Republican policy makers seem determined to undo the progress that has been made." For example , the Times says, the Administration "opposed Obama-era rules to update the nation's overt ime-pay protections for salaried workers, arguably the single most important policy option to raise middle-class pay," and both Trump and the House Budget Committee "issued budget proposals for 2018 that call for deep spending cuts to safety-net programs ." These "giant steps backward," the Times argues , would result in "greater income inequality" by shifting "income up the economic ladder. " WASHINGTON POST. "The Supreme Court Should Strike Down Wisconsin's Gerrymandering." The Washington Post (9/12, 10.38M) editorializes that the Supreme Court /\MERICAi\ pVERSIGHT EXT-18-248-C-000180 "has long kept a distance from argumen ts ove r gerrymandering," but early next month, "the justices will hear a challenge to the 2011 redrawing of Wisconsin's state legislative map by Republica n lawmakers - a demonstration of how increasingly powerful technology allows partisan mapmakers to distort representation with ever-greater precision." The Post adds that "using computer modeling, Wisconsin 's Republican-controlled legislature produced districts so unbalanced that, in 2012, Republicans won a supermajority in the state assembly even after losing the popular vote." The Post argues that "while the question of just where to draw the line between acceptable and unconstitutional partisan gerrymanders may be far from simple in many instances , Wisconsin's is an extreme case," and contends that "the judiciary cannot and should not be the sole solution to this crisis, but it has a valuable role to play in reassu ring Americans that their votes matter." "Tom Price Decides He Doesn't Want Medicare To Save Money." In an editorial, the Washington Post (9/12, 10.38M) laments "the coming crisis" if Medicare is not reformed and says "waste scored a victory when Health and Human Services Secretary Tom Price decided to stop or scale back 'bundled payment' experiments the Obama administration had begun. " Under the program, hospitals would be given "a flat payment covering the duration of a procedure and recovery ." Those "whose costs came in under the fee could keep the difference. Those whose did not would lose money." The Post argues that ":Price should be expanding the programs he is trying to end." "Metro Gets A Sudden Lifeline." A Washington Post (9/12, 10.38M) edito rial. WALL STREET JOURNAL. "How Florida Saved Taxpayers" The Wall Street Journal (9/12, Board, Subscription Publication, 6.45M) editorializes that reforms undertaken by taxpayer-backed Citizens Property Insurance Corp. have allowed it to cover all the claims from Hurricane Irma. Next, the Journal urges Florida to move on tort reform before the next big hurricane hits the state . "The Al Franken Standard." In an editorial , the Wall Street Journa l (9/12, Subscription Publication, 6.45M) writes that in light of Sen. Al Franken's recent announcement that he will refuse to return his blue slip on the nominat ion of a judge to the Eight Circuit, Judiciary Chairman Chuck Grassley should suspend Sen. Franken's blue slip. The Journal contends that Grass ley has full authority to suspend the blue slip tradition on a case-by-case should senators obstruct the nomination process. "Joseph Rago And A Disease Called Sarcoidosis." A Wall Street Journal (9/ 12, Board , Subscription Publication, 6.45M) editorial. The Big Picture: HEADLINES FROM TODAY'S FRONT PAGES. Wall Street Journal: Goldman Banks On Lending To Grow Herculean Task As Crews Race To Restore Power Apple Unveils New iPhone X To Fend Off Growing Competition There's A Speeding Mass Of Space Junk Orbiting Earth, Smashing Into Things New York Times: Amid Chaos Of Storms, US Shows It Has Improved Its Response South Korea Plans 'Decapitation Unit' To Try To Scare North's Leaders White House Weighs Lowering Refugee Quota To Below 50,000 Median US Household Income Up For 2nd Straight Year Edith Windsor, Whose Same-Sex Marriage Fight Led To Landmark Ruling , Dies At 88 De Blasio, Seeking Second Term, Wins An Easy Victory After More Than 20 Years, Newark To Regain Control Of Its Schools /\MERICAi\ pVERSIGHT EXT-18-248-C-000181 Washington Post: Paychecks Hit High For Middle Class Push For Tax Cuts Runs Into Old Problem : A Divided GOP Apple Edges Closer To Fraught Age Of Facial Recogn ition Tech 42 Years Later, A Guilty Plea In Murde r Of Md. Sisters Florida Prepares For Days - And Maybe Weeks - Without Power After Irma, A Former Gem In The US Virgin Islands Is Reduced To A Wasteland Financial Times: UK Cites Fox News As Hurdle To Rupert Murdoch 's Sky Deal Thousands Protest In France Against Macron's Labour Reforms North Korea's Opaque Trading Network Keeps Economy Afloat South Africa Businesses Under Pressure To Cut KPMG Ties Washington Times: Liberals With Eye On Presidency Rush To Support Sanders's 'Medicare For All' Bill Trump Punishes Sanctuary Countries, Halts Visas For Nations That Refuse To Cooperate On Deportations Islamic State's Rumiyah Magazine Glosses Over Losses To Boost Terror ist Morale Stunning Testimony : Voting Machines Can Be Hacked Without A Trace Of Evidence Ken Burns Goes Back To War : Vietnam Documentary Tells Uneasy Story From All Sides Story Lineup From Last Night's Network News: ABC: Hurricane Irma-Florida Keys; Hurricane Irma-Util ity Damage ; Hurricane Irma-Caribbean; Hurricane Jose-Forecast ; Hurricanes-Vehicle Damages; Baltimore Police Violence Trial; Steve Bannon Interview-Corney Firing; Maryland Abduction Cold Case; Apple-New Product Announcement; California-Street Vendor Police Bribery; Parking Lot Plane Crash ; Edith Windsor Dies; Hurricane Irma-Recovery . CBS: Hurricane Irma-Florida Keys ; Hurricane Irma-Utility Damages ; Hurricane Irma-Caribbean; Hurricane Harvey-Recovery ; Equifax-Cyber Security Breach; Russia Meddling-Special Council Investigation ; New Hampshire Police Violence Investigat ion; Edith Windsor Dies; Parking Lot Plane Crash; Apple-New Product Announcement. NBC: Hurricane Irma-Florida Keys; Hurricane Irma-US Navy Rescue Missions ; Hurricane IrmaUtility Damages; Hurricane Irma-Caribbean; Equifax-Cyber Security Breach; Edith Windsor Dies; Menopause-Hormone Therapy Safety; Parking Lot Plane Crash ; Trump-Grand Child; Sleeping Together With Dog; Apple-New Product Announcement. Network TV At A Glance: Hurricane Irma - 29 minutes, 20 seconds Apple-New Product Announcement - 4 minutes, 50 seconds Equifax-Cyber Security Breach - 4 minutes , 35 seconds Story Lineup From This Morning's Radio News Broadcasts: ABC: Hurricane Irma; Baltimore Police Violence Trial; Philade lphia Amtrack Crash Trial. CBS: Hurricane Irma; UN-North Korea Sanctions; Edith Windsor Dies; Apple-New Product Announcement; Wall Street News. FOX: Trump-Tax Reform; Hurricane Irma; Amazon HQ-Boston . NPR: Hurricane Irma; Macron-Caribbean Aid Pledge ; Sen . Sanders-Healthcare Bill; Trump-Tax Reform; Seattle Mayor Resigns . Last Laughs: LATE NIGHT POLITICAL HUMOR. Jimmy Kimmel: "Hillary Clinton's new book came out today . It is called 'What Happened.' That's not a joke . That's what it is called . This is why Hillary lost. A real President doesn 't write books . /\MERICAi\ pVERSIGHT EXT-18-248-C-000182 They write tweets ." James Carden: "Texas Senator Ted Cruz is coming under fire because , late last night , his official Twitter accou nt liked a pornographic video . So , if you ever meet Ted Cruz on the campaign trail , you might want to think twice before shaking that hand." Trevor Noah: "Everyone is freaking out about this and calling it a possible scandal all because a politician may have watched porn . Come on , people. No big deal. Everyone watches porn. Alright? It's part of being a norm human being, wh ich is exact ly why we know Ted Cruz didn't do it." Jimmy Fallon: "I guess Hillary Clinton's book 'What Happened' came out today, and I heard that it's almost 500 pages long. Unfortunately , the only person with enough time to read it is Hillary Clinton." Seth Meyers: "Hillary Clinton's new book titled 'What Happened ' was released today, as was Putin's new book 'Me."' Seth Meyers: "President Trump will reportedly visit China in November. 'Oh , can you pick up my handbags? ' asked lvanka." Conan O'Brien: "On Tw itter last night, someone discovered that Republican Senator Ted Cruz liked a tweet from a porn account. As you can imagine , that was one very embarrassing day for that porn account." Conan O'Brien: "The new iPhone will be able to track stair climbing and mountain hiking . The big question is, will it have any features for Americans? " This copy of the HHS News Briefing was sent to you because you are registered for email notification on our webs ite. If you would like to cancel emai l delivery click here. Copyright 2017 by Bulletin Intelligence LLC Reproduction or redistribut ion without permission prohibited. Content is drawn from thousands of newspapers , national magazines , national and local televis ion programs, radio broadcasts, social-media platforms and additional forms of opensource data. Sources for Bulletin Intelligence aud ience-size estimates include Scarborough, GfK MRI, comScore, Nielsen, and the Audit Bureau of Circulation. Data from and access to third party social media platforms , including but not limited to Facebook , Twitter , lnstagram and others, is subject to the respective platform's terms of use. Services that include Factiva content are governed by Factiva's term s of use. Services including embedded Tweets are also subject to Twitter for Website's information and privacy policies. 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Sender: Bulletin Intelligence Recipient: "HHS@bulletinintelligence.com" Sent Date: 2017/09/13 07:30:52 Delivered Date: 2017/09/13 07:34:47 /\MERICAi\ pVERSIGHT EXT-18-248-C-000183 Brodowski,Melissa (ACF) "ACF- Senior Leadership Officials "; To: "Wubbenhorst, William (ACF) " "Zimmerman, Elaine (ACF) "; "Thomas,Joyce (ACF) "; "Williams, Carlis (ACF) "; "Green, Angela (ACF) "; "PopeJackson, LaKesha(ACF) "; "Thoma, Nancy (ACF) "; "Hatch, Nikki (ACF) "; "Newell, nna (ACF) "; "Garza, Roberto (ACF) " Subject: OROMonthly Reportsfor July and August Date: 2017/09/13 10:53:07 Priority : Normal Type: Note To ACFSenior LeadershipAttached are the July and August reports of the Office of Regional Operation's (ORO) work on state relations, partnerships, and cross-program technical assistance. In the last two months, Regional Administrators have visited and met with at least 17 state and territory human services comm issioners and their senior staff to learn about their key priorities and needs from ACF. The reports also highlight state policy and budget updates, including a number of new laws and initiatives relat ed to child welfare, early childhood, and homelessness. Regions continue to work on strengthening state relationships , building and expanding public-private partnerships, and sharing state and local innovations. In addition, ORO continues to work closely with OHSEPRand Program Offices to provide daily Executive Briefing reports for leadership regarding Emergency Response activities for Hurricane Harvey and Hurricane Irma. We great ly appreciat e the partnership with staff from all t he Program Offices. If you should have any questio ns, do not hesitate to call on us. Regards, Melissa Lim Brodowski Strategic Initiatives Lead, Office of Regional Operations Phone: 202-401-9335 /\MERICAi\ pVERSIGHT EXT-18-248-C-000184 ~ NEW NUMBER Cell~(b)(6) Mishaela Duran Director, Office of Regional Operations Administration for Children and Families U.S. Department of Health and Human Services 330 C Street SW, Washington, DC 20201 Direct: (202) 401-4963 Mobile: I._ Cb _)(6 _)____ _. Mishaela.Duran@acf.hhs.gov www.acf.hhs.gov Sender: Brodowski, Melissa(ACF) "ACF- Senior Leadership Officials "; "Wubbenhorst, William (ACF) "; "Zimmerman, Elaine (ACF) "; "Thomas, Joyce (ACF) "; "Williams, Carlis (ACF) "; "Green, Angela (ACF) "; "Pope Jackson, LaKesha(ACF) "; "Thoma, Nancy (ACF) "; "Hatch, Nikki (ACF) "; "Newell, nna (ACF) "; "Garza, Roberto (ACF) " Sent Date: 2017/09/13 10:53:02 Delivered Date: 2017/09/13 10:53:07 /\MERICAi\ pVERSIGHT EXT-18-248-C-000185 Russell,Elizabeth (ACF) To: "Lloyd, Scott (ACF) " CC: "Moreno, Pedro (ACF) " Subject: Last officially approved NERP Date: 2017/09/15 08:16:08 Priority: Normal Type: Note FYI, Scott, Attached, please find the last officially approved NERP (in 2016). The revision of the NERP and the development of the Ebola (EVD) annex were part of an NSC effort in 2014. We worked with all the agenc ies listed on page #4-5 (except ARC) to clear this document through their ExecSecs . Clearance process included HHS StaffDivs and OpDvids. Former ACF Assistant Secretary and all applicable ACF Divisions , also reviewed and approved this plan. See the command structure on page# 13. Federal privileged information was removed from this document before sending to all the states in 2016. v/r, Elizabeth CDR Elizabeth B. Russell Coordinator, U.S. Repatriation Program Coordinator and Emergency Management Coordinator for Refugee Programs U.S. Department of Health and Human Services Administration for Children and Families Office of Refugee Resettlement Mary E. Switzer Building, 330 CST SW, Room 5123 Washington, DC 20201 .,,...,..,,.,,..,..-----. Tel: (202) 40 1-4845 , BB!,,-fb_ )(6..,,.., ) ,-,------' e-ma il: Elizabeth.ru ssell@acf.hhs.gov HSDN/STPR elizabeth.russell@dhs.sgov.gov Please note change of BB# Russell, Elizabeth (ACF) Recipient: "Lloyd, Scott (ACF) "; "Moreno, Pedro (ACF) " Sent Date: 2017/09/15 08:16:05 Delivered Date: 2017/09/15 08:16:08 /\MERICAi\ pVERSIGHT EXT-18-248-C-000186 From: Bena, Anna Marie (HHS/OGC)(ACF) To: "ORRSenior Leadership"; "Wynne, Maggie (HHS/IOS) " Subject: ORRWeekly Litigation Update Date: 2017/09/22 08:00:27 Priority: Normal Type: Note I have attached this week's litigation update. UAC litigation. In Flores (bond hearings), on 9/15, the 9th Circuit ordered that the case is not selected for inclusion in the Mediation Program (counsel may contact circuit mediator to discuss services). Also, on 9/19, the Acting Solicitor General determined the United States would not seek en bane review of the July 5 decision by the 9th Circuit. Refugee litigation. No updates this week. UAC bond hearings. • There are currently 21 outstanding bond hearing requests. Of these: o 1 hearing is scheduled for the Arlington court on October 18. o ORR is responding today to a scheduling notice for a bond hearing received from the San Francisco court. o Due to administrative problems at the New York court, ORR is re-filing motions, but must first receive confirmation from the court that the cases have been properly moved to that venue and have a judge assigned. o ORR will next file cases in San Antonio, TX and Portland , OR (2 in Portland mailed this week) • Since last week, ORR argued two bond hearings: o San Francisco, CA (telephonically). ORR submitted a letter signed by the Director indicating ORR did not consider the minor to be a danger. The judge made a ruling consistent with that letter. o Arlington, VA. The judge continued the case to October, advising either transfer to another care provider facility or release by that time. • To date there have been: /\MERICAi\ pVERSIGHT EXT-18-248-C-000187 o 5 hearings resulting in IJ decisions. In all cases the judges agreed with ORR. o 16 UACs who requested bond hearings but subsequently withdrew their requests o 1 UAC who requested a bond hearing, but due to insufficient notice to ORR the court declined to provide the hearing and instead scheduled a Master Calendar Hearing. o 10 UACs who requested bond hearings but no longer require them because they are no longer in ORR custody (e.g., because they were subsequently reunified with a sponsor, were ordered removed , aged out , etc.). Sender: Bena, Anna Marie (HHS/OGC)(ACF) Recipient: "ORR Senior Leadership "; "Wynne, Maggie (HHS/IOS) " Sent Date: 2017/09/22 08:00:23 Delivered Date: 2017/09/22 08:00:27 /\MERICAi\ pVERSIGHT EXT-18-248-C-000188 White, Jonathan (ACF) To: "Lloyd, Scott (ACF) " CC: "White, Laura (ACF) " Subject: Fwd: IES LF Shelter-Inquiry RegardingHeightened MedicalService(UAC Mejia-Lopez, D.G. XXX-XXX-535) Date: 2017/09/22 13:50:19 Priority: Normal Type: Note Scott, Direction provided again to IES program per your instructions. Jonathan Jonathan White Commander , US Public Health Service Deputy Director for Children's Programs Office of Refugee Resettlement Administration for Children and Familie s Jonathan. White acf.hhs.gov (b)(6) From: "Bartholomew , Michael (ACF)" Subject: FW: IES LF Shelter-Inguiy Regarding Heightened Medical Service (UAC fb)(6) _ Date: 22 September 2017 13:43 To: "De LA Crnz, James (ACF)" , "Gonzalez , Jose (ACF)" , "White, Jonathan (ACF)" Per your instruction Michael L. Bartho lomew, M.D., FAAP CDR, U.S. Public Health Service Director, Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Building 330 C St SW, MS 5123 Washington, DC 20201 /\MERICAi\ pVERSIGHT EXT-18-248-C-000189 Phone: 202-401-5375 michael. bartholomew@acf.hhs.gov www.acf.hhs .gov From: Bartholomew, Michael (ACF) Sent: Friday, September 22, 2017 1:43 PM To: 'Jessica Martinez'; De LA Cruz, James (ACF) Cc: Lowe, Amaeda (ACF); Claudia Gonzalez-Rivera; Brooks, Teresa (ACF); Jacobs Gainor, Rachel (ACF);l(b)(6) tvhite, Jonathan (ACF); ORR DHUC; Sualog, Jallyn (ACF); Misegades, Lara (ACF); Gonzalez, Jose (ACF) Subject: RE: IES LF Shelter-Inquiry Regarding Heightened Medical Service (UACfb)(6) ~ I ~--~ Good Afternoon, Thank you for your email. Please let ORR know when an appointment has been made for the options counseling. Please ensure that the child receives all emot ional/ psychological support that she might need to work through her thoughts and emotions during what is cert ainly a difficu lt time. I have spoken to leadership. To clarify, the program is not authorized to take her to receive termination services, or to any appointments that would prepare her for a termination, without consent from the Director. ORR Director consent cannot happen without written and notar ized consent of her parents. Program should proceed w ith life-affirming options counseling and notification to the parents of the pregnancy and the request for ter m ination, if sti ll desired. If you have any further questions, please fee l free to contact ORR. Michael L. Bartho lomew, M.D., FAAP CDR, U.S. Public Health Service Director, Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Building 330 C St SW, M S 5123 Washingt on, DC 20201 Phone: 202-401-5 375 michael. bartholomew@acf.hhs.gov www.acf.hhs.gov I From: J;')(6) [~ (b)(6l @iestex.org] Sent:ednesday, September 20, 20175:20 PM To: Bartholomew, Michael (ACF); De LA Cruz, James (ACF) Cc: Lowe, Amaeda ACF · Claudia Gonzalez-Rivera; Brooks, Teresa (ACF); Jacobs Gainor, Rachel (ACF) (b)(6) White, Jonathan (ACF); ORR DHUC; Sualog, Jallyn (ACF); Misegades, Lara (ACF) /\MERICAi\ pVERSIGHT EXT-18-248-C-000190 Subject: RE: IES LF Shelter-Inqu iry Regarding Heightened Medical Service (UACl(b)(B) ~ I ---- Good Afternoon Dr. Bartholomew , thank you for your prompt guidance . We will proceed as directed and ensure to keep ORR up-to-date . Please note , at this time UAC continues to voice she does not wish to disclose pregnancy to her parents whom reside in home country (GU). To our knowledge and according to UAC she has no "next of kin" residing in the U .S. Potential sponsor and minor 's POC in U.S. was an unverified "aunt " who declined to sponsor, there has been no further contact between care provider and this individual. Assigned Clinician will continue working closely with UAC with the hope that she will reconsider , at this point are there any other actions care provider must take due to the UAC being unwilling to proceed with parental notification?? We will be sure to inform ORR once appointment is secured, thank you. IE$ Shelter Los Fresnos International Educational Services, Inc. P.O. Box 112 Los Fresnos, TX 78566 Phone: 956-233-5705 ext:~ Cell: l(b)(B) Fax: 956-233-3435 ~b)(6) lcuiestex.org I >-= small create reflect live serve love CON FIDENTIALITY NOT ICE: This message contains information which may be confidential or privi leged. If yo u are not the intended recipient , be aware that any disclosure, copying, distribution or use of th e contents of this information is prohib ited . If you have received this transmi ssion in erro r, please not ify me immediately by telephone and permanently delete the e-mail and any attachments immediately. Thank you. From: Bartholomew , Michael (ACF) [mailto:Michael.Bartholomew@acf.hhs.gov Sent: Wednesday, September 20, 2017 3:44 PM ] ~ iestex .org >; De LA Cruz, James (ACF) roj (b)(6) Cc: Lowe, Amaeda (ACF) ; Claudia Gonzalez-Rivera ; Brooks, Teresa (ACF) ; Jacobs Gainor , /\MERICAi\ pVERSIGHT EXT-18-248-C-000191 Rachel (ACF) ;l(b)(6) @iestex .org >; White, Jonathan (ACF) ; ORR DHUC ; Sualog, Jallyn (ACF) ; Misegades , Lara (ACF) Subject: RE: IES LFShelter-Inquiry Regarding Heightened Medical Service (UA~b )(6) r b)(6) i .__ ___ __. Good Afternoon, I have discussed this email with leadership. In these particular situations, the child should seek spiritual counse ling, options counseling, and parental notification via a family session. Counseling can be provided at : Pregnancy Center of the Coastal Bend 4730 Everhart St Corpus Christi Please notify ORR when these services have been prov ided. I have added Mr. De La Cruz in case he has additional guidance Michael L. Bartholomew, M.D., FAAP CDR, U.S. Public Health Service Director, Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Building 330 C St SW, MS 5123 Washington, DC 20201 Phone: 202-401 -5375 michael. bartho lomew@a cf. hhs.gov www .acf.hhs.gov From:~b)(6) [ ~Cb)( 6) ~ iestex .org ] Sent: l uesday, September 19, zon 0.11 PM To: ORR DHUC Cc: Lowe, Amaeda (ACF); Claudia Gonzalez-Rivera; Brooks, Teresa (ACF); Jacobs Gainor, Rachel (ACF)fb)(6) Subject: [WARNING: MESSAGEENCRYPTED]FW: JES LF Shelter-Inquiry Regarding Heightened Medical Service (UAQb)(6) Importance: High I I Good Evening, /\MERICAi\ pVERSIGHT EXT-18-248-C-000192 TX Pleasebe advisedt~at IES LF Shelter has a 17-year-old female UAC ~b)(5) I l(b)(5) from Guatemala in care (DOE 9/7/17) whom is inquiring about the possibility of terminating pregnancy. On 9/18/17 UAC disclosed to assigned Clinician that she did not wish to continue her pregnancy, she shared she wished to end her pregnancy and return to home country as she has no viable sponsor options. UAC attended initial OB/GYN appointment on 09/11/2017 at RGV Women 's Health CenterHarlingen wit~(b)(6) ~n intrauterine pregnancy was confirmed by an OB sonogram Gestation is +/- 9 weeks . UAC did not share her thoughts with obstetrician during visit. Please note,fb)(6) !(obstetrician) and PCPj(b)(6) lare not currently aware UAC is seeking to terminate pregnancy, at this time the UAC has only shared this information with her assigned Clinician . In addition , care provider has not reached out to any community medical providers regarding minor's request, no appointment for the procedure /service has been made. This information has been elevated to designated ORR FFS and a Significant Incident Addendum (Event# 106940) has been submitted with regards to UAC's request for above referenced medical service. At this time care provider is reaching out to ORR Medical team in the hopes of obtaining procedural guidance regarding minor 's specific request. Please advise on how to proceed with minor 's request for this heightened medical service , thank you, we will wait for further guidance . *Password for attachment will follow in separate email, thank you. IES Shelter Los Fresnos International Educational Services, Inc. P.O. Box 112 Los Fresnos, TX 78566 Phone: 956-233-5705 ext: rb )(5 ) Cell ~(b)(6) Fax: 956-233-34~5 fbl(5) ~ iestex .orq I >-= small create reflect live serve love CONFIDENTIALITYNOTICE: This message cont ains infor mation whi ch may be confid ential or privi leged. If yo u are not th e int ended recipient , be aware th at any disclosure, copying , distr ibution or use of the contents of thi s inform atio n is prohib ited. If you have received thi s tran smission in erro r, please not ify me imm ediate ly by tel ephone and permanently delete the e-mail and any att achments im mediately . Thank you . /\MERICAi\ pVERSIGHT EXT-18-248-C-000193 White, Jonathan (ACF) "Lloyd, Scott (ACF) "; Recipient: "White, Laura (ACF) " Sent Date: 2017/09/22 13:50:19 /\MERICAi\ pVERSIGHT EXT-18-248-C-000194 From: To: Haron, Judith (HHS/ OGC) "White, Jonathan (ACF) "; "Lloyd, Scott (ACF) " "Bena, Anna Marie (HHS/OGC)(ACF) "; "Bowman, Matthew (HHS/OGC) " ; "Biswas, Toby RM (ACF) "; CC: "Suh, Victor (HHS/ OGC)(ACF) (CTR) "; "Keith, Robert (HHS/OGC)"; "Woolford, Llewellyn (HHS/ OGC) " Subject: FW: Unaccompaniedminor accessto abortion - urgent concern Date : 2017/ 09/ 22 15:55:33 Priority : Normal Type : Note fyi - Judy Haron Deputy Associa t e General Counsel Chil dren, Families and Aging Division HHS Office of the Genera l Counsel (202) 690 80 05 Notice: The contents of this message and any attachments may be privileged and confidentia l as attorney -client privileged/work product communications. Please do not disseminate without the approval of the Office of the General Counsel. If you are not an intended recipient , or have received th is message in error, please delete it without reading it and please do not print, copy, forward, disseminate, or otherwise use the information . Also, please notify the sender that you have received this communication in error . Your receipt of this message is not intended to waive any applicab le privi lege. This document is for INTERNALGOVERNMENTUSEONLYand may be exempt from disclosure under the Freedom of Information Act, 5 U.S.C.§§ 552(b)(S), (b)(7). From: Phipps, Peter (CIV) [mailto:Peter. Phipps@usdoj.gov ] Sent: Friday, September 22, 2017 3:52 PM To: Haron, Judith (HHS/OGC); Woolford, Llewellyn (HHS/OGC) Cc: Tomlinson, Mart in M. (CIV) Subject : FW: Unaccompanied minor access to abort ion - urgent concern By way of update, this is the latest from ACLU, if we could discuss on Monday that would be great . Fro m: Brigitte Amiri [mailto:bamiri@ aclu.org ] Se nt: Friday, September 22, 2017 3:07 PM To : Phipps, Peter (CIV) ; Tomlinson, Mart in M . (CIV) /\MERICAi\ pVERSIGHT EXT-18-248-C-000195 Subject: Unaccompanied minor access to abortion - urgent concern Peter & Marty: Thank you, Peter, for taking the time to speak with me on your day off. As I explained on the phone, I have been informed that there is a minor in the IESLos Fresnos, Texas shelter who has requested an abortion. Her immigration attorneys are ProBar. Her A# islCb}(5) ~ Her advocates have been told that she must receive counseling at an anti-abortion crisis pregnancy center in Corpus Christi, over two hours away, before ORRwill even consider the abortion request. This raises multiple concerns. Forcing a young women to receive counseling from a CPCviolates her First Amendment rights and privacy rights, as detailed in the attached case. Also, it seems as though ORRis wielding veto power over her abortion request. The government (or any person) exercise veto power over another's abortion decision as detailed in Planned Parenthood v. Casey, SOSU.S. 833 (1992). The delay created by these obstacles is also troub ling; although abortion is very safe, each each the pregnancy progresses increases the risks associated with the procedure. I appreciate that you are taking these concerns seriously. I look forward to speaking with when you have an update. Best, Brigitte From : Westlaw@westlaw.com Sent: Friday, September 22, 2017 8:22 AM To: Brigitte Amiri Subject: Planned Parenthood Minnesota, North Dakota, South Dakota v. Daugaard Brigitte Amiri sent you content from Westlaw. Please see the attached file. Item: Citation : Sent On: Sent By: Client ID: Planned Parenthood Minnesota , North Dakota, South Dakota v. Daugaard 799 F.Supp.2d 1048 Friday, September 22, 2017 Brigitte Amiri tb )(6) I Note: Westlaw © 2017 Thomson Reuters. No claim to original U.S. Government Works. Sender:IHaron,Judith (HHS/OGC) "White, Jonathan (ACF) "; "Lloyd, Scott (ACF) "; "Bena, Anna Marie (HHS/OGC)(ACF) "; "Bowman, Matthew (HHS/OGC)"; Recipient : "Biswas, Toby RM (ACF) "; "Suh, Victor (HHS/OGC)(ACF) (CTR) "; "Keith, Robert (HHS/OGC)"; "Woolford, Llewellyn (HHS/OGC)" Sent Date: 2017/09/22 15:55:32 Delivered Date: 2017/09/22 15:55:33 /\MERICAi\ pVERSIGHT EXT-18-248-C-000197 White, Jonathan (ACF) To: "Lloyd, Scott (ACF) " "White, Laura (ACF) "; CC: "Bowman, Matthew (HHS/OGC)" Subject: RE: IES LF Shelter-Inquiry RegardingHeightened Medical Servicel(b)(6) I Date: 2017/09/22 17:16:30 Priority: Normal Type: Note Understood. From: Lloyd, Scott (ACF) Sent: Friday, September 22, 2017 5:13 PM To: White, Jonat han (ACF) Cc: Wh ite, Laura (ACF); Bowman, Matt hew (HHS/OGC) Subject: RE: IES LF Shelter-Inquiry Regarding Heightened Medical Service (UA~(b)(5) ~ I ---- Thank you. She does not have to be the per son to speak with her parents, but her parents have to know that she is pregnant. If she wants the abort ion, we need her parents' consent. Understood on number two. b)(S) Thank you, Scott From: White, Jonathan (ACF) Sent: Friday, September 22, 2017 5:07 PM To: Lloyd, Scott (ACF) Cc: White, Laura {ACF) ,.,,.b.,..., ,,.,...-----, 5 Subject: RE: IES LF Shelter-Inquiry Regarding Heightened Medical Service (UAcl< )( > l(b)(6) I ~'--~ Scott , Understood. /\MERICAi\ pVERSIGHT EXT-18-248-C-000198 b)(5) Jonathan From: Lloyd, Scott (ACF) Sent: Friday, September 22, 2017 5:03 PM To: White, Jonatha n (ACF) Cc: White, Laura (ACF) Subject: RE: IES LF Shelter-Inquiry Regarding Heightened Medical Service (UAtj (b)(S) l(b)(6) I ,..__ __ ___. Importance: H1gn Jonathan , A few things to add, please : (b)(5) Thank you, Scott /\MERICAi\ pVERSIGHT EXT-18-248-C-000199 From: White, Jonathan (ACF) Sent: Friday, September 22, 2017 1:50 PM To: Lloyd, Scott (ACF) Jb Cc: White, Laura (ACF) Subject; Fwd· IES LFShelter-Inquiry Regarding Heightened Medical Service (Upt l(b)(6) I )(B) .___ __ __, Scott , Direction provided again to IES program per your instruction s. Jonathan Jonathan White Commander , US Public Health Service Deputy Director for Children' s Program s Office of Refugee Resettlement Administration for Children and Familie s Jonathan.White@acf. hhs.gov (202) 570-8916 From: "Bartholom ew, Michael (ACF)" Subiect· EW· IFS IF SbeJtec-Ioauin] Regarding Heightened Medical Service (UAC l(b)(6) Date: 22 September 2017 13:43 To: "De LA Cruz, James (ACF)" , "Gon zalez, Jose (ACF)" , "White, Jonathan (ACF)" Per your instruction Michael L. Bartholomew, M.D., FAAP CDR, U.S. Public Health Service Director, Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Building 330 C St SW, MS 5123 Washington, DC 20201 Phone: 202-401-5375 michael.bartholomew@acf. hhs.gov www.acf. hh s.gov From: Bartholomew, Michael (ACF) Sent: Friday, September 22, 2017 1:43 PM /\MERICAi\ pVERSIGHT EXT-18-248-C-000200 I To: l(b)(5) De LA Cruz, James (ACF) Cc: Lowe, Amaeda (ACF); Claudia Gonzalez-Rivera;Brooks, Teresa (ACF); Jacobs Gainor, Rachel(ACF); Roberto Lerma; White, Jonathan (ACF); ORR DHUC;Sualog, Jallyn (ACF); Misegades,Lara (ACF); Gonzalez,Jose (ACF) Subject: RE: IES LF Shelter-Inquiry Regarding Heightened Medical Service (UAcl(b)(5) l(b)(6) I ~--~ Good Afternoon, Thank you for your email. Please let ORR know when an appointment has been made for the options counseling . Please ensure that the child receives all emotional / psychological support that she might need to work through her thoughts and emotions during what is certainly a difficult time. I have spoken to leadership. To clarify, the program is not authorized to take her to receive te1mination services, or to any appointments that would prepare her for a tennination, without consent from the Director. ORR Director consent cannot happen without written and notarized consent of her parents. Program should proceed with lifeaffirming options counseling and notification to the parents of the pregnancy and the request for termination , if still desired. If you have any further questions, please feel free to contact ORR. Michael L. Bartholomew, M.D. , FAAP CDR, U.S. Public Health Service Director , Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and F amities U.S. Department of Health and Human Services Ma1y E. Switzer Building 330 C St SW, MS 5123 Washington , DC 20201 Phone:202-401-5375 michael. bartholomew @acf. hhs.gov www.acf. hhs.gov From:l(b)(6) l[ mailto:jessica.martinez@iestex.org] Sent: Wednesday, September 20, 2017 5:20 PM To: Bartholomew, Michael (ACF); De LA Cruz, James (ACF) Cc: Lowe, Amaeda ACF · Claudia Gonzalez-Rivera;Brooks, Teresa (ACF); Jacobs Gainor, Rachel(ACF)(b)(6) White, Jonathan (ACF); ORR DHUC;Sualog, Jallyn (ACF); Misegades,Lara (ACF) l(b~~bject; RE· IES Shelter-Inquiry Regarding Heightened Medical Service (UAC..... l(b-)(6 _l __ L] ____. Good Afternoon Dr. Bartholomew , thank you for your prompt guidance. /\MERICAi\ pVERSIGHT EXT-18-248-C-000201 We will proceed as directed and ensure to keep ORR up-to-date . Please note, at this time UAC continues to voice she does not wish to disclose pregnancy to her parents whom reside in home country (GU). To our knowledge and according to UAC she has no "next of kin" residing in the U.S. Potential sponsor and minor' s POC in U.S. was an unverifi ed "aunt" who declined to sponsor , there has been no further contact between care provider and this individual. Assigned Clinician will continue working closely with UAC with the hope that she will reconsider, at this point are there any other actions care provider must take due to the UAC being unwilling to proceed with parental notification?? We w ill be sure to inform ORR once appointment is secured , thank you . IES Shelter Los Fresnos International Educational Services, Inc. P.O. Box 112 Los Fresnos, TX 78566 Phone : 956-233-5705 exti (b)(B) Cell: l(b)(B) Fax: 956-233-3435 l(b)(B) ~ iestex.o rg I ,..__ _ __. ::,,-small create reflect live serve love CONF IDENTIALIT Y NOTICE: This message contains information which may be confidential or privi leged . If you are not the intende d recipient, be aware that any disclosure, copying, distribution or use of the contents of this infonnation is prohibited. If you have received this transmission in error, p lease notify me immediately by telephone and permanently de lete the e-mai l and any attachments immediate ly. Thank you . From : Bartholomew, Michael (ACF) [mailto:Michael.Bartholomew @acf.hhs.gov ] Sent: Wednesday, September 20, 2017 3:44 PM To:l (b)(B) @iestex.org>; De LA Cruz, James (ACF) Cc : Lowe, Amaeda (ACF) ; Claudia Gonzalez- Rivera ; Brooks, Teresa (ACF) ; Jacobs Gainor, Rachel (ACF) ; (b)(B) /\MERICAi\ pVERSIGHT EXT-18-248-C-000202 i; White, Jonathan (ACF) ; ORR DHUC ; Sualog, Jallyn (ACF) ; Misegades, Lara (ACF) Subject: RE: IES LF Shelter -Inquiry Regarding Heightened Medical Service (UAC r~ I Good Afternoon, I have discussed this email with leadership. In these particular situations, the child should seek spiritual counseling, options counseling, and parental notification via a family session. Counseling can be provided at : IPregnancy Center of the Coastal Bend I4730 Everhart St ICorpus Christi ITX Please notify ORR when these services have been provided. I have added Mr . De La Cruz in case he has additional guidance Michael L. Bartholomew, M.D., FAAP CDR, U.S. Public Health Service Director , Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Building 330 C St SW, MS 5123 Washington, DC 20201 Phone:202-401-5375 michael. bartholomew @acf.hhs.gov www.acf.hhs.gov From:l -= small create reflect live serve love /\MERICAi\ pVERSIGHT EXT-18-248-C-000204 CONFIDENTIALITY NOTICE: This message contains information which may be confidential or privileged. If you are not the intended recip ient, be aware that any disclosu re, copying , distribution or use of the contents of this infonnation is prohib ited. If you have received this transm ission in error, please notify me immediate ly by telephone and permanently de lete the e-mai l and any attachments immediate ly. Thank you. White, Jonathan (ACF) "Lloyd, Scott (ACF) "; "White, Laura (ACF) "; "Bowman, Matthew (HHS/OGC)" Sent Date: 2017/09/22 17:16:29 Delivered Date: 2017/09/22 17:16:30 /\MERICAi\ pVERSIGHT EXT-18-248-C-000205 White, Jonathan (ACF) "Lloyd, Scott (ACF) "; "Haron, Judith (HHS/OGC)"; "Bena, Anna Marie (HHS/OGC)(ACF) "; To: "Biswas,Toby RM (ACF) "; "White, Laura (ACF) "; "Bowman, Matthew (HHS/OGC)" "Sualog, Jallyn (ACF) "; "De LA Cruz, James (ACF) "; CC: "Swartz, Tricia (ACF) "; "Bartholomew, Michael (ACF) " Fwd· TFC:l.F C:helter-InquiryRegardingHeightened MedicalService (UACl(b)(6) Subject : b)(6) I I Date : 2017/09/22 19:18:10 Importan ce: High Priority : Urgent Type: Note FYSA . More to follow. Jonathan White Commander, US Public Health Service Deputy Director for Children's Programs Office of Refugee Resettlement Administration for Children and Families Jonathan .White@acf.hhs.gov I fb )(6) Begin Forwarded Message: From: fbl(5) @iestex.org> Subject: RE : IES LF Shelter-Inguirl Regarding Heightened Med ical Service (UAC r b)(6) _ Date: 22 September 2017 18:51 To: "Bartholomew , Michael (ACF)" , "De LA Cruz, James (ACF)" /\MERICAi\ pVERSIGHT EXT-18-248-C-000206 Cc: "Lowe , Amaeda (ACF )" , "fbl(6) @iestex.org >, "Brooks, Teresa (ACF)" ~------~ "JacobsGainor Rachel(ACF)" 5 , jCblCl @iestex.org>, "White , Jonathan (ACF)" , "ORR DHUC" , "Sualog, Jallyn (ACF)" , "Misegades, Lara (ACF)" , "Gonzalez, Jose (ACF)" , "l(b)(6) ., " ~ieste x.org> ICbl C6l All, Please be advised that care provider just received notice from legal service provider ProBar (see attached email correspondence) that UAC has a hearing scheduled on Monday, September 25, 2017 at 8:00a.m . in the 107th District Court at the Cameron County Courthouse located in Brownsville , Texas . Therefore , care provider will reschedule counseling appointment for Tuesday, September 26, 2017. Please do not hesitate to contact me should anyone have any questions , we will be in touch . Thank you, IES Shelter Los Fresnos International Educational Services, Inc. P.O. Box 112 Los Fresnos, TX 78566 6l Phone: 956-233-5705 ext:1Cbl( 5 Ce1ICblCl Fax: 956-233-3435 l(bl(6l ~ iestex .org I == small create reflect live serve love CONFIDENTIALITY NOTICE: This message conta ins information wh ich may be confiden t ial or privileged . If you are not the intended recipient, be aware that any disclosure, copying, di stribut ion or use of th e cont ents of thi s informat ion is prohib ited. If you have received th is transmission in error , please notify me immediately by telephone and permanently delete theemail and any attachments immed iate ly. Thank you. /\MERICAi\ pVERSIGHT EXT-18-248-C-000207 I 6) Fromj; De LA Cruz, James (ACF) Cc: Lowe, Amaeda (ACF) ;l(b)( 6 ) e)iestex.org>; Brooks, Teresa (ACF) ; Jacobs Gainor, Rachel (ACF) iestex.org>; White, Jonathan (ACF) b)(5 ) ; acf.hhs.gov>; Sualog, Jallyn (ACF) ; Misegades, Lara .,,...,..,.::-,'---~-~-------, (ACF) ; b)(6) iestex.org> 6 ,,.,.)--------, Sub·ect: RE: IES LF Shelter-Inquiry Regarding Heightened Medical Service (UA(f:""b.,.;)( (b)(6) Good Afternoon Dr. Bartholomew, I appreciate the additional guidance regarding this matter , we will proceed accordingly. Please note , care provider has secured counseling appointment with ORR approved provider on Monday at 10:00 a.m. The center is about 2.5-hour drive from our facility and we have informed their office of our estimated time of arrival. With regard to parental notification and consent, as previously noted, we will continue working with the UAC and notify ORR of any new developments. Again, we will ensure to proceed as directed and keep ORR updated on this matter. Should we have any further questions or concerns we will be sure to reach out to ORR promptly, thank you again for the issued guidance, we will be in touch . rb )(6) • IES Shelter Los Fresnos International Educational Services, Inc. P.O. Box 112 Los Fresnos, TX 78566 5> Phone: 956-233-57Q5 extj Cb)C Cellf b)(6) j ~-~ Fax: 956-233-3435 ~ iestex .org rb )(5 ) small create reflect live serve love CONFIDENTIALITY NOTICE: This message contains information which may be confidential or privileged. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited. If you have received this transmission in error, please notify me immediately by telephone and permanently delete thee mail and any attachments immediately. Thank you. again. /\MERICAi\ pVERSIGHT EXT-18-248-C-000208 From: Bartholomew , Michae l (ACF) (mailto:Michael.Bartholomew@acf.hhs.gov1 Se nt : Friday, September 22, 2017 12 :43 PM To:f bl(6) p>iestex.org >; De LA Cruz, James (ACF) Cc: Lowe, Amaeda (ACF) ;l(b)(5l @iestex.org >; Brooks, Teresa (ACF) ; Jacobs Gainor, Rachel (ACF) f b)(6) ~iest ex.org>; White, Jonat han (ACF) ; ORR DHUC ; Sualog, Jallyn (ACF) ; Misegades, Lara (ACF); Gonzalez, Jose (ACF) Subject : RE: IES LF Shelter-Inquiry Regarding Heightened Medical Service (UACl(b)(6) l(b)(6) I ~-----~ Good Afternoon, Thank you for your email. Please let ORR know when an appointment has been made for the options counseling. Please ensure that the child receives all emotional/ psychological support that she might need to work through her thoughts and emotions during what is certainly a difficult time. I have spoken to leadership. To clarify, the program is not authorized to take her to receive termination services, or to any appointments that would prepare her for a termination, without consent from the Director. ORR Director consent cannot happen without written and notarized consent of her parents. Program should proceed with life-affirming options counseling and notification to the parents of the pregnancy and the request for termination, if still desired. If you have any further questions, please feel free to contact ORR. Michael L. Bartholomew, M .D., FAAP CDR, U.S. Public Health Service Director, Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Building 330 C St SW, MS 5123 Washington, DC 20201 Phone: 202-401 -5375 m ichael.ba rtholo mew @acf.h hs.gov www.a cf.hhs.gov From: b)(6l [ mailt (bl(6l --:-~ ~ -=,...,..,=-=-=:,--=, -I ~~~ ~ Sent: We nes ay, September 20, 2017 5:20 PM To : Bartholomew, Michael (ACF); De LA Cruz, James (ACF) Cc: Lowe, Amaeda (ACF); Claudia Gonzalez-Rivera; Brooks, Teresa (ACF); Jacobs Gainor, Rachel (ACF); /\MERICAi\ pVERSIGHT EXT-18-248-C-000209 Roberto Lerma; White, Jonathan (ACF); ORRDHUC;Sualog, Jallyn (ACF); Misegades,Lara (ACF) Subject: RE: IES LF Shelter-Inquiry Regarding Heightened MedicalService (UACfb )(6) F I ----- Good Afternoon Dr. Bartholomew, thank you for your prompt guidance. We will proceed as directed and ensure to keep ORR up-to-date. Please note, at this time UAC continues to voice she does not wish to disclose pregnancy to her parents whom reside in home country (GU). To our knowledge and according to UAC she has no "next of kin" residing in the U.S. Potential sponsor and minor's POC in U.S . was an unverified "aunt " who declined to sponsor, there has been no further contact between care provider and this individual. Assigned Clinician will continue working closely with UAC with the hope that she will reconsider, at this point are there any other actions care provider must take due to the UAC being unwilling to proceed with parental notification?? We will be sure to inform ORR once appointment is secured , thank you. IES Shelter Los Fresnos International Educational Services, Inc. P.O. Box 112 Los Fresnos, TX 78566 Phage: 956-233-57Q5 ext:~ Cell~ (b)(5l ~----~ I Fax: 956-233-3435 @iestex .org ~b)(6) == small create reflect live serve love CONFIDENTIALITY NOTICE: This message cont ains inform ation wh ich may be confidentia l or privileged . If you are not the intended recipient, be aware that any disclosure, copying, di stribut ion or use of the cont ents of thi s informat ion is prohib ited. If you have received th is transmission in error, please notify me immediately by telephone and permanently delete theemail and any attachments immed iate ly. Thank you. From: Bartholomew, Michael (ACF) (mailto:Michael.Bartholomew@acf.hhs.gov Sent: Wednesday, Septemb er 20, 2017 3:44 PM Tol(b)(6) ~ iestex.org >; De LA Cruz, James (ACF) Cc:Lowe, Amaeda (ACF) l(b)(5) /\MERICAi\ pVERSIGHT 1 ~ iestex.org >; EXT-18-248-C-000210 Brooks, Teresa (ACF) ; Jacobs Gainor, Rachel (ACF) ; White, Jonathan (ACF) ; e 1ca acf.hh s. ov >; Sualog, Jallyn (ACF) ; Misegades, Lara (ACF) Sub·ect: RE: IES LF Shelter-Inquiry Regarding Heightened Medical Service (UACl(b)(6) (b)(6) ~.-------~ Good Afternoon, I have discussed this email with leadership. In these particular situations, the child should seek spiritual counseling, options counseling, and parental notification via a family session. Counseling can be provided at: Pregnancy Center of the Coastal Bend 4730 Everhart St Corpus Christi Please notify ORR when these services have been provided. I have added Mr. De La Cruz in case he has additional guidance Michael L. Bartholomew, M.D., FAAP CDR, U.S. Public Health Service Director, Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Building 330 C St SW, MS 5123 Washington, DC 20201 Phone: 202 -401-5375 m ichael. ba rtholomew@acf. h hs.gov www.acf .hhs.gov From:fb l(6) t ~( b)(6) ~iestex.o rg ] Sent: Tuesday, September 19, 20178:11 PM To : ORR DHUC Cc: Lowe. Amaeda (ACF);l(b)(6) Brooks, Teresa (ACF); Jacobs Gainor, Rachel (ACF); fb )(6) 7 . .I Sub1ect: [WARNING : MESSAGEENCRYPTED]FW: IES LF Shelter-Inquiry Regarding Heightened Medical Service (UAqb )(6) I Importance: High Good Evening , /\MERll Al\ pVERSIGHT EXT-18-248-C-000211 TX advised that IES LF Shelter has a 17-year-old female UAC ~(b)(5) rom Guatemala in care (DOE 9/7/17) whom is inquiring about the poss1b1htyof pregnancy. On 9/18/17 UAC disclosed to assigned Clinician that she did not wish to continue her pregnancy, she shared she wished to end her pregnancy and return to home country as she has no viable sponsor options. UAC attended initial OB/GYN appointment on !An 09/11/2017 at RGV Women's Health Center- Harlingen wit~(b)(6) intrauterine pregnancy was confirmed by an OB sonogram Gestation is +/- 9 weeks. UAC did not share her thoughts with obstetrician during visit. O 5 lobstetrician) and PCPfbl(6 ) !are not currently aware UAC is Please noteJ(b)(l seeking to terminate pregnancy, at this time the UAC has only shared this information with her assigned Clinician. In addition, care provider has not reached out to any community medical providers regarding minor's request , no appointment for the procedure/service has been made. This information has been elevated to designated ORR FFS and a Significant Incident Addendum (Event# 106940) has been submitted with regards to UAC's request for above referenced medical service. At this time care provider is reaching out to ORR Medical team in the hopes of obtaining procedural guidance regarding minor's specific request. Please advise on how to proceed with minor's request for this heightened medical service, thank you , we will wait for further guidance. *Password for attachment will follow in separate email, thank you . IES Shelter Los Fresnos International Educational Services, Inc. P.O. Box 112 Los Fresnos, TX 78566 ~ Phone: 956-233-5705 ext: L__J Cell*b )(6) Fax: 956-233-3435 fbl(6) ~ iestex.org I == small create reflect live serve love CONFIDENTIALITY NOTICE: This message contains information which may be confidential or privileged. If you are not the intended recipient, be aware that any disclosure, copying, distribut ion or use of the contents of this informat ion is prohibited. If you have received this transmission in error, please notify me immediately by telephone and permanently delete theemail and any attachments immed iatel y. Thank you. /\MERICAi\ pVERSIGHT EXT-18-248-C-000212 I Sender: White, Jonathan (ACF) "Lloyd, Scott (ACF) "; "Haron, Judith (HHS/OGC)"; "Bena, Anna Marie (HHS/OGC)(ACF) "; "Biswas,Toby RM (ACF) "; "White, Laura (ACF) "; Recipient: "Bowman, Matthew (HHS/OGC)"; "Sualog, Jallyn (ACF) "; "De LA Cruz, James(ACF) "; "Swartz, Tricia (ACF) "; "Bartholomew, Michael (ACF) " Sent Date: 2017/09/22 19:18:08 Delivered Date: 2017/09/22 19:18:10 /\MERICAi\ pVERSIGHT EXT-18-248-C-000213 From: To: (b)(5 l iestex.org" b)( 5 l iestex.org> Beatriz Jones Subject: Appointment to meet with minor Date: Fri, 22 Sep 2017 22:11:15 +0000 b)(6 l Good Afternoon , We will ensure that UAC be ready for tomorrow (9/23/17) at requested time. Also, UAC will be at the court building at the requested time and date. Thank you , I.E.S. Los Fresnos, TX 78566,'--~~ Phone # (956) 233 -5705 exfbl(5) Fax # (956) 233-1396 -----Original Message----@abaprobar.org > From: •~b )(5l Sent: Friday , September 22, 2017 4:53 m iestex.org ,~b)(6l @iestex.org To b)(6l iestex.org b)(5l 5 6 Cc b)( l gmail.com , "GarzaPLLC" b)( l arza He.com>, "Low e, < ma eda.Lowe @acf.hh s.gov>, b)(6) abaprobar.org >, (b)(6) abaprobar.org > .....,_u~~ e_c_t:_A_p_p_o~m• ~tment to meet with mino b)(6) '------------' Good afternoon~ Attorney s Rochelle Garza and Marie Chri stine Cortez , copied here, repre sent the above referenced minor on a legal matter and will be meeting with her at the shelter on Saturday, September 23, 2017 at 2:00 p.m. The y will be followin g thi s email with a noti ce of repre sentation. The minor ha s a hearing scheduled on Monday , September 25, 2017 in the 107th District Court at the Cameron County Courthouse locat ed at 974 E. Harrison St., Brownsville, Texas 78520. Please have the minor present at 7:30 a.m. /\MERICAi\ pVERSIGHT EXT-18-248-C-000214 Best, ro I ren s Project 202 S 1st Street Suite 300 Harlingen, TX 78550 956-365-3775 le/ 956-365-3789 fax Sender : iestex.org> Cb)(B) (b)(6) kbl(6l ea~ ba;aa; )(;;a; 6)=====;-r "· tpiestex.org b)(B) - :s-tex e .org ;;,:b-,2 )(6 ~)------c--:- iestex.org>"; ie_s_te_x_.O J~rg>"; l Recipient: /\MERICAi\ pVERSIGHT @gmail.com b)(6) gmail.com>"; "Garza PLLC "; " Lowe Amaeda ACF "; " (b)(6) abaprobar.o rg>"; (b)(6) abaprobar.org>"; 'fo l<6l !1)iestex.org>"; "Cla udia Gonzalez-Rivera " EXT-18-248-C-000215 White, Jonathan (ACF) "Lloyd, Scott (ACF) "; "Bowman, Matthew (HHS/OGC)"; "Haron, Judith (HHS/OGC)" "Sualog, Jallyn (ACF) "; "De LA Cruz, James (ACF) "; "Swartz, Tricia (ACF) "; "Bartholomew, Michael (ACF) "; "Bena, Anna Marie (HHS/OGC)(ACF) "; "Biswas, Toby RM (ACF) "; "White, Laura (ACF) " Fwd: IES LF Shelter-Inquiry Regarding Heightened Medical Service (UACl(b)(6) Subject: (b)(6) I I Date: 2017/09/22 19:20:58 Importance: High Priority: Urgent Type: Note URGENT Please see below and attached. ~t IES that direction from ORR Director and/or HHS I have advise~(b)(5l OGC will be forthcoming. Jonathan White Commander, US Public Health Service Deputy Director for Children's Programs Office of Refugee Resettlement Administration for Children and Families Jonathan. White acf.hhs.gov (b)(6) From: •rb)(6) @iestex.org> Subject: RE: IES LF Shelter-Inqui] Regarding Heightened Medical Service (UAC J(b)(6) Date: 22 September 2017 19: 12 To: "Bartholomew, Michael (ACF)" , "De LA Cruz, James (ACF)" /\MERICAi\ pVERSIGHT EXT-18-248-C-000216 Cc: "Lowe,Amaeda (ACF)" , fbl( 6l 5 l(b)( l ) iestex.org>, "Brooks, Teresa (ACF)" ~------~ "Jacobs Gainor Rachel ACF " iestex.org>, "White, , b)(5l Jonathan (ACF)" , "ORR DHUC" , "Sualog, Jallyn (ACF)" , "Misegades, Lara (ACF)" , "Gonzalez, Jose (ACF)" e}iestex.org> , i-= small create reflect live serve love CONFIDENTIALITYNOTICE: This message contains information which may be confidential or privileged . If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited . If you have received this transmission in error, please notify me immediate ly by telephone and permanently delete the e-mai l and any attachments immediately. Thank you . ~ Sent: Friday , September 22, 2017 5:51 PM From:~l (b_)(5_l ____ To: 'Bartholomew, Michael (ACF)' ; 'De LA Cruz, James (ACF)' 5 Cc: 'Lowe, Amaeda (ACF)' f~b-}(_l _______ ~ 6 fbl( ) ~ iestex.org>; 'Brooks, Teresa (ACF)' ; 'Jacobs Gaino r, Rachel (ACF)' fbl(6) ~iestex.org>; 'Wh ite, Jonathan (ACF)' ; 'ORR DHUC' ; 'Sualog, Jallyn (ACF)' ; 'Misegades, /\MERICAi\ pVERSIGHT EXT-18-248-C-000217 Lara (ACF)' ; 'Gonzalez, Jose (ACF)' l(b)(6) ~iestex.org> ~----~ Subject: RE: IES LFShelter-Inquiry Regarding Heightened Medical Service (UArl (b)(6) F I ,____ ~ All, Please be advised that care provider just received notice from legal service provider ProBar (see attached email correspondence) that UAC has a hearing scheduled on Monday, September 25, 2017 at 8:00a .m. in the 107th District Court at the Cameron County Courthouse located in Brownsville, Texas. Therefore, care provider will reschedule counseling appointment for Tuesday , September 26, 2017. Please do not hesitate to contact me should anyone have any questions, we will be in touch. Thank you , l(b)(6) IES Shelter Los Fresnos International Educational Services, Inc. P.O. Box 112 Los Fresnos, TX 78566 Phone: 956-233-5705 ext: 1410 Cell: *b )(6) Fax: 956-233-3435 l(b )(6) p2iestex.org I >-= small create reflect live serve love CONFIDENTIALITYNOTICE: This message contains information which may be confidential or privil eged. If yo u are not th e int ended recipient, be aware that any disclosu re, copying, distribution or use of the contents of this information is prohib ited. If you have received this transmission in error, please notify me immediately by telephone and permanently delete the e-mail and any attachments immediately . Thank you . From: Jessica Mart inez Sent: Friday, September 22, 2017 1:43 PM To: 'Bartholomew, Michael (ACF)' ; De LA Cruz, James (ACF) Cc: Lowe, Amaeda (ACF) J~~)(6 _)_______ ~ 6 l(b)( ) ~ iestex.org >; Brooks, Teresa (ACF) ; Jacobs Gainor, Rachel (ACF) ;fb)(6) ~ iestex.org >; /\MERICAi\ pVERSIGHT EXT-18-248-C-000218 White , Jonathan (ACF) ; ORR DHUC ; Sualog, Jallyn (ACF) ; Misegades, Lara (ACF)· Gonzalez Jose ACF iestex.or > ; b)(5) Subject: RE: IESLFShelter-lnqul-iry--=R-eg_a_r...,..,....__,,..,........,........,..----r-,,....,........,.,...ic-ar-1 S :'."' e=r~ vi""' ce ~ (UAC~fb)(6- l---~ l(b)(6) I - Good Afternoon Dr. Bartholomew , I appreciate the additional guidance regarding this matter, we will proceed accordingly. Please note, care provider has secured counseling appointment with ORR approved provider on Monday at 10:00 a.m. The center is about 2.5-hour drive from our facility and we have informed their office of our estimated time of arrival. With regard to parental notification and consent , as previously noted, we will continue working with the UAC and notify ORR of any new developments. Again, we will ensure to proceed as directed and keep ORR updated on this matter. Should we have any further questions or concerns we will be sure to reach out to ORR promptly, thank you again for the issued guidance, we will be in touch. rb )(6) • IES Shelter Los Fresnos International Educational Services, Inc. P.O. Box 112 Los Fresnos, TX 78566 Phone: 956-233-5705 ext: 1410 Cell:fb l(6) Fax: 956-233-3435 fbl(6) ~ iestex .org I >-= small create reflect live serve love CONFIDENTIALITYNOTICE: This message contains information which may be confidential or privileged. If yo u are not the intended recipient , be aware that any disclosure, copying, distr ibution or use of the contents of this information is prohib ited. If you have received this transmission in error, please notify me immediately by telephone and permanently delete the e-mail and any attachments immediately. Thank you . again. From: Bartholomew, Michael (ACF) [mailto:Michael.Bartholomew@acf .hhs.gov] Sent: Friday, September 22, 2017 12:43 PM /\MERICAi\ pVERSIGHT EXT-18-248-C-000219 piestex.org >; De LA Cruz, James (ACF) 5 Cc: Lowe, Amaeda (ACF) f~~-l<_l_______ ~ b)(6) iestex .or >; Brooks, Teresa (ACF) ; Jacobs Gainor, ac e ACF) fbJ(6) ~ iestex.org >; White, Jonathan (ACF) ; ORR DHUC ; Sualog, Jallyn (ACF) ; Misegades, Lara (ACF); Gonzalez, Jose (ACF) Subject : RE: IES LFShelter-Inquiry Regarding Heightened Medical Service (UA9(bl(6l l(b )(6) I I Good Afternoon, Thank you for your email. Please let ORR know when an appointment has been made for the options counseling. Please ensure that the child receives all emotional/ psychological support that she might need to work through her thoughts and emotions during what is certainly a difficult time . I have spoken to leadership. To clarify, the program is not authorized to take her to receive termination services, or to any appointments that would prepare her for a termination, without consent from the Director. ORR Director consent cannot happen without written and notarized consent of her parents. Program should proceed with life-affirming options counseling and notification to the parents of the pregnancy and the request for termination, if still desired. If you have any further questions, please feel free to contact ORR. Michael L. Bartholomew, M.D., FAAP CDR, U.S. Public Health Service Director, Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Building 330 C St SW, MS 5123 Washington, DC 20201 Phone : 202-401-5375 michael. bartho lomew @acf .hhs.gov www .acf .hhs.gov I(illfilttQf bl(6) From: p»<6l p)iestex .orq] Sent: Wednesday, September 20, 2017 5:20 PM To: Bartholomew, Michael (ACF): De LA Cruz, James (ACF) Cc : Lowe, Amaeda (ACF);fbl(6l arooks, Teresa (ACF); Jacobs Gainor, Rachel (ACF); Roberto Lerma; White, Jonathan (ACF); ORR DHUC; Sualog, Jallyn (ACF); Misegades, Lara (ACF) 5 Subject; RE;IES~F Shelter-Inquiry Regarding Heightened Medical Service (UA9(bl( l l(b)(6) /\MERICAi\ pVERSIGHT j '-·___ ___, EXT-18-248-C-000220 Good Afternoon Dr. Bartholomew , thank you for your prompt guidance . We will proceed as directed and ensure to keep ORR up-to-date. Please note, at this time UAC continues to voice she does not wish to disclose pregnancy to her parents whom reside in home country (GU). To our knowledge and according to UAC she has no "next of kin" residing in the U.S. Potential sponsor and minor 's POC in U.S. was an unverified "aunt" who declined to sponsor, there has been no further contact between care provider and this individual. Assigned Clinician will continue working closely with UAC with the hope that she will reconsider, at this point are there any other actions care provider must take due to the UAC being unwilling to proceed with parental notification?? We will be sure to inform ORR once appointment is secured, thank you. IES Shelter Los Fresnos International Educational Services, Inc. P.O. Box 112 Los Fresnos, TX 78566 Phone: 956-233-5705 ext: 1410 Celll (b)(6) Fax: 956-233-3435 l(bl(6l ~ iestex.org I >-small create reflect live serve love CONFIDENTIALITYNOTICE: This message contains information which may be confidential or privileged. If you are not the intended recipient , be aware that any disclosure, copying, distr ibution or use of the contents of this information is prohib ited. If you have received this transmission in error, please notify me immediately by telephone and permanently delete the e-mail and any attachments immediately. Thank you . From: Bartholomew , Michael (ACF)[mailto:Michael. Bartholomew@acf .hhs.gov] Sent: Wednesday, September 20, 2017 3:44 PM Toj(b)(6) ~ iestex.org>; De LA Cruz, James (ACF) Cc: Lowe, Amaeda (ACF);I._ Cb_ lC6 _l_______ _. ~b)(6) JPiestex.org>; Brooks, Teresa (ACF); JacobsGainor, Rachel(ACF); White, Jonathan (ACF); ORRDHUC /\MERICAi\ pVERSIGHT EXT-18-248-C-000221 ; Sualog, Jallyn {ACF) ; Misegades, Lara (ACF) Subject: RE: IES LFShelter-Inquiry Regarding Heightened Medical Service (UAC rb)(6) l(b)(6) I ~--~ Good Afternoon, I have discussed this email with leadership. In these particular situations, the child should seek spiritual counseling, options counseling, and parental notification via a family session. Counseling can be provided at : I Pregnancy Center of the Coastal Bend I4730 Everhart St ICorpus Christi ITX Please notify ORR when these services have been provided. I have added Mr. De La Cruz in case he has additional guidance Michael L. Bartho lomew, M.D., FAAP CDR, U.S. Public Health Service Director, Division of Health for Unaccompanied Children {DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Building 330 C St SW, MS 5123 Washington, DC 20201 Phone: 202-401-5375 michael. bartho lom ew@a cf. hhs.gov www .acf .hhs.gov 6) From: *b)(6) l ~b)( ~ iestex.orq ] Sent: luesoay, ::,epce111bcr 19, 2017 8:11 PM To: ORR DHUC Cc: Lowe, Amaeda (ACF); b)(6) eresa (ACF); Jacobs Gainor, Rachel (ACF); b)(6) Subject: [WATT'KTTl<'TT_,:,......,,.=""-,1GE ENCRYPTED)FW: IES LF Shelter-Inquiry Regarding Heightened Medical Service (UAcl-small create reflect live serve love CONFIDENTIALITYNOTICE: This message contains information which may be confidential or privileged. If you are not the intend ed recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is prohib ited. If you have received this transmission in error, please notify me immediately by telephone and permanently delete the e-mail and any attachments immediately . Thank you . /\MERICAi\ pVERSIGHT EXT-18-248-C-000223 White, Jonathan (ACF) "Lloyd, Scott (ACF) "; "Bowman, Matthew (HHS/OGC)"; "Haron, Judith (HHS/OGC)"; "Sualog, Jallyn (ACF) "; "De LA Cruz, James (ACF) "; "Swartz, Tricia (ACF) "; "Bartholomew, Michael (ACF) "; "Bena, Anna Marie (HHS/OGC)(ACF) "; "Biswas, Toby RM (ACF) "; "White, Laura (ACF) " Sent Date: 2017/09/22 19:20:57 Delivered Date: 2017/09/22 19:20:58 /\MERICAi\ pVERSIGHT EXT-18-248-C-000224 Moreno, Pedro (ACF) To: "Lloyd, Scott (ACF) " Subject: FW: RepartiationSQREXReadAhead Materials Date: 2017/09/27 15:04:21 Priority : Normal Type: Note Scott, As discussed, please find attached the repatriation exercise documents for next week, organized by ASPR. Best, Pedro From: Moore, William (OS/ASPR/OEM) Sent: Wednesday, Septembe r 27, 2017 2:47 PM To: Mackay, Thomas (OS/ASPR/OEM) Cc : Athena Strateg ic Design Inc (chr istiana .briggs@athenast rategicdes ign.com); Tidman, Sarah (Tidmans@cna.org); Butterworth, Virginia (OS/ASPR/OEM); Barton, Jessie-Kate (OS/ASPR/OEM); Moreno, Pedro (ACF); Russell, Elizabeth (ACF); Vineyard, Michael (OS/ASPR/OEM) Subject: Repartiation SQREX Read Ahead Materia ls Hi Tom, As promised, the read ahead materials for the Repatriation SQREXare attached. Please forward to Chris and on to the schedulers for distribution to the invitees . I will send the fina l documents to the planning team directly. I recomme nd participants read the HHS NERPSQREXSit uation Manual and the HHS NERPSQREXSlide Presentation fi rst. The other documents are for deeper background and refe rence. V/R Mike William (M ike) Moore Exercise Branch Chief Tr aining, Exercises and Lessons Learned ASPR/OEM /\MERICAi\ pVERSIGHT EXT-18-248-C-000225 U.S. Departme nt of Health and Human Services 202-570-6 106 Moreno, Pedro(ACF) Recipient: "Lloyd, Scott (ACF) " Sent Date: 2017/09/27 15:04:17 Delivered Date: 2017/09/27 15:04:21 /\MERICAi\ pVERSIGHT EXT-18-248-C-000226 White, Jonathan (ACF) To: "Lloyd, Scott (ACF) " "White, Laura (ACF) "; CC: "Bartholomew, Michael (ACF) " Subject: IES case summary Date: 2017/09/28 14:30:57 Priority: Normal Type: Note Scott, The one pager became a two pager but thi s is still succinct given the complexity of the case. Thanks to Michael and Laura for their help preparing it. Please review for any edits you wish to make_fb)(S) (b)(5) Jonathan Jonathan D. White Commander, U.S. Public Health Service Deputy Director for Children's Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services 330 C Street SW (202) 690-6984 j onathan. white@acf.hhs.gov White, Jonathan (ACF) "Lloyd, Scott (ACF) "; "White, Laura (ACF) "; "Bartholomew, Michael (ACF) " Sent Date: 2017/09/28 14:30:56 Delivered Date: 2017/09/28 14:30:57 /\MERICAi\ pVERSIGHT EXT-18-248-C-000227 White, Laura (ACF) To: "Lloyd, Scott (ACF) " CC: "White, Jonathan (ACF) " Subject : Information Memo to Secretary on UACCase_092817.docx Date: 2017/09/28 17:10: 11 Priority : Normal Type: Note Scott, I have attached the info memo to Sl on the UAC case. Please let us know if you have any questions. We should send this to Steve and then send it to Maggie/ Tim Clark. Thank s, Laura White, Laura (ACF) "Lloyd, Scott (ACF) "; Recipient: "White, Jonathan (ACF) " Sent Date: 2017/09/28 17:10:11 /\MERICAi\ pVERSIGHT EXT-18-248-C-000228 Davis, Ms. Cynthia (ACF) To: "Davis, Ms. Cynthia (ACF) " Subject : ACFCongressional Daily News - September29, 2017 Date: 2017/09/29 10:18:49 Priority : Normal Type: Note Administration for Children and Families Office of Legislative Affairs and Budget ACF Congressional Daily News for Friday, September 29, 2017 House and Senate Floor Activity The Senate and House are not in session today and will reconvene on October 2. OLAB Hearing Coverage On October 4, the House Homeland Secur ity Committee will hold a markup of H.R. 3548, the Border Security fo r America Act. Congressional Press Releases Related to ACF DOMESTIC VOILENCE Blunt. Klobuchar Introduce Bill to Strengthen Privacy Protections for Domestic Violence Victims - Sen. Blunt (R-MO) HUMAN TRAFFICKING Cortez Masto Urges Coordination among Local. State. and Federal Authorities to Crack Down on Human Trafficking in Indian Country - Sen. Costez Masto (D-NV) /\MERICAi\ pVERSIGHT EXT-18-248-C-000229 Murkowski on Human Trafficking of American Indian and Alaska Natives - Sen. Murkowski (R-AK ) Tester Combats Human Trafficking in Indian Country - Sen Tester (D-MT} REFUGEE RESETTLEMENT Rep. Lieu Responds to Trump's Plan to Reduce Refugee Cap - Rep. Lieu (D-CA) Carper Statement on Trump's Decision to Cut Refugee Admissions - Sen. Carper (D-DE) Goodlatte Statement on Trump Administration's Refugee Ceiling for FY 2018- Rep. Goodlatte (R-VA) Pascrell Statement on Trump Administration Reduction in Refugee Acceptance - Rep. Pascrell (D-NJ) Congressional Daily News Bloomberg Government reports on today's congressional activity below. What to Watch Next Week By Robin Meszoly I September 29, 2017 8:42AM ET Budget and taxes, immigration and abortion restrict ions will top the agenda as Congress kicks off the new fiscal year. Majority Leader Kevin McCarthy (R-Calif.) said the House would vote next week on its fiscal 2018 budget resolution (H.Con.Res. 71) shepherded by Budget Committee Chairman Diane Black (R-Tenn.). Adopting the budget resolution with reconciliation instructions would pave the way for an overhaul of the tax code by a simple majority in the Senate. The decision by the House Freedom Caucus to endorse the tax framework unveiled by GOP leaders removed a potential hurdle for adoption of the blueprint. The Senate Budget Committee plans to mark up that chamber's budget resolution next week, Majority Leader Mitch McConnell (R-Ky.) said. /\MERICAi\ pVERSIGHT EXT-18-248-C-000230 ABORTION: The House plans to vote on a measure (H.R. 36) that would make it a crime to perform or attempt an abortion if the probable post-fertilization age of the fetus is 20 weeks or more. The proposed Pain Capable Unborn Child Protection Act would provide exceptions in cases of rape or incest. The House has passed similar bills in the two previous Congresses, largely along party lines. OBAMACARE: We'll be watching for a potential bipartisan agreement to help stabilize individual insurance markets. Senate Health, Educat ion, Labor and Pensions Committee Chairman Lamar Alexander (R-Tenn.) told reporters yesterday that he and the committee's ranking Democrat Patty Murray (Wash.) are close to a deal and need the support of leaders and members to move forward. NOMINATION: Federal Communications Commission Chairman Ajit Pai is up for a confirmation vote Monday for a new five-year term. The Senate voted 55-41 yesterday to invoke cloture on the nomination of Pai, who has drawn Democrats' criticism over plans to rewrite Obama administrat ion rules on net neutrality and broadband classification. The same day, former Equifax Inc. Chairman and CEO Richard Smith , is scheduled to testify before a House Energy and Commerce Digital Commerce and Consumer Protection Subcommittee oversight hearing on the cyberbreach at the company that resulted in the theft of more than 143 million Americans' personal data. Smith returns to Capitol Hill Wednesday to appear before Senate Banking Committee. The Senate Judiciary Privacy, Technology and the Law Subcommittee plans a hearing that day on the Equifax breach. Senate Minority Leader Chuck Schumer (D-N.Y.) and other Democrats are citing the Wells Fargo and Equifax scandals as a reason Congress shouldn't kill a rule designed to make it easier for consumers to sue financial firms. EX-PRESIDENTS' PERKS : The Senate Homeland Security and Governmental Affairs Committee plans Wednesday to mark up legislation (S. 1791) sponsored by Joni Ernst (R-lowa) that would cap former presidents' monetary allowances for items such as office space and staff salaries, and reduce the allowance by each dollar of income a former president earns in excess of $400,000. "With the national debt quickly approaching $20 trillion , we cannot afford to generously subsidize the perks of former presidents to the tune of millions of dollars," Ernst said in a Sept. 12 statement. She cited "former presidents raking in tens of millions of dollars from book deals, speaking engagements and more." Then-President Barack Obama vetoed similar legislation last year, saying it "would impose onerous and unreasonable burdens on the offices of former presidents" and terminate staffers' salaries abruptly. The /\MERICAi\ pVERSIGHT EXT-18-248-C-000231 House Oversight and Government Reform Committee approved a companion bill (H.R. 3739) by voice vote Sept. 13. Sender: Dav is, Ms. Cynthia (ACF) "Davis, Ms. Cynth ia (ACF) " Sent Date: 2017/09/29 10: 18:43 Delivered Date: 2017/09/29 10:18 :49 /\MERICAi\ pVERSIGHT EXT-18-248-C-000232 Wynne, Maggie (HHS/IOS) To: "Lloyd, Scott (ACF) " Subject: One other thought Date: 2017/10/0118:43:49 Priority: Normal Type: Note 1~)(5) Wynne, Maggie (HHS/IOS) Recipient: "Lloyd, Scott (ACF) " Sent Date: 2017/10/0118:43:49 /\MERICAi\ pVERSIGHT EXT-18-248-C-000233 Davis, Ms. Cynthia (ACF) To: "Davis, Ms. Cynthia (ACF) " Subject : ACFCongressional Daily News - October 3, 2017 Date: 2017/10/03 10:55:10 Priority : Normal Type: Note Administration for Children and Families Office of Legislative Affairs and Budget ACF Congressional Daily News for Tuesday, October 3, 2017 House and Senate Floor Activity The Senate and House meet at 10 a.m. OLAB Hearing Coverage On October 4, the House Energy and Commerce Committee will markup a bill concerning abstinence education and the PREP program. For a post-markup summary, please contact OLAB's Preeti Kanodia . Congressional Press Releases Related to ACF LIHEAP ICYM I: Shea-Porter , Bipartisan Group of Members Press for More LIHEAP Funding - Rep. Shea-Porter (D-NH) REFUGEE RESETTLEMENT Hoyer Statement on the Trump Administration's Decision to Admit Fewer Refugees to the United States Rep. Hoyer (D-MD) /\MERICAi\ pVERSIGHT EXT-18-248-C-000234 UNACCOMPANIED ALIEN CHILDREN Reps. Roybal-Allard & Jayapal Statement on Whi te House Immigration Proposal - Rep. Roybal-Allard (DCA) Congressional Daily News BUDGET RSC Budget Allows Conservatives to Lay Down Auste re Marker - Roll Call Bloomberg Government reports on today 's congressional activity below. What to Watch Today By James Rowley I October 3, 2017 8:53AM ET Unable to repeal Obamacare or dramatically cut government spending , House Republicans will try to rally their party's socially conservative base with a floor vote today on a measure that would limit legal abortion. The measure would permit abortion only in the first 20 weeks of pregnancy except in cases of rape, incest or a threat to a woman's life. This will be the third time for considerat ion of th is type of bill in the six years Republicans have held their House majority. In 2013 and 2015, the House passed legislation banning late-term abortions. Both measures died in the Senate, which Democrats controlled in 2013 and had the power to deploy the filibuster to block consideration in 2015 . Rep. Trent Franks (R-Ariz .), who has sponsored all three versions of the bill he calls the Pain-Capable Unborn Child Protection Act , said in a Twitter post yesterday that his legislat ion is urgently needed because "unborn babies feel pain by at least 20 weeks . Late, dismemberme nt abortions are too extreme for America ." Medical organizat ions such as the Amer ican Congress of Obstetricians and Gyneco logists have disputed claims that fetuses feel pain at 20 weeks of gestation . /\MERICAi\ pVERSIGHT EXT-18-248-C-000235 Many Republicans campaigned on promises to repeal Obamacare and bar Planned Parenthood, a leading abortion provider, from federal funding. With efforts to repeal Obamacare having failed so far and legislation to overhaul the tax code still to be written, Republicans are pushing what lawmakers call message bills as a "compensatory gesture" to their political base, Rutgers University political scientist Russ Baker said. "They need to compensate the right-to-life people who were such a big element" in their political coalition, said Baker . An effort earlier this year to defund Planned Parenthood failed during spending negotiations for the remainder of fiscal 2017. Democrats used their leverage in those talks to craft the $1 .1 trillion spending package that rejected Trump 's demand to cut $18 billion from domestic programs. The Supreme Court has upheld the legality of abortion through 24 weeks of pregnancy, when a fetus is generally believed to be capable of living outside the womb. Sender: Recipient: Davis, Ms. Cynthia (ACF) "Davis, Ms. Cynthia (ACF) " Sent Date: 2017/10/03 10:55:04 Delivered Date: 2017/10/03 10:55:10 /\MERICAi\ pVERSIGHT EXT-18-248-C-000236 Bowman, Matthew (HHS/OGC) "Wynne, Maggie (HHS/IOS) "; "Lloyd, Scott (ACF) " Subject: Draft heightened medical Date: 2017/10/04 18:51:56 Importance: High Priority: Urgent Type: Note The wording reflected in the attached cons titu tes legal advice in the contex t of current and potential legal risk s and proceeding s. Confidentialpre-decisional deliberativ e process and attorney client privilege Matt Bowman Deputy General Coun sel HHSOGC 202.868.9791 matthew.bowman @hhs.gov Bowman, Matthew (HHS/OGC) "Wynne, Maggie (HHS/IOS) "; "Lloyd, Scott (ACF) " Sent Date : 2017/10/04 18:51:55 Delivered Date : 2017/10/04 18:51:56 /\MERICAi\ pVERSIGHT EXT-18-248-C-000237 Bowman, Matthew (HHS/OGC) "Wynne, Maggie (HHS/IOS) "; To: "Lloyd, Scott (ACF) "i "Wagner, Steven (ACF) " Subject: FW: PleadingsFiled by ACLUin ACLUv. Wright, N.D. Cal. 16-3539 Date: 2017/10/05 18:47:14 Priority: Normal Type: Note This is the injunction mo tion Attornev cr1ent commumcat1on Bowman, Matthew (HHS/OGC) "Wynne, Maggie (HHS/IOS) "; Recipient: "Lloyd, Scott (ACF) "i "Wagner, Steven (ACF) " Sent Date: 2017/10/05 18:47:11 Delivered Date: 2017/10/05 18:47:14 /\MERICAi\ pVERSIGHT EXT-18-248-C-000238 From: Bulletin Intelligence To: "HHS@Bulletinintel ligence.com" Subject: HHS Secretary's News Briefing for Friday, October 06, 2017 Date: 2017/10/06 05:59:53 Priority: Normal Type: Note HHS SECRETARY'S NEWS BRIEFING FRIDAY, OCTOBER 6, 2017 6:00 AM EDT Top National Stories: AS ACA ENROLLMENT NEARS, ADMINISTRATION KEEPS CUTTING FEDERAL SUPPORT OF THE LAW Washington Post (10/5, Juliet Eilperin) The Washington Post reports on its front page that President Trump directly weighed in on Iowa's Section 1332 waiver request to implement a "stopgap measure" aimed at revitalizing its "ailing health-insurance marketplace." The Post reports that Trump "read about the request in a newspaper story," called then-Secretary of HHS Tom Price who was trave ling in Asia and unavailable, and then the "president called Seema Verma, administrator of the Centers for Medicare and Medicaid Services, the agency charged with authorizing or rejecting Section 1332 applications ." "Trump's message was clear, according to individuals who spoke on the condition of anonymity to discuss private conversations: Tell Iowa no." The president's "highly unusual intervention" in the Iowa waiver process comes amid claims from ACA advocates that the Administration "has done more to suppress the number of people signing up" for ACA plans "than to boost it." More Coverage. Trump Told HHS To Deny Request To Fix Iowa ObamaCare Market: Report (The Hill, 10/5, Julia Manchester), Trump Directed HHS To Deny Iowa's Proposal To Prevent Healthcare Market Collapse (New York Daily News, 10/6) TRUMP ADMINISTRATION SET TO ROLL BACK BIRTH CONTROL MANDATE New York Times (10/5, Roberl Pear) The New York Times reports that the Trump Administration could issue new rules as early as Friday which would expand exemptions to the federal requirement that employers include "birth control coverage in their health insurance plans." The Times says, "More than 55 million women have access to birth control without co-payments because of the contraceptive coverage mandate, according to a study commissioned by the Obama administration." The new rule would exempt "any employer or insurer that objects to covering contraceptive services 'based on its sincerely held religious beliefs"' and any employers that have "moral convictions" against covering contraceptives . Dr. Haywood L. Brown , President of the American College of Obstetricians and Gynecologists, said, "Affordable contraception for women saves lives. It prevents pregnancies. It improves maternal mortality. It prevents adolescent pregnancies." More Coverage. Trump Administration To Narrow Affordable Care Act's Contraception Mandate (Washington Post, 10/5, William Wan and Juliet Eilperin) Health Reform, Marketplaces & Healthcare: MANY STATES BLAME TRUMP, GOP FOR OBAMACARE PREMIUM INCREASES /\MERICAi\ pVERSIGHT EXT-18-248-C-000239 The Hill (10/5, Jessie Hellmann) The Hill reports that 20 states are blaming ACA "premium increases next year " on "uncerta inty caused by the Trump administration and Republicans in Congress ," an analys is conducted by Protect Our Care found . The group , which advocates the ACA, examined data from 28 states "where final, state-approved rates are public, and found that 20 specifically cited uncerta inty at the federa l level for at least part of the reason for increases. " JOHNSON THREATENS TO SUBPOENA OPM OVER OBAMACARE 'CONGRESSIONAL EXEMPTION' The Hill (10/5, Rachel Roubein) The Hill reports Sen. Ron Johnson (R-WI) says he will "subpoena documents from the Office of Personnel Management [OPM] over what he refers to as the ObamaCare 'congressional exemption ."' The article says the senator "has criticized rules that allow members of Congress and their staff to rece ive emp loyer contributions toward the ir ObamaCare health plans." In a letter dated August 16, Johnson requested that OPM exp lain why this is allowed. More Coverage. Sen . Ron Johnson Threatens To Subpoena OPM Over Obamacare 'exemption' (Washington Times, 10/5, Tom Howell Jr.) HIGHMARK'S OBAMACARE POLICIES TO RISE 25 PERCENT IN DELAWARE Wilmington (DE) News Journal (10/5) The Wilmington (DE) News Journal reports Highmark Blue Cross Blue Shield will continue to offer ACA plans through Delaware 's exchange in 2018 , but the insurer will raise rates by 25 percent. The company had actually requested an increase of 33.6 percent in June, but state insurance regulators reduced the figure . The article adds that Highmark will be the only ACA option for Delaware residents , since Aetna Inc. decided to exit the state 's marketplace . More Coverage. Delawareans To Pay 25 Percent More For ACA Coverage (Associated Press, 10/5, Randall Chase) HOUSE DEM CALLS FOR BIPARTISAN TALKS TO FUND CHILDREN'S HEALTH CARE The Hill (10/5, Rachel Roubein) The Hill reports Rep . Frank Pallone , Jr (D-NJ), the House Energy and Commerce Committee's top Democrat , announced Thursday that "Republ icans' actions in Comm ittee make it more difficult to come to a bipartisan agreement and will further delay reauthorization of' the Children's Health Insurance Program , "Community Health Centers and other important public health laws." The statement came after the committee approved a partisan measure Wednesday. Pallone called for renewed negotiations on the legislat ion. He added that funding for CHIP and community health centers has historically been a bipartisan issue, and said "that should not be any different this year." More Coverage. The GOP Is Holding Children Hostage , They Must Reauthorize CHIP (U.S. News & Wor ld Report , 10/5) , Hospitals Brace For Unpaid Bills If GOP Balks On Children's Healthcare (Forbes , 10/5, Bruce Japsen) SANDERS BLASTS PROPOSED MEDICARE CUTS : THESE 'WILL KILL PEOPLE ' The Hill (10/5, Niv Elis) The Hill reports Sen. Bernie Sanders (I-VT} "berated his Republican colleagues on Thursday over proposed cuts to health spending " dur ing the Senate Budget Committee markup of a Republican budget that outlined $473 billion in cuts to Medicare and $1 trillion to Medicaid. He said, "These are cuts that will kill people, these are cuts that will hurt people, and these are cuts that should not in a humane society be allowed to take place." Sen . John Kennedy (R-LA) defended the proposal , saying, "Nobody up here wants to hurt Medicare . Nobody does. But we have to mindful of the costs. " More Coverage. Democrats Attack Republican Budge t's Changes To Healthcare Programs /\MERICAi\ pVERSIGHT EXT-18-248-C-000240 (Washington Examiner, 10/5) TOM PRICE'S FLIGHT REIMBURSEMENT CHECK TO US TREASURY HAS BEEN PROCESSED CNN (10/5, Sophie Tatum and Rene Marsh) CNN reports the Department of Health and Human Services confirmed Thursday that former Secretary Tom Price paid $51,887.31 prior to his resignation to reimburse taxpayers for the cost of his seats on private flights. CNN adds that the "total cost of the travel was estimated to be in the hundreds of thousands of dollars and his check was to cover his seat on the flights rather than the entire cost of the flights." More Coverage. Tom Price Did Reimburse Government For Seats On Private Jets (Washington Examiner , 10/5), Price's $51 K Check To HHS For Private Flights Processed (The Hill, 10/5, Josh Delk) FEDS ACTIVATE EMERGENCY PRESCRIPTION PROGRAM FOR UNINSURED PUERTO RICANS The Hill (10/5, Jessie Hellmann) The Hill reports that the Department of Health and Human Services has launched the Emergency Prescription Assistance Program (EPAP) , which "will pay for prescription medications for uninsured Puerto Ricans impacted by Hurricane Maria." Dr. Robert Kad lec , HHS's assistant secretary for preparedness and response, said, "We are dedicated to helping these Americans living in Puerto Rico meet their medical needs during this disaster , and I encourage uninsured residents to take advantage of this vital assistance ." GRAHAM BRINGS 20-WEEK ABORTION BAN TO SENATE WITH 45 CO-SPONSORS The Hill (10/5, Jessie Hellmann) The Hill reports that Sen. Lindsey Graham (R-SC) on Thursday proposed the "Pain-Capable Unborn Child Protection Act," a 20-week ban on abortion backed by "45 GOP senators." The article says a "similar bill passed the House" two days ago , but Graham's bill is unlikely to pass the upper chamber. The measure "would make it illegal for any person to perform or attempt an abortion after 20 weeks of pregnancy w ith the possibility of five years in prison, fines or both." More Coverage. Abortion Fight May Draw Trump's Filibuster Wrath (Politico, 10/5, Burgess Everett) , Lindsey Graham Says He Doesn't Support Ending Filibuster As He Introduces Abortion Ban (Washington Examiner, 10/5), Cheney Backs 'Fetal Pain' Abortion Ban In Congress (Casper (WY) Star-Tribune , 10/5) CAR CRASH DEATH RATES HIGHEST IN REMOTEST RURAL AREAS Reuters (10/5) Reuters reports fatalities from car crashes grow as population density decreases , due partially to a difference in seat belt usage, according to a CDC study . Lead study author Laurie Beck of the CDC said , "We already knew that death rates were higher and seat belt use was lower in rural versus urban areas. This study expanded those findings to show that, even within rural areas, there are differences in passenger-vehicle occupant death rates and seat belt use." DRUGMAKERS IN STORM-BATTERED PUERTO RICO MUST NOW RIDE OUT RECOVERY Bloomberg News (10/4, Michelle Cortez and Jared S Hopkins) Bloomberg News reports that whi le pharmaceutical companies "rode out Hurricane Maria in Puerto Rico," it is "likely to be tougher " to keep their facilities "running whi le the devastated island picks up the pieces." Speak ing about the hurricane's impact, FDA Commissioner Dr. Scott Gottlieb said, "I've never seen someth ing on this scale. This is an existential risk we face as a nation." The FDA "is monitoring the production of about 40 drugs from 10 companies, including 13 that are made only in Puerto Rico." While "none of the companies with operations on the island have said they expect shortages as a result of Maria, having stocked up inventories ahead of the storm ," industry analysts "are concerned that bottlenecks could deve lop as Maria's effects /\MERICAi\ pVERSIGHT EXT-18-248-C-000241 linger." SENATE PANEL TO HOLD DRUG PRICING HEARING AFTER DELAY The Hill (10/5, Nathaniel Weixel} The Hill reports that the Senate Health Committee "will hold a second hearing as part of the panel's investigat ion into high cost drugs after the committee's chairman delayed the hearing for months due to partisan fighting over ObamaCare repeal." According to Sen. Lamar Alexander (RTN), the committee chairman, the hearing will be a "deeper dive" into the prescription drug process "beginning with a manufacturer 's development of a drug, the different steps through which the drug travels before arriving in the patient's hands, how this is paid for, and what the costs are at each of the different steps." Opioid News: OPIOID EPIDEMIC 'GETTING WORSE INSTEAD OF BETTER, ' PUBLIC HEAL TH OFFICIALS WARN USA Today (10/5, Michael Collins) USA Today reports Dr. Francis Collins, the director of the National Institutes of Health, said at a Senate hearing on the opioid crisis, "We need all hands on deck." Collins "said more emphasis must be placed on alternative treatments, such as acupuncture, which might be effective in treating pain and would keep people from getting addicted to drugs." Dr. Debra Haury , the director of the Centers for Disease Control and Prevention's Nationa l Center for Injury Prevention and Control, testified at a Senate hearing that the opioid crisis "is one of the few public health problems that is getting worse instead of better." More Coverage. Senators, Agencies Plot Ways To Head Off Opioids Addict ion (Washington Times, 10/5, Tom Howell Jr.), NIH Director Pushes For Research On Non-opioid Pain Treatments (The Hill, 10/5, Rachel Roubein), Sen. Alexander Kicks Off Series Of Capitol Hill Hearings Addressing Opioid Crisis (Chattanooga (TN) Times Free Press, 10/6, Elizabeth Fite) TOP MENTAL HEALTH RESEARCHER SUGGESTS LINK BETWEEN OPIOID OVERDOSES AND SUICIDES Huffington Post (10/5) The Huffington Post reports that Joshua A. Gordon , MD, PhD, the director of the National Institute of Mental Health, "believes that there may be a stronger link between the opioid epidemic and suicide than previously realized." Dr. Gordon said, "There are, of course, links between addictions in general and opioid addictions in particular and suicide. There is a lot of concern that many of the overdose deaths could be suicides. We need to learn more about the prevalence of suicidality amongst opioid addicted individua ls." CLEANING UP 'METHADONE MILE' AND OTHER DRUG HAVENS Associated Press (10/5, Philip Marcelo) The AP reports on the "Methadone Mile" in Boston, a segment "of Massachusetts Avenue south of downtown where methadone clinics, sober homes and other drug treatment services have" proliferated next to Boston Medical Center. The article says the stretch has "become the city's most visible symbol of the national opioid crisis." NEW JERSEY SUES DRUGMAKER INSYS OVER OPIOID PAINKILLER Wall Street Journal (10/5, Sara Randazzo) The Wall Street Journal reports New Jersey filed a lawsuit against opioid manufacturer lnsys Therapeutics Inc on Thursday. Massachusetts recently announced a $500 ,000 settlement with the company following a similar lawsuit. More Coverage. New Jersey Sues lnsys As Opioid Maker Settles With Massachusetts (Reuters, 10/5, Nate Raymond), NJ Sues lnsys Over Opioid-fentanyl Drug Subsys (North Jersey (NJ) Media Group, 10/5, Dustin Racioppi) , New Jersey Sues Painkiller Company. Calls Its Conduct /\MERICAi\ pVERSIGHT EXT-18-248-C-000242 'Evil' (Associated Press, 10/5), N.J . Sues Major Opioids Maker Over 'Evil' Practices (NJ News, 10/5, S.P. Sullivan), New Jersey Sues Fentany l Drug Maker (Daily Caller, 10/5, Steve Birr) THE LAWYER WHO BEAT BIG TOBACCO TAKES ON THE OPIOID INDUSTRY Bloomberg News (10/5, Esme E. Deprez and Paul Barrett) Bloomberg News reports that Mississippi's Mike Moore , who years ago was "the first state AG to sue tobacco companies for lying about nicotine addiction and hold them accountable for sick smokers ' health-care costs," is turning his focus to the opioid crisis after his nephew almost suffered a fatal overdose. FIRE CHIEFS URGE LAWMAKERS TO ACT ON OPIOID CRISIS Associated Press (1015) The AP reports the Connecticut Fire Chiefs Association this week issued "a statement...urging legis lators to address opioid abuse." The article says association members support stricter "laws for people caught dealing narcotics and better recovery options for drug users." The story adds that drug overdose fatalities "in Connecticut have significantly increased in recent years," according to CDC data. Biogs: REDUCING THE EXTERNALITIES CAUSED BY LIMITED BENEFIT PLANS Health Affairs (1015, Katherine Hempstead) Katherine Hempstead writes for the Health Affairs blog that harm to customers posed by "limited benefit or non-Affordable Care Act (ACA)-compliant health insurance products " is "neither necessary nor sufficient to make the case that limited benefit plans are bad for the market. " Without the limited benefit option, it is not known how many of potentially more than 7 million customers would pursue ACA-compliant plans or go without insurance at all, and the limited benefit plans create "negative externalities in the ACA-compliant market" that may need to be regu lated as "a recent analysis showed that nearly all states with adverse market outcomes have permitted the sales of limited coverage and transition products." THE CHRONIC CARE ACT PASSES SENATE, OBSTACLES REMAIN Health Affairs (1015, Billy Wynne) Billy Wynne writes for the Health Affairs blog that with the Senate 's passage Tuesday of the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act. The post outlines at length "the key components of the legislation, assesses its outlook in the House, and considers what its progress may tell us about the prospect for more bipartisan action on health care in the future." NINE MILLION CHILDREN FALL VICTIM TO BACK-AND-FORTH BY LAWMAKERS Think Progress (10/5, E. A. Grunden) E. A. Grunden writes for Think Progress that lawmakers are "engaged in a precarious back-andforth" over funds for the Children's Health Insurance Program after Congress allowed the prog ram to expire. On Monday, House Republicans proposed tacking $1 billion in aid to Puerto Rico onto a proposal "funding CHIP for the next five years" while raising Medicare rates for "higher-income seniors" and "redirecting the ACA 's prevention funds ." Democrats support the program but don 't want money taken from the ACA or Medicare. Opinion: WILL TRUMP TRUMPIFY THE FED? New York Times (1016, Paul Krugman) Paul Krugman writes in his New York Times column that it appears "Rex Tillerson has demoralized and degraded the State Department to the point of uselessness. " Krugman says former HHS Secretary Tom Price "did much the same to Health and Human Services before /\MERICAi\ pVERSIGHT EXT-18-248-C-000243 jetting off." He adds that "similar sto ries are unfolding throughout the execut ive branch ." HOUSE REPUBLICANS' UNFORGIVING ASSAULT ON THE FREEDOM TO CHOOSE Washington Post (1015) In an editorial , the Wash ington Post criticizes the House's passage of a measure to "ban abortions of fetuses that have passed 20 weeks of gestat ion." The Post calls the bill "an unforgiving assa ult on the freedom to choose," and adds that the fact that the Senate "almost certainly will not pass the bill," does not matter because Republicans "need money and passion from antiabortion groups, who insisted on moving the bill." The Post points out that one the measure 's co-sponsors , Rep. Tim Murphy, on Thursday announced his resignation over a scandal in which he appeared to have pressed a mistress to have an abortion after a pregnancy scare . The Post notes that the American Congress of Obstetr icians and Gynecologists "says that fetuses cannot feel pain at 20 weeks ." THE HEAL TH 202: THE HEALTH-CARE FIGHT IS BACK - AS PART OF THE GOP 'S TAX OVERHAUL. Washington Post (10/5, Paige Winfield) Paige Winfield writes in the Washington Post "The Health 202" that Republicans are making another attempt to cut Medicaid spending in their tax reform proposal. She says the Senate Budget Committee "will consider a resolution that instructs lawmakers to find ways to reduce Medicaid spending by $1 trill ion (and Medicare spending by $473 billion) over the next decade. " Winfield adds that these cuts are much deeper than the ones proposed in Republicans' ACA repeal efforts , and "the GOP could barely advance those bills." A SINGLE-PAYER LITMUS TEST WON'T HELP THE PROGRESSIVE AGENDA Los Angeles Times (10/5, Tom Epstein) Tom Epstein writes in a Los Angeles Times op-ed that the ACA remains the law of the land , after Republican 's latest effort to repeal it failed. He says "many Democrats are embracing a singlepayer 'Medicare for all' system as the next step in healthca re reform ," yet "making single-payer the top priority now could jeopard ize the gains made since passage of the Affordable Care Act , which is still being sabotaged by the Trump administration. " AUTOPSY OF A FAILED HEALTH INSURANCE EXPERIMENT : DID IT DIE OF NATURAL CAUSES. OR WAS IT MURDERED? Huffington Post (10/5, Anthony W. Orlando) Contributor Anthony W. Orlando writes in a Huffington Post piece that "quietly - so quietly that almost no one noticed - the Department of Health and Human Services pulled another Jenga block out of the teetering tower that is the Affordable Care Act. " While the ACA "did not fall," it became more expensive . Orlando says HHS failed to process Oklahoma's 1332 waiver request which sought to lower premiums for ACA plans, and as a result, premiums for next year will be high. He wonders if that was "HHS's intent all along," and posits there is "malfeasance happening inside HHS." DO AMERICANS FEEL DIFFERENTLY ABOUT HEALTH CARE NOW THAT TRUMP IS PRESIDENT? Huffington Post ( 10/5, Laura Adams) Contributor Laura Adams writes in the Huffington Post that Preside nt Trump "may have been elected for his strong stance against the Affordab le Care Act," but his Administration "has done little to change Americans ' attitude toward the nation's health care system as more than half of the population feels the same about Obamacare as they did before the 2016 presidentia l race." She adds that according to a recent survey conducted by Princeton Survey Research Assoc iates International on beha lf of insuranceQuotes, "53 percent of Americans ' opin ion toward the ACA ...has not budged." HHS PROPOSAL WOULD HURT HEAL TH-CARE PROVIDERS AND THEIR MOST VULNERABLE PATIENTS /\MERICAi\ pVERSIGHT EXT-18-248-C-000244 The Hill (10/5, former Rep. Philip Gingrey (r-Ga.)) Former Rep. Philip Gingrey (R-GA) writes in an op-ed for The Hill that while Congress continues to debate the ACA's fate, "a significant change is making its way through the regulatory process that could dramatically reduce affordable access to prescription therapies for some of the nation's most vulnerable patients." Gingrey says CMS is proposing "drastic cuts to the 340B Drug Pricing Program, which provides the nation's safety-net hospitals and health-care facilities affordable access to prescription drugs for the many low-income patients that they serve." He warns that if CMS does not withdraw the proposal, "we put patients at risk." ANOTHER HIDDEN ACA ATTACK The Hill (1015, Frederick lsasi and Stan Dorn) Frederick lsasi and Stan Dorn write in The Hill "Congress Blog" that some are "characterizing the new Senate budget bill and related tax legislation as signs that the Republicans have temporarily stopped their fight against the Affordable Care Act (ACA) and Medicaid." However, "hidden in the budget bill's underbelly are carefully crafted measures that lay the groundwork for another, purely partisan assault on Americans' health insurance." TRUMP WANTS TO SELL HEALTH INSURANCE ACROSS STATE LINES. WHY THAT'S A BAD IDEA Philadelphia (PA) Inquirer (10/5, Drew A. Harris) Drew A. Harris, DPM, MPH , writes in a Philadelphia Inquirer op-ed that following the collapse of Senate Republicans' latest ACA repeal bill, President Trump "announced that he is issuing an executive order allowing the sale of health insurance across state lines." Harris says it remains "unclear whether he has the authority to do this, but this has long been proposed as a way to lower premiums ." He argues, "If unfettered interstate sale of health policies is allowed , it's fairly certain that some states will weaken their health insurance regulations to attract new business , starting a race to the bottom." National Front Page News: HEADLINES FROM TODAY'S FRONT PAGES. Wall Street Journal : Russian Hackers Stole NSA Data On US Cyber Defense From Broken Home To Real-Estate Riches: The Life Of The Las Vegas Shooter No End In Sight For Stocks' Longest Streak In 20 Years Shale Juggernaut Shows Signs Of Fatigue New York Times: Trump Is Expected To 'Decertify' The Iran Deal And Let Congress Deal With The Fallout Decades Of Sexual Harassment Accusations Against Harvey Weinstein For Republican Leaders In Congress, The Headaches Keep Mounting Search For A Motive In Las Vegas: Slow But 'We'll Get There' Kazuo lshiguro Is Awarded The Nobel Prize In Literature Deadly Ambush Of Green Berets In Niger Belies A 'Low-Risk' Mission Catalonia Separatism Revives A Long-dormant Spanish Nationa lism Washington Post: President's Iran Decision Imperils Vital Alliances Trump Likely To 'Decertify ' Deal With Iran ACA Supporters See Sabotage In Cuts For Funds, Enrollment A New Lifesaving Approach Is Put To The Test New Organ Leads The 'Chaaarqe!' At Nats Park NRA: Restrict Rapid- Fire Gun Adapter /\MERICAi\ pVERSIGHT EXT-18-248-C-000245 This copy of the HHS Secretary's News Briefing was sent to you because you are registered for email notification on our website . If you would like to cance l email delivery click here. Copyright 2017 by Bulletin Intelligence LLC Reproduction or redistribut ion without permission prohibited. Content is drawn from thousands of newspapers , national magazines , national and local television programs , radio broadcasts, social-media platforms and additional forms of opensource data. Sources for Bulletin Intelligence aud ience-size estimates include Scarborough, GfK MRI, comScore, Nielsen , and the Audit Bureau of Circulation. Data from and access to third party socia l media platforms , including but not limited to Facebook , Twitter , lnstagram and others, is subject to the respective platform's terms of use. Services that include Factiva content are governed by Factiva's terms of use . 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Sender: Bulletin Inte lligence Recipient: "HHS@Bulletinintelligence.com " Sent Date: 2017/10/06 05:59:06 Delivered Date: 2017/10/06 05:59:53 /\MERICAi\ pVERSIGHT EXT-18-248-C-000246 White, Laura (ACF) To: "Lloyd, Scott (ACF) " Subject: RE: FiscalYear 2018 Opening Guidancefor ExecutivePerformancePlans- Due by October 1 Date: 2017/10/06 11:16:31 Priority: Normal Type: Note Scott, b)(S) Let me know if you want me to review the plan and see ifl can find where they align. /\MERICAi\ pVERSIGHT EXT-18-248-C-000247 From: Lloyd, Scott (ACF) Sent: Friday , October 06, 2017 10:31 AM To: White , Laura (ACF) Subject: FW: Fiscal Year 2018 Opening Guidance for Executive Performance Plans Due by October 1 I don't understand this: "Identify the strategic alignment document for each result driven element." Any insight? From: White, Laura (ACF) Sent: Friday , October 06, 2017 8:48 AM To: Lloyd, Scott (ACF) Subject: Fiscal Year 2018 Opening Guidance for Executive Performance Plans - Due by October 1 /\MERICAi\ pVERSIGHT EXT-18-248-C-000248 Scott , (b)(5) Thanks , Laura White, Laura (ACF) Recipient: /\MEf 1 ICAI\ pVERSIGHT "Lloyd, Scott (ACF) " EXT-18-248-C-000249 Sent Date: 20 17/10/06 11:16:20 Delivered Date: 20 17/10/06 11:16:31 /\MERICAi\ pVERSIGHT EXT-18-248-C-000250 Bowman, Matthew (HHS/OGC) "Lloyd, Scott (ACF) "; "Wynne, Maggie (HHS/IOS) "; "Wagner, Steven (ACF) " Subject: Fwd: draft mem in opp re plaintiff's motion to amend Date: 2017/10/09 12:18:22 Priority: Normal Type: Note I've also heard we will getting an amicus brief tomorrow from Texas and various states. Attorney-client communication Begin Forwarded Message: From: "Tomlinson, Martin M. (CIV)" Subject: RE: draft mem in opp re plaintiffs motion to amend Date: 09 October 2017 11:59 To: "Bowman, Matthew (HHS/OGC)" , "Haas, Alex (CIV)" , "Phipps, Peter (CIV)" , "Haron, Judith (HHS/OGC)" , "Woolford, Llewellyn (HHS/OGC)" Cc: "Ricketts, Jennifer D (CIV)" , "McElvain, Joel L (CIV)" All, Please find attached copies of the two opposition pleadings we filed today with the Court, as well as the opposition filed by USCCB. Thank you so much for your invaluable help with this. We will obviously keep you posted as to further developments. Hope you all enjoy the rest of your holiday weekends . Martin M. Tomlinson Trial Attorney I U.S. Department of Justice Civil Division I Federal Programs Branch 20 Massachusetts Ave., NW, Room 6134 Phone: (202) 353-4556 Fax: (202) 616-8470 Fo r overn ight/courier deliveries: /\MERICAi\ pVERSIGHT EXT-18-248-C-000251 Marti n M. Tomlinson Department of Justice Federal Prog rams Branch , Room 6 134 950 Pennsylvania Avenue, N.W. Washington, DC 20530 Bowman, Matthew (HHS/OGC) "Lloyd, Scott (ACF) "; "Wynne, Maggie (HHS/IOS) "; "Wagner, Steven (ACF) " Sent Date: 2017/10/09 12:18:21 Delivered Date: 2017/10/09 12:18:22 /\MERICAi\ pVERSIGHT EXT-18-248-C-000252 From: (b)(6) ~iestex.org> "Lloyd, Scott (ACF) " "White, Jonathan (ACF) "; CC: "Brooks,Teresa (ACF) " Subject: Fw: State Court hearing Date : 2017/10/09 13:14:27 Priority: Normal Type: Note Good Morning M r. Lloyd, I am writing to request further guidance regarding t he following, I realize now I may have missed the opportunity to ask these questions to Mr. Wagner (AUSA) during our debriefing and i apologize for that but the following matters have arise and I am in need of guidance ... • /\MERICAi\ pVERSIGHT • Since the "Jane Doe Due Process" case has been transferred to federal court, does any portion of the previously issued state court restraining order remain in place?? Such as the stipulations prohibiting care provider from o • "Disturbing the peace of the child Petitioner" ...this was explained to us by UAC's attorneys as all care provider staff must refra in from speaking with UAC about her pregnancy, "her baby", or her "decision to terminate"examples provided by attorneys were • • No sonograms • • No forcing UAC to listen to baby's heart rate • • No referring to UAC's baby or seeking discussion or making comments about her gestationa l period, her pregancy expectations, her feelings, etc ... • • No "encouraging" her to discuss or make contact with her parents • • No "religion based" counseling regarding o • Care provider must refrain from "Making remarks to child petitioner's family that concern pet it ioner's pregnancy" .... o • "Discussing any litigation concerning the child Petitioner in the presence or within hearing of the child Petitioner or on any form of social media" EXT-18-248-C-000253 • • UAC has a OB/GYN appointment for basic prenatal care with Dr. Torres this afternoon at 2:30p.m. (CST), please note that OB Dr. Torres is not aware UAC has requeted to terminate preganancy, Dr. Torres is not aware of current litigat ion regarding the case of th is minor, is care provider to discuss these matters directly with Dr. Torres??? Should the child be informed that care provider will discuss her request to term inate and current litigation with OB? • • If UAC attends this prenatal care appointment, is the doctor to proceed with sonogram ??? • Is child allowed to contact parents?? Her parents are named in the suit as " inflicting abuse on minor " is UAC able to make contact despite this claim" If UAC requests to make contact with mother/father is care provider to allow contact, if allowed is all contact to be monitored or may the UAC make contact with out monitoring? • Please advise, thank you so much in advance for your guidance! From: Lloyd , Scott (ACF) Sent: Monday, October 9, 2017 10:02 AM To: Brooks , Teresa (ACF); White , Jonathan (ACF); Jessica Martine z Cc: Wagner , Steven (ACF) ; Wynne, Maggie (HHS/IOS); Bowman , Matthew (HHS/OGC); Haas , Alex (CIV) Subject: RE: State Court hearing Teresa, Many thanks for your work on this, and thank you for the update. I was very much reassured to know that you would be present th is morning. Barring any additional need to wrap things up with IES,please return to the rest of your day off. Let us know if you need anything - I am sure things will continue throughout the week. Sincerely, Scott From: Brooks, Teresa (ACF) Sent: Monday, October 09, 2017 10:57 AM To: Lloyd, Scott (ACF); White, Jonathan (ACF); Jessica Martinez Cc: Wagner, Steven (ACF); Wynne, Maggie (HHS/ IOS); Bowman, Matthew (HHS/OGC); Haas, Alex (CIV) Subject: Re: State Court hearing Please be advised that at approximately 8:35 am CT, the Cameron County Judge , attorneys from Garza and Garza , who are/were representing the UAC at the State level, the UAC, and Mr. Paxton Warner, AUSA from the DOJ met in the Judge' s chambers in /\MERICAi\ pVERSIGHT EXT-18-248-C-000254 a closed proceeding. Mr. Lucio, attorney for the IES staff, was also in chambers, as an observer to the proceeding as he has clients who have been affected by the legal process of the matter. DHS ICE ERO Officer, Eva Sanchez, was present at the Courthouse , outside of the courtroom and chambers. I was asked to wait immediately outside of the Judge's chambers. During the discussion in chambers, Mr. Warner left chambers to inquire as to if the UAC had been "forced" to speak to her parents. I advised that the UAC had been afforded the right to speak to either or both of her parents since arriving into ORR custody, but to my awareness had not chosen to do so to date. It should be noted that the IES program did obtain a contact number for the UAC's father as the UAC had stated that she wished to speak to him at one time. Mr. Warner also asked if the. IES program could provide the UAC could be provided with a new case manager as the UAC has stated that the current case manager was not effectively managing the UAC's case. (This is presumed to be referring to a possible family reunification case. At this time, it is my understanding that no viable sponsor has been identified for the UAC.) I informed Mr. Warner that IES would identify an appropriate case manager to assume oversight of the UAC's case. Finally , Mr. Warner stated that the attorneys for the UAC were concerned that an IES staff member was always within a visual "line of sight" of the UAC and the attorneys felt that this was not allowing the client sufficient privacy. I explained to Mr. Warner, that in accordance to TDFPS licensing standards, the attorneys are not considered trained child care providers, and in order to maintain standards of care, the staff needed to maintain sight of the UAC , but were not in able to hear/overhear any confidential attorney- client communication. Mr. Warner took the information back to chambers. When Mr. Warner returned he advised that the UAC should be returned to her placement at the IES shelter program in Los Fresnos , TX. Mr. Warner stated that the case, in its entirety , had been moved to a Federal court venue. Mr. Warner advised that the attorneys from Garza and Garza would continue to represent the UAC in the case. Mr. Lucio conferred with the IES staff, whom he was representing today. Mr. Warner thanked the IES staff for their efforts in caring for this UAC and all of the UAC that IES cares for. All parties were advised that they/we were free to leave the courthouse. I thanked the DHS ICE ERO Officer for her support, and instructed IES to transport the UAC back to the program site. All parties exited the courthouse at approximately 9:45 am CT. Please advise as to if there are any questions or if additional information is needed regarding this message. Teresa Teresa Brooks Supervisory ORR Federal Field Specialist HHS ACF ORR DUCO /\MERICAi\ pVERSIGHT EXT-18-248-C-000255 202.631.3775 T eresa.Brooks@acf.hhs.gov On: 08 October 2017 18:58, "Brooks, Teresa (ACF)" wrote: Please see the attached with regard to the request to OHS ICE EROfor the presence of a OHS ICE ERO Officer at the 107 th District Court in Cameron County Texas on Monday, October 9, 2017. Please advise as to if there are any questions concerning the OHS ICE ERO request or response. Please be advised that, to remain in compliance with Texas Department of Family Protective Services Residential Child Care Licensing Standards, appropriate IESstaff will be transporting the UAC from the IESShelter Program to the Courthouse building . Additional IESstaff who are required to be present at the District Court will arrive to the Courthouse apart from the UAC. will be meeting with all of t he IESstaff and with the OHS ICE ERO Officer, either immed iately outside of the Court building, or in the lobby of the building . We will then proceed to the identified area of the Courthouse . Please advise of any additiona l instruction as is felt appropriate. Sincerely, Teresa Teresa Brooks Federal Field Specialist Supervisor, South Texas HHS ACF ORR DUCO 202.631.3775 Teresa.Brooks@acf. hhs.gov From: Brooks, Teresa (ACF) Sent: Sunday, October 08, 2017 5:20 PM To: Lloyd, Scott (ACF); White, Jonathan (ACF); Jessica Martinez Cc: Wagner, Steven (ACF); Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC); Haas, Alex (CIV) Subject: Re: State Court hearing I can be at the Courthouse at 8:30 am CT as requested. I can attempt to reach Officer~ho see if there is an ICE Officer ~le is the covering Officer for the FOJC now to to be present at the Court tomorrow morning. I will update all appropriate parties of outcome of the contact with ICE. /\MERICAi\ pVERSIGHT EXT-18-248-C-000256 Teresa Teresa Brooks Supervisory ORR Federa l Field Spec ialist HHS ACF ORR DUCO 202.631.3775 Teresa .Brooks @acf.hhs.gov On: 08 Octobe r 2017 16:46, "Lloyd, Scott (ACF)" wrote: Hello everyone, Please see below . There should be no hearing tomorrow. However, there is need to have the UAC brought to the comthouse at the time appointed, to avoid contempt while we confirm that the state court knows the case has been removed. Teresa I'd like you there if at all possible, or field staff in the alternative . I will ask that DOJ contact us if they receive confirmation and this becomes unnece ssary. Teresa , are you in contact with anyone from DHS (ICE seems most appropriate) who could ride along? If you need help I can help get someone. If she goes to the courthouse the point would be to inform them that the case has been removed. There should be no transfer of custody and federal law enforcement could help us reinforce that point. Please let me know if you have any questions. Thank you, Scott Begin Forwarded Message: From: "Haas , Alex (CIV)" Subject: State Court hearing Date: 08 October 2017 17:25 To: "Bowman, Matthew (HHS/OGC)" , "Lloyd, Scott (ACF)" Cc: "Ricketts, Jennifer D (CIV)" , "Hu, Daniel (USATXS)" , "Warner, Paxton (USATXS)" , "Fabian, Sarah B (CIV)" Matt/Scott, Our colleagues from the USAO just filed the removal papers in federal court and also filed a notice /\MERICAi\ pVERSIGHT EXT-18-248-C-000257 electronically in state court . While this should be enough to deprive the state court of ju risdiction, we are also sending a AUSA to hand a copy to the jud ge as well. Because the state court order is directed to individuals working at TES who could still be held in contempt (pote ntially), our strong recommendation would be for the minor to be sent with the federal field spec ialist to the court proceeding. With that federal officer there and the AUSA we think there is a very small likelihood of any shenanigans. You could also potentially ask so meone from ICE or CBP to attend to the transport. Please let me know if you'd like to discuss Alex Sent from my Verizon, Samsung Galaxy smartphone Sender!(b)(6) ~iestex.org> "Lloyd,Scott(ACF)"; "White,Jonathan (ACF)"; "Brooks,Teresa (ACF)" Sent Date: 2017/10/0913:14:12 Delivered Date: 2017/10/0913:14:27 /\MERICAi\ pVERSIGHT EXT-18-248-C-000258 Bowman, Matthew (HHS/OGC) "Lloyd, Scott (ACF) "; "Haas, Alex (CIV) " Subject: Re: Legal guidance needed Date: 2017/10/09 13:35: 13 Priority : Normal Type: Note (b)(5) On: 09 October 2017 13: 16, "Lloyd, Scott (ACF)" wrote: Privileged Matt/ Alex, 1~)(5) /\MERICAi\ pVERSIGHT EXT-18-248-C-000259 Thank you, Scott From: l(b)(6) [mailtol(b)(6) ~iestex.org] Sent: Monday,October 09, 2017 1:14 PM To: Lloyd, Scott (ACF) Cc: White, Jonathan (ACF); Brooks,Teresa (ACF) Subject: Fw: State Court hearing Good Morning Mr. Lloyd, I am writing to request further guidance regarding the following, I realize now I may have missed the opportunity to ask these questions to Mr . Wagner (AUSA) during our debriefing and i apologize for that but the following matters have arise and I am in need of guidance ... • • Since the "Jane Doe Due Process" case has been transferred to federal court, does any portion of the previously issued state court restraining order remain in place?? Such as the stipulations prohibiting care provider from o • "Disturbing the peace of the child Petitioner" ...this was explained to us by UAC's attorneys as all care provider staff must refrain from speaking with UAC about her pregnancy, "her baby", or her "decision to terminate"examples provided by attorneys were • • No sonograms • • No forcing UAC to listen to baby's heart rate • • No referring to UAC's baby or seeking discussion or making comments about her gestationa l period, her pregancy expectations, her feelings, etc ... • • No "encouraging" her to discuss or make contact with her parents • • No "religion based" counseling regarding o • Care provider must refrain from "Making remarks to child petitioner's family that concern petitioner's pregnancy " .... o • "Discussing any litigation concerning the child Petitioner in the presence or within hearing of the child Petitioner or on any form of social media" • /\MERICAi\ pVERSIGHT • UAC has a OB/GYN appointment for basic prenatal care with Dr. Torres this afternoon at 2:30p.m. (CST),please note that OB Dr. Torres is not aware UAC has requeted to terminate preganancy, Dr. Torres is not aware of current litigation EXT-18-248-C-000260 regarding the case of this minor, is care provider to discuss these matters directly with Dr. Torres??? Should the child be info rmed that care provider will discuss her request to terminate and current litigation with OB? • • If UAC attends this prenatal care appointment, is the doctor to proceed with sonogram ??? • • Is child allowed to contact parents?? Her parents are named in the suit as "inflicting abuse on minor " is UAC able to make contact despite this claim " If UAC requests to make contact w ith mother/father is care provider to allow contact, if allowed is all contact to be monitored or may the UAC make contact with out monitoring? Please advise, thank you so much in advance for your guidance! From: Lloyd, Scott (ACF) Sent: Monday, October 9, 2017 10:02 AM To: Brooks, Teresa (ACF); White, Jonathan (ACF);Jessica Martinez Cc: Wagner, Steven (ACF);Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC); Haas, Alex (CIV) Subject: RE:State Court hearing Teresa, Many thanks for your work on this, and thank you for the update. I was very much reassured to know that you would be present this morning. Barring any additional need to wrap things up with IES,please return to the rest of your day off. Let us know if you need anything - I am sure things will continue throughout the week. Sincerely, Scott From: Brooks,Teresa (ACF) Sent: Monday,October 09, 2017 10:57 AM To: Lloyd, Scott (ACF); White, Jonathan (ACF);JessicaMartinez Cc: Wagner, Steven (ACF); Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC);Haas, Alex (CIV) Subject: Re: State Court hearing Please be advised that at approximately 8:35 am CT, the Cameron County Judge, attorneys from Garza and Garza, who are/were representing the UAC at the State level, the UAC , and Mr. Paxton Warner, AUSA from the DOJ met in the Judge's chambers in a closed proceeding. Mr. Lucio , attorney for the IES staff, was also in chambers , as an observer to the proceeding as he has clients who have been affected by the legal process of the matter. DHS ICE ERO Officerj(b)( 6) f1vaspresent at the Courthouse , /\MERICAi\ pVERSIGHT EXT-18-248-C-000261 outside of the courtroom and chambers. I was asked to wait immediately outside of the Judge's chambers. During the discussion in chambers, Mr. Warner left chambers to inquire as to if the UAC had been "forced" to speak to her parents. I advised that the UAC had been afforded the right to speak to either or both of her parents since arriving into ORR custody, but to my awareness had not chosen to do so to date. It should be noted that the IES program did obtain a contact number for the UAC's father as the UAC had stated that she wished to speak to him at one time. Mr. Warner also asked if the IES program could provide the UAC could be provided with a new case manager as the UAC has stated that the current case manager was not effectively managing the UAC's case. (This is presumed to be referring to a possible family reunification case. At this time , it is my understanding that no viable sponsor has been identified for the UAC.) I informed Mr. Warner that IES would identify an appropriate case manager to assume oversight of the UAC's case. Finally, Mr. Warner stated that the attorneys for the UAC were concerned that an IES staff member was always within a visual "line of sight" of the UAC and the attorneys felt that this was not allowing the client sufficient privacy. I explained to Mr. Warner, that in accordance to TDFPS licensing standards, the attorneys are not considered trained child care providers , and in order to maintain standards of care, the staff needed to maintain sight of the UAC, but were not in able to hear/overhear any confidential attorney- client communication. Mr. Warner took the information back to chambers. When Mr. Warner returned he advised that the UAC should be returned to her placement at the IES shelter program in Los Fresnos , TX. Mr. Warner stated that the case, in its entirety, had been moved to a Federal court venue. Mr. Warner advised that the attorneys from Garza and Garza would continue to repre sent the UAC in the case. Mr. Lucio conferred with the IES staff, whom he was representing today. Mr. Warner thanked the IES staff for their efforts in caring for this UAC and all of the UAC that IES cares for. All parties were advised that they/we were free to leave the courthouse. I thanked the DHS ICE ERO Officer for her support, and instructed IES to transport the UAC back to the program site. All parties exited the courthouse at approximately 9:45 am CT. Please advise as to if there are any questions or if additional information is needed regarding this message. Teresa Teresa Brooks Supervisory ORR Federal Field Specialist HHS ACF ORR DUCO 202.631.3775 T eresa .Brook s@acf.hhs.gov /\MERICAi\ pVERSIGHT EXT-18-248-C-000262 On: 08 October 2017 18:58, "Brooks, Teresa (ACF)" wrote: Please see the attached with regard to the request to OHS ICE EROfo r the presence of a OHS ICE ERO Officer at the 107 th District Court in Cameron County Texas on Monday, October 9, 2017. Please advise as to if there are any questions concerning the OHS ICE ERO request or response. Please be advised that, to remain in com pliance with Texas Department of Family Protective Services Residential Child Care Licensing Standards, appropriate IESstaff will be transporting the UAC from the IESShelter Program to the Courthouse building. Add itional IESstaff who are required to be present at the District Court will arrive to the Courthouse apart from the UAC. will be meeting wit h all of the IESstaff and with the OHS ICE ERO Officer, either immed iately outside of the Court building, or in the lobby of the building. We will then proceed to the identified area of the Courthouse. Please advise of any additiona l instruc t ion as is f elt appr opriate. Sincerely, Teresa Teresa Brooks Federal Field Specialist Supervisor, South Texas HHS ACF ORR DUCO 202.631.3775 Teresa.Brooks@acf.hhs.gov From: Brooks, Teresa (ACF) Sent: Sunday, October 08, 2017 5:20 PM To: Lloyd, Scott (ACF); White, Jonathan (ACF); Jessica Martinez Cc: Wagner, Steven (ACF); Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC); Haas, Alex (CIV) Subject: Re: State Court hearing I can be at the Courthouse at 8:30 am CT as requested. ~ho is the covering Officer for the FOJC now to I can attempt to reach Office~b)(5) see if there is an ICE Officer who is able to be present at the Court tomorrow morning. I will update all appropriate parties of outcome of the contact with ICE. Teresa Teresa Brooks /\MERICAi\ pVERSIGHT EXT-18-248-C-000263 Supervisory ORR Federal Field Specialist HHS ACF ORR DUCO 202 .631.3775 Teresa.Brooks @acf.hhs.gov On: 08 October 2017 16:46, "Lloyd, Scott (ACF)" wrote : Hello everyone, Plea se see below. There should be no hearing tomorrow. However, there is need to have the UAC brought to the courthouse at the time appointed, to avoid contempt while we confirm that the state court know s the case has been removed. Teresa I'd like you there if at all possible, or field staff in the alternative . I will ask that DOJ contact us if they receive confirmation and this becomes unnece ssary. Teresa, are you in contact with anyone from DHS (ICE seems most appropriate) who could ride along? If you need help I can help get someone. If she goes to the courthouse the point wou ld be to inform them that the case has been removed . There should be no transfer of custody and federa l law enforcement could help us reinforce that point. Please let me know if you have any questions . Thank you, Scott Begin Forwarded Message: From: "Haas, Alex (CIV)" Subject: State Court hearing Date : 08 October 2017 17:25 To: "Bowman, Matthew (HHS/OGC)" , "Lloyd, Scott (ACF)" Cc: "Ricketts, Jennifer D (CIV)" , "Hu, Daniel (USATXS)" , "Warner, Paxton (USATXS)" , "Fabian , Sarah B (CIV)" Matt/Scott, Our colleagues from the USAO just filed the removal papers in federal court and also filed a notice electron ically in state court. Whi le this should be enough to deprive the state court of jur isdict ion, we are also sending a AUSA to hand a copy to the judge as well. Because the state court order is directed to individuals working at IES who could still be held in contempt /\MERICAi\ pVERSIGHT EXT-18-248-C-000264 (potentially) , our strong recommenda tion would be for the minor to be sent wi th the federa l field spec ialist to the court procee ding. With that federal officer there and the AUSA we think there is a very small likelihood of any shena nigans. You could also potentially ask so meone from ICE or CBP to atte nd to the transport . Please let me know if you'd like to discuss Alex Sent from my Verizon Samsung Galaxy smartphone Bowman, Matthew (HHS/OGC) "Lloyd, Scott (ACF) "; Recipient : (FYDIBOHF23SPDL "Haas, Alex (CIV) " Sent Date: 2017/10/09 13:35:12 Delivered Date: 2017/10/09 13:35:13 /\MERICAi\ pVERSIGHT EXT-18-248-C-000265 From b)(6) tliiestex.org> "Lloyd, Scott (ACF) " "White, Jonathan (ACF) "; "Brooks, Teresa (ACF) "; CC: "Bowman, Matthew (HHS/OGC)"; "Wagner, Steven (ACF) " Subject: Re: State Court hearing Date: 2017/10/09 13:53:44 Priority: Normal Type: Note Received , we will proceed as recommended. UAC does not have a counseling session today , we will for further guidance , thank you ! ! I l(b)(6) IES EMERGENCY SHELTER Los Fresnos, Texas Sent from my iPhone On Oct 9, 2017, at 12:49 PM, Lloyd , Scott (ACF) wrote: Regarding the appointment today: Make sure that the UAC knows that this is to get an update on whether it is really necessary to have her exercise so severely restricted - to find out if it might be possible to allow her to do more. Please get her to consent to the appointment . If she does not want it, she does not have to go- we arranged it to accommodate her distress over lack of physical activity . This was a concern she voiced to the program and that we noticed in her record . We are trying to be responsive to her concerns with this request . If they offer her a sonogram at the appointment, please remind the doctor that she has already had two and suggest that it is not necessary, and that it should not happen in any case if she does not give consent. Regarding your other questions-if she has a counseling session today, please contact me. If not, let' s wait for DOJ' s response. /\MERICAi\ pVERSIGHT EXT-18-248-C-000266 Let me know if you have any questions. Thank you, Scott From:~ b)(B) t mailtofb)(6) @iestex.org] Sent: Monday,October 09, 2017 1:14 PM To: Lloyd, Scott (ACF) Cc: White, Jonathan(ACF); Brooks,Teresa (ACF) Subject: Fw: State Court hearing Good Morning Mr. Lloyd, I am writing to request further guidance regarding the following, I realize now I may have missed the opportunity to ask these questions to Mr. Wagner (AUSA) during our debriefing and i apologize for that but the following matters have arise and I am in need of guidance ... • • Since the "Jane Doe Due Process" case has been transferred to federal court , does any portion of the previously issued state court restraining order remain in place?? Such as the stipulations prohibiting care provider from o • "Disturbing the peace of the child Petitioner" ...this was explained to us by UAC's attorneys as all care provider staff must refrain from speaking with UAC about her pregnancy, "her baby", or her "decision to terminate"examples provided by attorneys were • • No sonograms • • No forcing UAC to listen to baby's heart rate • • No referr ing to UAC's baby or seeking discussion or making comments about her gestational period , her pregancy expectations, her feelings, etc ... • • No "encouraging" her to discuss or make contact with her parents • • No "religion based" counseling regarding o • Care provider must refrain from "Making remarks to child pet itioner's family that concern petitioner's pregnancy" .... o • "Discussing any litigation concerning the child Petitioner in the presence or within hearing of the child Petitioner or on any form of social media" /\MERICAi\ pVERSIGHT EXT-18-248-C-000267 • • UAC has a OB/GYN appointment for basic prenatal care with Dr. Torres this afternoon at 2:30p.m . (CST),please note that OB Dr. Torres is not aware UAC has requeted to terminate preganancy, Dr. Torres is not aware of current litigation regarding the case of this minor, is care provider to discuss these matters directly with Dr. Torres??? Should the child be informed that care provider will discuss her request to terminate and current litigation with OB? • • If UAC attends this prenatal care appointment, is the doctor to proceed with sonogram ??? • • Is child allowed to contact parents?? Her parents are named in the suit as "inflicting abuse on minor" is UAC able to make contact despite this claim" If UAC requests to make contact with mother/father is care provider to allow contact, if allowed is all contact to be monitored or may the UAC make contact with out monitoring? Please advise, thank you so much in advance for your guidance! From: Lloyd, Scott (ACF) Sent: Monday, October 9, 2017 10:02 AM To: Brooks, Teresa (ACF); White, Jonathan (ACF);Jessica Martinez Cc: Wagner, Steven (ACF); Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC); Haas, Alex (CIV) Subject: RE:State Court hearing Teresa, Many thanks for your work on this, and thank you fo r the updat e. I was very much reassured to know that you would be present t his morning. Barring any additional need to wrap t hings up with IES,please return to the rest of your day off. Let us know if you need anything-I am sure things will continue thro ughout the week . Sincerely, Scott From: Brooks,Teresa (ACF) Sent: Monday,October 09, 2017 10:57 AM To: Lloyd, Scott (ACF); White, Jonathan (ACF); JessicaMartinez Cc: Wagner, Steven (ACF); Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC); Haas,Alex (CIV) Subject: Re: State Court hearing Please be advised that at approximately 8:35 am CT, the Cameron County Judge , attorneys from Garza and Garza, who are/were representing the UAC at the State /\MERICAi\ pVERSIGHT EXT-18-248-C-000268 level, the UAC, and Mr. Paxton Warner, AUSA from the DOJ met in the Judge's chambers in a closed proceeding. Mr. Lucio , attorney for the JES staff , was also in chambers, as an observer to the proceeding as he has clients who have been affected by the legal process of the matter. DHS ICE ERO Officer,~b)(6) jwas present at the Courthouse , outside of the courtroom and chambers. I was asked to wait immediately outside of the Judge's chambers. During the discussion in chambers, Mr. Warner left chambers to inquire as to if the UAC had been "forced" to speak to her parents. I advised that the UAC had been afforded the right to speak to either or both of her parents since arriving into ORR custody, but to my awareness had not chosen to do so to date. It should be noted that the IES program did obtain a contact number for the UAC's father as the UAC had stated that she wished to speak to him at one time. Mr. Warner also asked if the JES program could provide the UAC could be provided with a new case manager as the UAC has stated that the current case manager was not effectively managing the UAC's case. (This is presumed to be referring to a possible family reunification case. At this time, it is my understanding that no viable sponsor has been identified for the UAC.) I informed Mr. Warner that JES would identify an appropriate case manager to assume oversight of the UAC's case. Finally , Mr. Warner stated that the attorneys for the UAC were concerned that an IES staff member was always within a visual "line of sight" of the UAC and the attorneys felt that this was not allowing the client sufficient privacy. I explained to Mr. Warner , that in accordance to TDFPS licensing standards, the attorneys are not considered trained child care providers, and in order to maintain standards of care, the staff needed to maintain sight of the UAC, but were not in able to hear/overhear any confidential attorneyclient communication. Mr. Warner took the information back to chambers. When Mr. Warner returned he advised that the UAC should be returned to her placement at the IES shelter program in Los Fresnos, TX. Mr. Warner stated that the case, in its entirety, had been moved to a Federal court venue. Mr. Warner advised that the attorney s from Garza and Garza would continue to represent the UAC in the case. Mr. Lucio conferred with the JES staff, whom he was representing today. Mr. Warner thanked the IES staff for their efforts in caring for this UAC and all of the UAC that IES cares for. All parties were advised that they/we were free to leave the courthouse. I thanked the DHS ICE ERO Officer for her support, and instructed IES to transport the UAC back to the program site. All parties exited the courthouse at approximately 9:45 am CT. Please advise as to if there are any questions or if additional information is needed regarding this message. Teresa /\MERICAi\ pVERSIGHT EXT-18-248-C-000269 Teresa Brooks Supervisory ORR Federal Field Specialist HHS ACF ORR DUCO 202.63 1.3775 Teres a.Brook s@acf.hhs.gov On: 08 October 2017 18:58, "Brooks, Teresa (ACF)" wrote: Please see the attached with regard to the request to DHS ICE EROfor the presence of a DHS ICE EROOfficer at the 107th District Court in Cameron County Texas on Monday, October 9, 2017. Please advise as to if there are any questions concerning the DHS ICEERO request or response. Please be advised that, to remain in compliance with Texas Department of Family Protective Services Residential Child Care Licensing Standards, appropriate IES staff will be transporting the UAC from the IESShelter Program to the Courthouse building. Additional JESstaff who are required to be present at the District Court will arrive to the Courthouse apart from the UAC. I will be meeting with all of the IESstaff and with the DHS ICE ERO Officer, either immediately outside of the Court building, or in the lobby of the building. We will then proceed to the identified area of the Courthouse. Please advise of any additional instruction as is felt appropriate . Sincerely, Teresa Teresa Brooks Federal Field Specialist Supervisor, South Texas HHS ACF ORR DUCO 202.631.3775 Teresa.Brooks@acf.hhs.gov From: Brooks, Teresa (ACF) Sent: Sunday, October 08, 2017 5:20 PM To: Lloyd, Scott (ACF); White, Jonathan (ACF); Jessica Mart inez Cc: Wagner, Steven (ACF); Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC); Haas, Alex (CIV) Subject: Re: State Court hearing I can be at the Courthouse at 8:30 am CT as requested. /\MERICAi\ pVERSIGHT EXT-18-248-C-000270 I can attempt to reach Office~ to see if there is an ICE Offi~ mornmg. ho is the covering Officer for the FOJC now able to be present at the Court tomorrow I will update all appropriate parties of outcome of the contact with ICE. Teresa Teresa Brooks Supervisory ORR Federal Field Specialist HHS ACF ORR DUCO 202 .631.3775 Teresa.Brooks @acf.hhs.gov On : 08 October 2017 16:46, "Lloyd, Scott (ACF)" wrote: Hello everyone, Please see below . There should be no hearing tomorrow. However , there is need to have the UAC brought to the courthouse at the time appointed , to avoid contempt while we confirm that the state court knows the case has been removed. Teresa I'd like you there if at all possible , or field staff in the alternative. I will ask that DOJ contact us if they receive confirmat ion and this becomes unnecessary. Teresa , are you in contact with anyone from DHS (ICE seems most appropriate) who could ride along? If you need help I can help get someone. If she goes to the courthouse the point would be to inform them that the case has been removed. There should be no transfer of custody and federal law enforcem ent could help us reinforce that point. Please let me know if you have any questions. Thank you, Scott Begin Forwarded Message : From : "Haas, Alex (CIV)" Subje ct: State Court hearing Date: 08 October 2017 17:25 To : "Bowman, Matthew (HHS/OGC)" , "Lloyd, Scott (ACF)" /\MERICAi\ pVERSIGHT EXT-18-248-C-000271 Cc: "Ricketts, Jennifer D (CIV)" , "Hu, Daniel (USATXS)" , "Warner, Paxton (USATXS)" , "Fabian, Sarah B (CIV)" Matt/Scott, Our colleagues from the USAO ju st filed the removal papers in federal court and also filed a notice electro nica lly in state court . While this should be enough to deprive the state court of jurisdiction , we are also send ing a AUSA to hand a copy to the judge as well. Because the state court order is directed to individuals working at TES who could still be held in conte mpt (pote ntially), our strong recommenda tion would be for the mino r to be sent with the federa l field specialist to the court proceed ing . With that federal officer there and the AUSA we think there is a very small likelihood of any shenanigans . You could also potentially ask someone from ICE or CBP to attend to the transport. Please let me know if you'd like to discuss Alex Sent from my Verizon, Samsung Galaxy smart phone Sender: ~b)(6) l@iestex.org> "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; "Brooks, Teresa (ACF) "; "Bowman, Matthew (HHS/OGC) "; "Wagner, Steven (ACF) " Sent Date: 2017/10/09 13:53 :19 Delivered Date : 2017/10/09 13:53:44 /\MERICAi\ pVERSIGHT EXT-18-248-C-000272 Bowman, Matthew (HHS/OGC) "Lloyd, Matt (OS/ASPA)"; "Murphy, Ryan (OS/ASPA)"; "Bult, Nathan (OS/ASPA)"; "Oakley, Caitlin B. (OS/ASPA)" "Wynne, Maggie (HHS/IOS) "; "Lloyd, Scott (ACF) " Subject: Amicus brief in Texas minor case Date: 2017/10/10 11:32:03 Priority: Normal Type: Note Attached please see an amicus brief that was just filed in our favor by seven states, in one of the cases involving the Texas minor seeking an elective abortion while in ORR custody. The states on the brief are Texas, Louisiana , Missouri, Nebraska, Ohio , Oklahoma , and South Carolina The Texas Attorney General's office also sent this press release: https://texasattomeygeneral.gov /news/releases /ag-paxton-texas-must-not-become-asanctuary-state-for-abortions AG Paxton: Texas Must Not Become a Sanctuary State for Abortions Tuesday, October I 0, 2017 - Austin Attorney General Ken Paxton today filed a friend-of-the-court brief with a U.S. District Court in San Francisco in defen se of the federal government's right to deny access to abortion services to an unlawfully-present minor alien in Texas. Immigration officials detained the unlawfully-present alien ("Doe"), who entered the U.S. without her parents , in a shelter funded by the U.S. Department of Health and Human Services in Brownsville. "No federal court has ever declared that unlawfully-pre sent aliens with no substantial ties to this country have a constitutional right to abortion on demand ," Attorney General Paxton said. "If 'Doe' prevails in this case, the ruling will create a right to abortion for anyone on earth who enters the U.S. illegally. And with that right, countless others undoubtedly would follow. Texas must not become a sanctuary state for abortions." /\MERICAi\ pVERSIGHT EXT-18-248-C-000273 Attorney General Paxton told the court that "Texas has a legitimate and substantial interest in preserving and promoting fetal life, as well as an interest in promoting respect for human life at all stages in a pregnancy." "Doe" first filed a lawsuit in Texas state court, seeking to compel Health and Human Services to take her to get an abortion. Now the American Civil Liberties Union (ACLU) is asking a federal court in San Francisco to allow it to add "Doe" to a pending lawsuit against Health and Human Services and the U.S. Conference of Catholic Bishops over a completely unrelated dispute. Joining Texas on the amicus brief are the states of Louisiana, Missouri, Nebraska, Ohio, Oklahoma, and South Carolina. View the amicus brief here: http://bit.ly/2ye2ItY Bowman, Matthew (HHS/OGC) "Lloyd, Matt (O5/ASPA)"; "Murphy, Ryan (O5/ASPA)"; "Bult, Nathan (O5/ASPA) "; Recipient: "Oakley, Caitlin B. (O5/ASPA)"; "Wynne, Maggie (HHS/IOS) "; "Lloyd, Scott (ACF) " Sent Date: 2017/10/10 11:32:03 /\MERICAi\ pVERSIGHT EXT-18-248-C-000274 From: To: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) " "Biswas, Toby RM (ACF) "; "White, Jonathan (ACF) "; "Sualog,Jallyn (ACF) "; "White, Laura (ACF) "; "Swartz, Tricia (ACF) " Subject: FW:f b)(5) IResearch& Resources Date : 2017/10/10 14:14:31 Priority : Normal Type: Note Scott, I haven't read this yet, but here's the OGCopin ion on~b)(S) AnnaMar ie ~--------~ From: DeSarbo, Lynne (OGC/CFAD) Sent: Tuesday, October 10, 2017 1:52 PM To : Bena, Anna Marie (HHS/OGC)(ACF); Biswas, Toby R M (ACF) Cc: Haron Judith HHS/OGC); Mestre, Lisette (HHS/OGC);DeSarbo, Lynne (OGC/CFAD) Subject: b)(5) Research & Resources Hello Anna Marie , I hope that you had a wonderfu l vacation in Italy! ~b)(S) b)(5) r ~O)l :JJ Please do not hesitate to contact me should you have questions about the attached . Best, Lynne Lynne DeSarbo Attorney Children, Families & Aging Division Off ice of General Counsel U.S. Department of Health and Hum an Services (202) 690-5754 Lynne.DeSarbo@hhs.gov /\MERICAi\ pVERSIGHT EXT-18-248-C-000275 Notice: The contents of this message and any attachments may be privileged and confidential as attorney-client privileged/work product communications. Please do not disseminate without the approval of the Office of the General Counsel. If you are not an intended recipient, or have received this message in error, please delete it without reading it and please do not print, copy, forward, disseminate, or otherwise use the information. Also, please not ify the sender that you have received this communication in error. Your receipt of this message is not intended to waive any applicable privilege. This document is for INTERNALGOVERNMENTUSEONLY and may be exempt from disclosure under the Freedom of Information Act, 5 U.S.C.§§ 552(b)(S), (b)(7). Sender: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; "Biswas, Toby RM (ACF) "; "White, Jonathan (ACF) "; Recipient: "Sualog, Jallyn (ACF) "; "White, Laura (ACF) "; "Swartz, Tricia (ACF) " Sent Date: 2017/10/10 14:14:13 Delivered Date: 2017/10/10 14:14:31 /\MERICAi\ pVERSIGHT EXT-18-248-C-000276 Bowman, Matthew (HHS/OGC) "Lloyd, Scott (ACF) "; To: "Wynne, Maggie (HHS/IOS) " Subject: NIH Date: 2017/10/10 17:11:53 Priority: Normal Type: Note https://www. niddk.nih.gov/health-information/weight-management/health-tips-pregnantwomen Physical Activity Should I be physically active during my pregnancy? Almost all women can and should be physically active during pregnancy. Regular physical activity may • • help you and your baby gain the right amounts of weight • • reduce backaches , leg cramps, and bloating • • reduce your risk for gestational diabetes (diabetes that develops when a woman is pregnant) If you were physically active before you became pregnant , you may not need to change your exercise habits. Talk with your health care provider about how to change your workouts during pregnancy. It can be hard to be physically active if you do not have child care for your other children, have not worked out before , or do not know what to do. Keep reading for tips about how you can work around these things and be physically active. How much physical activity do I need? /\MERICAi\ pVERSIGHT EXT-18-248-C-000277 Most women need the same amount of physical activity as before they became pregnant. Aim for at least 30 minutes of aerobic activity per day on most days of the week. Aerobic activities use large muscle groups (back, chest, and legs) to increase heart rate and breathing. The aerobic activity should last at least 10 minutes at a time and should be of moderate intensity. This means it makes you breathe harder but does not overwork or overheat you. If you have health issues like obesity , high blood pressure , diabetes, or anemia (too few healthy red blood cells), ask your health care provider about a level of activity that is safe for you. How can I stay active while pregnant? Even if you have not been active before, you can be active during your pregnancy by using the tips below: • • Go for a walk around the block, in a local park, or in a shopping mall with a family member or friend. If you already have children, take them with you and make it a family outing. • •Getup and move around at least once an hour if you sit in a chair most of the day. When watching TV, get up and move around during commercials. Even a simple activity like walking in place can help. How can I stay safe while being active? For your health and safety, and for your baby's , you should not do some physical activities while pregnant. Some of these are listed below. Talk to your health care provider about other physical activities that you should not do. Make a plan to be active while pregnant. List the activities you would like to do, such as walking or taking a prenatal yoga class. Think of the days and times you could do each activity on your list, like first thing in the morning , during lunch break from work, after /\MERICAi\ pVERSIGHT EXT-18-248-C-000278 dinner, or on Saturday afternoon. Look at your calendar or planner to find the days and times that work best, and commit to those plans. Safety Dos and Dont's Follow these safety tips while being active. Do ... Don't. .. Choose moderate activities that are not likely to injure you, such as walking or aqua aerobics. Avoid brisk exercise outside during very hot weather. Drink fluids before, during, and after being physically active. Don't use steam rooms, hot tubs , and saunas. Wear comfortable clothing that fits well and supports and protects your breasts. After the end of week 12 of your pregnancy, avoid exercises that call for you to lie flat on your back. top exercising if you feel dizzy, short of breath, tired, or sick to your stomach. ACTIVITY /\MERICAi\ pVERSIGHT WHEN EXT-18-248-C-000279 Bowman, Matthew (HHS/OGC) Recipient: "Lloyd, Scott (ACF) "; "Wynne, Maggie (HHS/IOS) " Sent Date: 2017/10/10 17:11:52 Delivered Date: 2017/10/10 17:11:53 /\MERICAi\ pVERSIGHT EXT-18-248-C-000280 From: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; "Moreno, Mr. Pedro(ACF) "; "White, Jonathan (ACF) "; "Swartz, Tricia (ACF) "; "Sualog,Jallyn (ACF) " CC: "Biswas, Toby R M (ACF) "; "White, Laura (ACF) " Subject: FW: draft mem in opp re plaintiffs motion to amend Date: 2017/10/11 09:51:16 Priority : Normal Type: Note I'm still making my way through email, and assume you all have seen this, but forwa rding just in case. From: Haran, Judit h (HHS/OGC) Sent: Tuesday, October 10, 2017 11:29 AM To : Bena, Anna Marie (HHS/OGC) (ACF); Biswas, Toby R M (ACF); Suh, Victor (HHS/OGC) (ACF) (CTR) Cc: Keith, Robert ( HHS/OGC) Subject: Fwd : draft mem in opp re plaintiff's mot ion to amend FYI Begin Forwarded Message: From : "Tomlinson, Marti n M. (CIV)" Subject: RE: draft mem in opp re plaintiff's motion to amend Date: 10 October 2017 10:02 To : "Bowman, Matthew (HHS/OGC)" , "Phipps, Peter (CIV)" , "Haron, Judith (HHS/OGC)" , "Woolford, Llewellyn (HHS/OGC)" Cc: "Haas, Alex (CIV)" , "Ricketts, Jenn ifer D (CIV)" , "McElvain, Joel L (CIV)" Matthew, Please see attached for the Stat es' amicus materials as well as the Plaintiff's reply brief, which was just filed with the Court. Martin M. Tomlinson /\MERICAi\ pVERSIGHT EXT-18-248-C-000281 Trial Attorney ! U.S. Depar tment of Justice Civil Division ! Federal Program s Branch 20 Massachusetts Ave., NW , Room 6134 Phone: (202) 353-4556 Fax : (202) 616 -8470 For overnight/courier deliveries: Martin M. Tomlinson Department of Justice Federal Programs Branch, Room 6134 950 Pennsylvania Avenue, N.W. Washington, DC 20530 Sender: Bena, Anna Marie (HHS/OGC)(ACF) (FYDIBOHF23SPDL T)/CN==RECIPIENTS/CN "Lloyd, Scott (ACF) "; "Moreno, Mr. Pedro(ACF) "; "White, Jonathan (ACF) "; "Swartz, Tricia (ACF) "; "Sualog, Jallyn (ACF) "; "Biswas, Toby RM (ACF) "; "White, Laura (ACF) " Sent Date: 2017/10/11 09:51:13 Delivered Date: 2017/10/11 09:51:16 /\MERICAi\ pVERSIGHT EXT-18-248-C-000282 Holt, Lydia (ACF) "Lloyd, Scott (ACF) "; "Tota, Kennet h (ACF) " ; "White, Jonathan (ACF) " Subject: FOR YOUR AWARENESS: Reveal, Cente r for Investiga t ive Reporting: Court fil ing : Trump appo intee blocks preg nant teen migrant from getting abortio n Date: 20 17/10/11 11 :43:26 Importance: High Priority: Urgent Type: Note Court filing: Trump appoint ee blocks pregnant teen migrant from getting abortion Reveal, Center for Investigative Reporting Oct. 10, 2017 A Trump appointee has prevented a 17-year-old migrant at a federally funded shelter in Texas from getting an abortion and directed she be sent instead to religious counseling , according to a motion filed in federa l court last week . Lawyers with the ACLU of Northern Cal ifornia will argue on her behalf at an emergency court hearing in San Francisco Wednesday. In court filings over the last few days, they 've argued that changes at the Office of Refugee Resettlement under President Donald Trump 's administration are to blame and that the girl, referred to as Jane Doe, is not an isolated case. According to emails filed with the court, new ORR Director Scott Lloyd has met with a minor in federal custody to discuss her pregnancy and directed his staff to counsel girls about the risks of abortion - an early sign of how Lloyd's priorities will reflect his past work in pro-life advocacy. In a declaration filed with the court, Doe explained that she decided to get an abortion and made appointments at a clinic, but was never allowed to go. Instead, she said, officials sent her to a crisis pregnancy center where she was given a sonogram and "forced to look" at the image. "Defendants have been talking to me about my pregnancy," she said. "I feel like they are trying to coerce me to carry my pregnancy to term." Doe told the court she is afraid to tell her family about her plans to get an abortion , and had hoped to keep her pregnancy secret. But she said ORR officials already told her mother she was pregnant. /\MERICAi\ pVERSIGHT EXT-18-248-C-000283 According to the ACLU, Doe's case exemplifies a new order of business at ORR under the Trump administration. On March 4, the office's acting director, Kenneth Tota, sent a memo to the private groups that operate shelters under contracts with ORR, telling them they "are prohibited from taking any action that facilitates an abortion without direction and approval from the Director of ORR." Tota referred to rules the office previously issued in March 2008. Tota 's memo was apparently prompted by news the day before that a minor at an ORRcontracted shelter had begun a medically induced abortion the day before. In his letter, Tota directed ORR officials to take that child to an emergency room and try to preserve her pregnancy, over the child's own wishes. On March 10, according to a heavily redacted email filed with the court, ORR required , "effective immediately," that shelter operators send word whenever any girl expresses an interest in ending her pregnancy. On March 14, according to another email filed with the court, new ORR Director Scott Lloyd offered some advice to his staff after visiting a girl in ORR custody. "Ofte n these girls start to regret abortion," he wrote , "and if this comes up, we need to connect her with resources for psychological and/or religious counseling." In another email, Lloyd told shelters to only steer minors to "pregnancy services and lifeaffirming options counseling," not abortion providers. Lloyd reminded his staff to that "the unborn child is a child in our care," and to make medical decisions accordingly. On April 1, Lloyd directed Jonathan White, an ORR deputy director, to make sure that a minor in custody in Arizona get an ultrasound and counseling at Choices Pregnancy Centers , a Christian organization that, like Lloyd, suggests abortion regret is far more likely than research suggests . Such crisis pregnancy centers are engineered to persuade women to carry their pregnancies to term , often using myths, religious messages and bad science . Crisis pregnancy centers are well-represented on a list of ORR's approved counseling centers also filed with the court. It's no coincidence that these directions were some of Lloyd 's first actions after he was appointed to the office by Trump in mid-March. Before joining the office, Lloyd was an attorney for the Knight of Columbus, a Catholic charity, and served on the board of the pro-life Front Royal Pregnancy Center . In 2011, writing for the Center for Morality in Public Life, Lloyd argued that "the defining event in an abortion, as we use the tenn in our common parlance and in medical settings, is the death of a human being who has not yet been born." As a Health and Human Services official under President George W. Bush, Lloyd championed a rule protecting health care providers that oppose abortion on religious /\MERICAi\ pVERSIGHT EXT-18-248-C-000284 grounds, according to This Week in Immigration. President Barack Obama undid that rule in the first year of his pre sidency. But the Trump administration has ushered in new limits on health care in the religiou s liberty protections, including last week's decision to stop requiring employers to cover contraception in their health insurance plans. (Lloyd , writing in 2009, once argued that federal support for contraception would be a boon to abortion providers.) Ahead of Wednesday's hearing , seven attorney generals have lined up behind the Trump administration, led by Texas' Ken Paxton, saying that "Texas must not become a sanctuary state for abo1tions." Their brief argues that siding with Doe would sugge st that "unlawfully-present aliens with no substantial ties to this country have a constitutional right to abortion on demand." Any minor seeking an abortion in Texas faces a number of roadblocks, even if they aren't living in a federal shelter. Without a parent's permission, a minor in Texas must get a judge's permission to get an abortion, then make two separate appointments at a clinic at least 24 hours apart, the first of them for a mandatory sonogram. Doe had already navigated those steps, and made appointments in the last week of September before federal officials intervened. Texas also bans abortions after 20 weeks, creating a tight deadline in the court case. ACLU attorneys hope federal District Judge Laurel Beeler will order ORR to let Doe leave the shelter and end her pregnancy, and to extend that protection to other pregnant unaccompanied minors in ORR custody. Many children who arrive unaccompanied are fleeing abuse at home , and also face a high risk of sexual assault during their journey north. Under a settlement in another court case, known as the Flores agreement, the federal government has to provide unaccompanied minors with medical care, including family planning. Lydia A. Holt Public Affairs Specialist Office of Refugee Resettlement Administration for Children and Familie s (ACF) U .S. Department of Health and Human Services 330 C Street SW Washington, D.C. 2020 1 Lydia.Holt@acf.hhs.gov 202.40 I .9217 (W) 202.868.9893 (C) Teleworking on Mondays /\MERICAi\ pVERSIGHT EXT-18-248-C-000285 Holt, Lydia (ACF) "Lloyd, Scott (ACF) "; "Tota, Kenneth (ACF) "; "White, Jonathan (ACF) " Sent Date: 2017/10/1111:43:26 /\MERICAi\ pVERSIGHT EXT-18-248-C-000286 White, Laura (ACF) To: "Lloyd, Scott (ACF) " CC: "White, Jonathan (ACF) " Subject: FW: Family PlanningServicesPolicy Pregnancydraft.docx Date: 2017/10/11 12:27:38 Priority: Normal Type: Note ScottPlease see attached policy with comments-I have also provided you with a copy on your chair. We will discuss the comments more in depth at tomorrow ' meeting. Thanks, Laura From: White, Jonathan (ACF) Sent: Friday, October 06, 2017 11:27 PM To: White, Laura (ACF) Cc: Biswas, Toby R M (ACF); Swartz, Tricia (ACF); Sualog, Jallyn (ACF); Bartholomew, Michael (ACF); Bena, Anna Marie ( HHS/OGC) (ACF) Subject: RE: Family Planning Services Policy Pregnancy draft.docx Laura, As requested , Toby and I have provided comments /edits on the draft Family Planning Services Policy Pregnancy section by COB (soITy, my COB is pretty late) . Toby prepared his comments (which appear as TRMB) and forwarded to me. I concur with all his comments and have added more of my own. Because the policy so deeply engages UAC Program staff, and descr ibes actions DUCO and DHUC Federal staff must take, I sought input from the key program managersTricia, Jallyn, and Michael- as well. I have consolidated all our comments into a single document , so that while most of the "JDW" comme nts are mine , some are Tricia' s or Michael' s (those are marked as such on the comment bubble). Jallyn's comments are some of the "WU" comments but I have noted which are hers as well. (b)(5) /\MERICAi\ pVERSIGHT EXT-18-248-C-000287 Jonathan From: White, Laura (ACF) Sent: Friday, October 06, 2017 10:50 AM To: Biswas,Toby R M (ACF); White, Jonathan (ACF) Subject: Family Planning ServicesPolicy Pregnancydraft.do0< Jonathan and Toby, Scott would like your comments / edits to the new policy by COB today or Tuesday. Let me know what is more doable . I'd like one of you to review and then the next person so I don't have to combine two different documents with comments/ edits. It will be easier for clearance. Let me know if that is doable and who will edit/ comment first. Thanks, Laura White, Laura (ACF) "Lloyd, Scott (ACF) "; Recipient: "Wh ite, Jonathan (ACF) " Sent Dat e: 20 17/10/1112 :27 : 37 Delivered Dat e: 2017/ 10/1112:27 : 38 /\MERICAi\ pVERSIGHT EXT-18-248-C-000288 ACFMedia Clips (ACF) To: "ACF- All ACFStaff " Subject : ACFMedia Clips for Oct. 11, 2017 Date: 2017/10/1113:47:ll Priority : Normal Type: Note ACF Media Clips for Oct. 11, 2017 - Child Care Sen. Patty Murray wants to fix what experts call 'enormous inequalities' in child care Murray's bill would add more affordable child-care options, support universal preschool programs and increase compensation for child-care workers. She introduced it this past month, with strong support from Democrats but none yet from Republicans. Seattle Times, WA Oct. JO, 2017 - Children, Youth & Families Supreme Court refuses to hear Kentucky foster care case The U.S. Supreme Court has refused to hear a case involving a growing number of Kentucky relatives providing free foster care for children. The result is that Kentucky must begin paying those relatives the same as they do licensed foster families, news outlets report. Associated Press, KY Oct. 11, 2017 The $600-a-night foster care bed The payment of high per-night fees was first reported by Investigate West, Crosscut and KCTS9 last fall. Since then, InvestigateWest has learned that the top rate the state is willing to pay has nearly doubled over the last year from $325 to $600 . And new payment records requested from the state, as well as confidential but incomplete data obtained by Investigate West, show that at least a handful of foster families are making a small fortune on the practice. Investigate West, WA Oct. 11, 2017 70-plus children missing from Kansas' foster care system Lawmakers are expressing outrage after learning more than 70 foster children are missing in Kansas. Foster care contractors provided the information during a meeting Tuesday in response to questions about the disappearance of three sisters from a northeast Kansas foster home, The Kansas City Star reports. Police believe the still-missing girls - ages 15, 14 and 12 - ran away in August. Associated Press, KS /\MERICAi\ pVERSIGHT EXT-18-248-C-000289 Oct. 11, 2017 Lawmakers shocked to learn 70-plus children missing from Kansas' foster care system In a revelation that shocked lawmakers, the companies running the state's foster care system said Tuesday that more than 70 foster children are missing in Kansas. Lawmakers also were furious that Phyllis Gilmore, secretary of the Kansas Department for Children and Families, appeared unaware that three sisters have been missing from a northeast Kansas foster home since Aug. 26. Kansas City Star, KS Oct.JO, 2017 Nowhere else to go: Why kids are sleeping in child welfare offices In the past few years , Arizona, Louisiana, Texas and Washington, D.C., have all used office space as an emergency option to park children when they have nowhere else to sleep. In most cases, the office stays are for a single night, and caseworkers supervise the children. Governing, DC Oct. 10, 2017 Fla. school district picks abstinence-only center for sex education. Lesson 8: 'Steps of intimacy and how to stop them' A Florida school district has signed on with an abstinence-only center to provide sex education - or, rather, "relationship education" - to teens, replacing curriculum that had been informed by the Florida Department of Health. Analysis Washington Post, DC Oct. 10, 2017 - Head Start Head Start report shows allegations of abuse to JCPS students (featuring A CF) Seven Jefferson County Public School Head Start employees are out a job and it could just be the beginning of a broader investigation as a report reveals the mistreatment of several children under the districts care. The facts so shocking the head of the Office of Head Stai1 flew to Louisville to tell school leaders they are on notice. The report was written by the administration for Children and Families, which is a division of the US Department of Health and Human Services. The allegations are so severe Linehan threatened to pull the plug on the district's federally funded program. WHAS, KY Oct. JO, 2017 - Early Head Start program expanding in Southwest Missouri (featuring ACF) Lamar Missouri Tuesday celebrated the opening of a new child care facility with an open house and Chamber of Commerce Ribbon Cutting ceremony. It's the result of Economic Security Corporation's Early Head Start program which has worked creating partnerships in over 6 Southwest Missouri communities to expand high-quality no cost child care opportunities. KOAM,MO Oct. JO, 2017 /\MERICAi\ pVERSIGHT EXT-18-248-C-000290 Native Americans New lawsuit targets custody battles in tribal courts A lawsuit filed Tuesday targets the Minnesota Department of Human Services and Scott County, organizations the plaintiffs allege are violating federal law by sending child custody cases to Indian tribal court without the consent of both parents. KMSP,MN Oct. 10, 2017 - Refugee Resettlement Vermont refugee resettlement program plans for fewer refugees after US admissions cap Amila Merdzanovic, director of the Vermont Refugee Resettlement Program, says the effects of the reduction will be felt in Vermont and across the country. The agency had hoped to resettle 450 refugees in Vermont this coming year. Because of the Trump administration's effort to limit resettlement, they've had to scale their efforts back to 345. The State Department has approved plans to resettle 270 refugees in Colchester and 75 in Rutland. In Colchester , recent refugees have been from a number of countries, including Nepal, Bhutan, Somalia, the Congo and others. Rutland is expecting families from Syria and Iraq. Vermont Public Radio, VT Oct. JO, 2017 Trafficking Iowa human-trafficking laws better, need work Efforts to legislate against human trafficking have increased in recent years, at both the state and federal levels, but there may still be a lot left to be done. According to the 2014 Polaris report, Iowa has done well by passing several laws to combat human trafficking , but it could do more to implement new laws and improve existing ones. Meanwhile, Iowa landed near the bottom of Polaris ' list when it came to victim-assistance laws. Daily Iowan, IA Oct. 11, 2017 - Unaccompanied Alien Children The Trump administration is preventing undocumented immigrant minors from getting abortions (featuring A CF) Thousands of unaccompanied, undocumented immigrant minors are currently in the custody of the United States federal government, which is legally obligated to provide them with health care. In March of 2017 , the Office of Refugee Resettlement announced that federally funded shelters are barred from taking "any action that facilitates" abortion for these unaccompanied minors without "direction and approval" from ORR Director Scott Lloyd. And according to the ACLU, Lloyd, a Trump nominee, is now prohibiting minors from accessing abortion care-and instead sending them to "crisis pregnancy center s" that urge them not to terminate their /\MERICAi\ pVERSIGHT EXT-18-248-C-000291 pregnancies. According to the ACLU, Lloyd, the current ORR director , has personally called pregnant minor s in an attempt to talk them out of terminate their pregnancies. Slate Magazine, NY Oct. 11, 2017 Teen detained in Texas after crossing border fights to have abortion (featuring ACF) Advocates for a pregnant 17-year-old girl held in a Texas facility for immigrant children who have crossed the border alone are asking a federal judge to allow her to get an abortion, over the opposition of U.S. and state officials. A federal magistrate judge in San Francisco has scheduled a hearing Wednesday on a request filed by the American Civil Liberties Union of Northern California, which accuses the U.S. Department of Health and Human Services of refusing to let the girl be taken for the procedure. Staff at the facility where she's being held refused to take her to her appointments with a doctor to seek an abortion, or let the attorney take her, even though private groups that support abortion rights have raised money for the procedure. Instead , she was taken to a crisis pregnancy center. Associated Press, TX Oct. JO, 2017 Court filing: Trump appointee blocks pregnant teen migrant from getting abortion (featuring A CF) A Trump appointee has prevented a 17-year-old migrant at a federally funded shelter in Texas from getting an abortion and directed she be sent instead to religious counseling, according to a motion filed in federal court last week. In court filings over the last few days, they've argued that changes at the Office of Refugee Resettlement are to blame and that the girl, referred to as Jane Doe, is not an isolated case. According to emails filed with the court, new ORR Director Scott Lloyd has met with a minor in federal custody to discuss her pregnancy and directed his staff to counsel girls about the risks of abortion - an early sign of how Lloyd's priorities will reflect his past work in pro-life advocacy. Reveal/The Center for Inv estigative Reporting , CA Oct. 10, 2017 Undocumented teenager seeks court authorization to access abortion services (featuring ACF) A pregnant , 17-year-old, undocumented immigrant is at the center of a legal dispute over whether unaccompanied immigrant minors have the right to an abo11ion in the United States. Jane Doe, as she's referred to in court filings, is currently at a shelter in Brownsville, in the custody of the Office of Refugee Resettlement (ORR) , a federal agency responsible for refugees and unaccompanied undocumented minors. Doe is seeking an emergency court order authorizing her to access abortion services after the federal office blocked her from attending a pre-abortion medical appointment. Texas Tribune, TX Oct. 10, 2017 - Pregnant immigrant in Texas will test abortion access (featuring ACF) Officials with the ACLU and Janes Due Process , a nonprofit that helps teenagers gain access to abortion, argue that Jane Doe's experience is part of a larger pattern by the Office of Refugee /\MERICAi\ pVERSIGHT EXT-18-248-C-000292 Resettlement, which under President Donald Trump has refused to allow unaccompanied minors to receive abortions, referring them instead to crisis pregnancy centers which counsel women against abortions, often from a religious perspective. "Trump administration officials are literally holding her hostage," ACLU lawyer Brigitte Amiri said. "The interference by government officials about the most intimate and personal decision a woman can make is horrific. It's also blatantly unconstitutional." Austin American-Statesman, TX Oct. JO,2017 Trump administration blocks legal abortion for undocumented Texas minor in federal care (featuring A CF) A 17-year-old undocumented minor living in federal custody in Texas is being denied her right to an abortion by the federal government. American Civil Liberties Union lawyers, who call the move "shocking" and "straight from dystopian fiction" are requesting an emergency hearing Wednesday in a California federal court to grant her abortion access before she's too far along in her pregnancy. The girl, dubbed "Jane Doe" in court documents, is currently living in a Brownsville facility for undocumented and unaccompanied minors run by the feds where, by law, she is required access to "family planning services, including pregnancy tests and ... access to medical reproductive health services and emergency contraception." San Antonio Current, TX Oct. JO, 2017 Texas must not be a 'sanctuary state for abortions,' AG Ken Paxton says in court brief (featuring A CF) The federal government should not give unauthorized immigrant minors the right to have abortions, Texa s Attorney General Ken Paxton said Tuesday. The American Civil Liberties Union wants to add "Jane Doe," a 17-year-old unauthorized immigrant who sued in Texas to have an abortion, to an existing federal case against the U.S. Department of Health and Human Services. Paxton filed a brief in the case in response, arguing that unauthorized minors do not have the right to have abortions. The ACLU argues that restricting reproductive and abortion care is unconstitutional, but Paxton said the case could establish Texas as a "sanctuary state for abortions." Dallas Morning News, TX Oct. 10, 2017 Teenage illegal immigrant crosses border to get abortion. Now it's up to a iudge if she can. (featuring A CF) A judge is deciding Wednesday whether the state of Texa s must help a teenage illegal immigrant get an abortion - a case that could have serious ramifications. Even though the 17-year-old illegal immigrant received a judicial waiver allowing her - a minor - to get an abortion, the officers detaining her refuse to take her to an abortion clinic American Civil Liberties Union (ACLU) lawyer, Rochelle Garza, told The Associated Press on Tuesday. "I feel like they are trying to coerce me to carry my pregnancy to term," the girl told a federal court earlier in October, explaining that she was taken to a crisis pregnancy center instead of an abortion clinic. Daily Caller, DC Oct. 11, 2017 /\MERICAi\ pVERSIGHT EXT-18-248-C-000293 This information is provided for internal research purposes and should not be circulated outside of ACF. Each article is copyrighted by the source listed, and the prior written permission of the source is needed for further copying. Sender: Recipient: ACF Media Clips (ACF) "ACF- All ACFStaff " Sent Date: 2017/ 10/1113:4 1:54 Delivered Date: 2017/ 10/1113:47 :11 /\MERICAi\ pVERSIGHT EXT-18-248-C-000294 Wagner, Steven (ACF) "Bowman, Matthew (HHS/OGC)"; To: "Wolfe, Kenneth (ACF) "; "Wynne, Maggie (HHS/IOS) " "Marriott, Brian (ACF) "; "Negri, Warren A. (ACF) "; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Oakley, Caitlin B. (OS/ASPA)"; CC: "Yoest, Charmaine(OS/ASPA)"; "Murphy, Ryan (OS/ASPA)"; "Lloyd, Matt (OS/ASPA)"; "Bult, Nathan (OS/ASPA)" Subject: RE: UAC,abortion Date: 2017/10/1118:37:40 Priority: Normal Type: Note Thank s Matt and Charmaine From: Bowman, Matthew (HHS/OGC) Sent: Wednesday, October 11, 2017 6:34 PM To: Wolfe, Kenneth (ACF); Wynne, Maggie (HHS/IOS) Cc: Wagner, Steven (ACF); Marriott, Brian (ACF); Negri, Warren A. (ACF); Lloyd, Scott (ACF); Pilato, Anna (ACF); Oakley, Caitlin B. (OS/ASPA); Yoest, Charmaine (OS/ASPA); Murphy, Ryan (OS/ASPA); Lloyd, Matt (OS/ASPA); Bult, Nathan (OS/ASPA) Subject: RE: UAC, abortion I received a revi sed version from ASP A, and OGC' s redline s to that version are attached. Confidential pre-decisional deliberative process and attorney client privilege /\MERICAi\ pVERSIGHT EXT-18-248-C-000295 Matt Bowman Deputy General Counsel HHSOGC 202.868.9791 rnatthe w.bo wman @hh s.gov From: Wolfe, Kenneth (ACF) Sent: Wednesday,October 11, 2017 5:43 PM To: Yoest, Charmaine (OS/ASPA);Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC) Cc: Wagner, Steven (ACF); Marriott, Brian (ACF); Negri, Warren A. (ACF); Lloyd, Scott (ACF); Pilato, Anna (ACF) Subject: UAC,abortion We have at least three media requests for comment , including Buzzfeed and the Washington Times, on the Texas UAC story. Please review the following draft response DRAFT - pre-decisional b)(5) DRAFT - pre-decisional For reference , here are other clips on the subject: The Trump administration is preventing undocumented immigrant minors from getting abortions Thousands of unaccompanied , undocumented immigrant minors are currently in the custody of the United States federal government, which is legally obligated to provide them with health care. In March of2017 , the Office of Refugee Resettlement announced that federa lly funded shelters are barred from taking "any action that facilitates" abortion for these unaccompanied minors without "direction and approval" from ORR Director Scott Lloyd. And according to the ACLU, Lloyd, a Trump nominee, is now prohibiting /\MERICAi\ pVERSIGHT EXT-18-248-C-000296 minors from accessing abortion care-and instead sending them to "crisis pregnancy centers" that urge them not to terminate their pregnancies. According to the ACLU, Lloyd, the current ORR director, has personally called pregnant minors in an attempt to talk them out of terminate their pregnancies. Slate Magazine, NY Oct. 11, 2017 Teen detained in Texas after crossing border fights to have abortion Advocates for a pregnant 17-year-old girl held in a Texas facility for immigrant children who have crossed the border alone are asking a federal judge to allow her to get an abortion, over the opposition of U.S. and state officials. A federal magistrate judge in San Francisco has scheduled a hearing Wednesday on a request filed by the American Civil Liberties Union of Northern California, which accuses the U.S. Department of Health and Human Services of refu sing to let the girl be taken for the procedure. Staff at the facility where she's being held refused to take her to her appointments with a doctor to seek an abortion, or let the attorney take her, even though private groups that support abortion rights have raised money for the procedure. Instead , she was taken to a crisis pregnancy center. Associated Press, TX Oct. JO,2017 Court filing: Trump appointee blocks pregnant teen migrant from getting abortion A Trump appointee has prevented a 17-year-old migrant at a federally funded shelter in Texas from getting an abortion and directed she be sent instead to religious counseling, according to a motion filed in federal court last week. In court filings over the last few days , they've argued that changes at the Office of Refugee Resettlement are to blame and that the girl, referred to as Jane Doe, is not an isolated case . According to emails filed with the court, new ORR Director Scott Lloyd has met with a minor in federal custody to discuss her pregnancy and directed his staff to counsel girls about the risks of abortion an early sign of how Lloyd's priorities will reflect his past work in pro-life advocacy. Reveal/The Center.for Investigative Reporting, CA Oct. JO,2017 Undocumented teenager seeks court authorization to access abortion services A pregnant, 17-year-old, undocumented immigrant is at the center of a legal dispute over whether unaccompanied immigrant minors have the right to an abortion in the United States. Jane Doe, as she's referred to in court filings, is currently at a shelter in Brownsville , in the custody of the Office of Refugee Resettlement (ORR), a federal agency responsible for refugees and unaccompanied undocumented minors. Doe is seeking an emergency court order authorizing her to access abortion services after the federal office blocked her from attending a pre-abortion medical appointment. Texas Tribune, TX Oct. 10, 2017 -Pregnant /\MERICAi\ pVERSIGHT immigrant in Texas will test abortion access EXT-18-248-C-000297 Officials with the ACLU and Janes Due Process , a nonprofit that helps teenagers gain access to abortion, argue that Jane Doe's experience is part of a larger pattern by the Office of Refugee Resettlement, which under President Donald Trump has refused to allow unaccompanied minors to receive abortions, referring them instead to crisis pregnancy centers which counsel women against abortions, often from a religious perspective. "Trump administration officials are literally holding her hostage," ACLU lawyer Brigitte Amiri said. "The interference by government officials about the most intimate and personal decision a woman can make is horrific. It's also blatantly unconstitutional." Austin American-Statesman, TX Oct. 10, 2017 Trump administration blocks legal abortion for undocumented Texas minor in federal care A 17-year-old undocumented minor living in federal custody in Texas is being denied her right to an abortion by the federal government. American Civil Liberties Union lawyers , who call the move "shocking" and "straight from dystopian fiction" are requesting an emergency hearing Wednesday in a California federal court to grant her abortion access before she's too far along in her pregnancy. The girl, dubbed "Jane Doe" in court documents, is currently living in a Brownsville facility for undocumented and unaccompanied minors run by the feds where, by law, she is required access to "family planning services, including pregnancy tests and ... access to medical reproductive health services and emergency contraception." San Antonio Current, TX Oct. JO,2017 Texas must not be a 'sanctuary state for abortions,' AG Ken Paxton says in court brief) The federal government should not give unauthorized immigrant minors the right to have abortions, Texas Attorney General Ken Paxton said Tuesday. The American Civil Liberties Union wants to add "Jane Doe," a 17-year-old unauthorized immigrant who sued in Texas to have an abortion, to an existing federal case against the U.S. Department of Health and Human Services. Paxton filed a brief in the case in response, arguing that unauthorized minors do not have the right to have abortions. The ACLU argues that restricting reproductive and abortion care is unconstitutional, but Paxton said the case could establish Texas as a "sanctuary state for abortions." Dallas Morning News, TX Oct. 10, 2017 Teenage illegal immigrant crosses border to get abortion. Now it's up to a judge if she can. A judge is deciding Wednesday whether the state of Texas must help a teenage illegal immigrant get an abortion - a case that could have serious ramifications. Even though /\MERICAi\ pVERSIGHT EXT-18-248-C-000298 the 17-year-old illegal immigrant received a judicia l waiver allowing her - a minor - to get an abort ion, the office rs detaining her refuse to take her to an abortion clinic Ame rican Civil Liberties Union (ACLU) lawye r, Roche lle Garza , told The Associated Press on Tuesday. "I feel like they are trying to coerce me to carry my pregnancy to term," the girl told a federal court earlier in October, explaining that she was taken to a crisis pregna ncy center instead of an abort ion clinic . Daily Caller, DC Oct. 11, 2017 Wagner, Steven (ACF) "Bowman, Matthew {HHS/OGC) "; "Wolfe, Kenneth (ACF) "; "Wynne, Maggie (HHS/IOS) "; "Marriott, Brian (ACF) "; "Negr i, Warren A. (ACF) "; "Lloyd, Scott (ACF) "i Recipient: "Pilato, Anna (ACF) "; "Oakley , Caitlin B. (OS/ASPA) "; "Yoest, Charmaine (O5/ASPA) "; "Murphy, Ryan (O5/ASPA) "; "Lloyd, Matt (O5/ASPA) "; "Bu lt, Nathan (O5/ASPA) " Sent Date: 20 17/10/11 18:37:39 Delivered Date: 20 17/10/1118:37:40 /\MERICAi\ pVERSIGHT EXT-18-248-C-000299 Russell,Elizabeth (ACF) "Lloyd, Scott (ACF) "; To: "Moreno, Mr. Pedro (ACF) " Subject: Talking Points and FIERGroup meeting Date: 2017/10/11 21:47:44 Priority: Normal Type: Note Scott, Pedro Attached , plea se find some talking points for the FIER meeting. Please let me know if you have any questions. Best, Elizabeth CDR Elizabeth B. Russell Coordina tor, U.S. Repatriation Program Coordinator and Emergency Management Coordina tor for Refugee Programs U.S. Department of Health and Human Services Administration for Children and Families Office of Refugee Resett lement Mary E. Switzer Building , 330 CST SW, Room 5123 Washington, DC 20201 .,,...,...,.,,.,------, Tel: (202) 401-4845, BB J~~)(5_) --~ e-mail: Elizabeth.russell@acf.hhs.gov HSDN/SlPR elizabeth.russe ll@dhs.sgov .gov Please note change of BB# Russell,Elizabeth (ACF) "Lloyd, Scott (ACF) "; Recipient: "Moreno, Mr. Pedro (ACF) " Sent Date: 2017/10/ 11 21:47:42 Delivered Date: 2017/10/11 21:47:44 /\MERICAi\ pVERSIGHT EXT-18-248-C-000300 Wolfe, Kenneth (ACF) "Marriott, Brian (ACF) "; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Wynne, Maggie (HHS/IOS) "; "Bowman, Matthew (HHS/OGC)" "Wagner, Steven (ACF) "; "Negri, Warren A. (ACF) " Subject: Re: UAC,abortion Date: 2017/10/11 22:13:53 Priority: Normal Type: Note Our statement is in the Assoc iated Press article, which also contains the phrase "unborn child" not in quotes. http s://apnew s.com/8fe5857bd 15549569fa l 83d09cdc4dc4 On: 11 October 2017 21 :46, "Marriott , Brian (ACF)" wrote : Thanks so much. The majority will come in tomorrow on inquiries, etc. Brian On: 11 October 2017 19:21, "Wolfe, Kenneth (ACF)" wrote: We sent it to seven reporter s upon reque st so far, stating it is to be attributed to the Adm inistration for Children and Familie s at the U.S . Department of Health and Hum an Services. From: Lloyd, Scott (ACF) Sent: Wednesday, October 11, 2017 7: 12 PM To: Pilato, Anna (ACF); Wolfe, Kenneth (ACF); Wynne, Maggie (HHS/10S); Bowman, Matthew (HHS/OGC) Cc: Wagner, Steven (ACF); Marriott , Brian (ACF); Negr i, Warren A. (ACF) Subject: RE: UAC, abortion /\MERICAi\ pVERSIGHT EXT-18-248-C-000301 I am still wondering who is the speaker? Thank you, Scott From: Pilato, Anna (ACF) Sent: Wednesday, October 11, 2017 7:01 PM To: Lloyd, Scott (ACF); Wolfe, Kenneth (ACF); Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC) Cc: Wagner, Steven (ACF); Marriott, Brian (ACF); Negri, Warren A. (ACF) Subject: RE: UAC, abortion No problem! From: Lloyd, Scott (ACF) Sent: Wednesday, October 11, 2017 6:58 PM To: Pilato, Anna (ACF); Wolfe, Kenneth (ACF); Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC) Cc: Wagner, Steven (ACF); Marriott, Brian (ACF); Negri, Warren A. (ACF) Subject: RE: UAC, abortion Yes, I saw that it had been tweaked after I sent it-sorry for the confusion From: Pilato, Anna (ACF) Sent: Wednesday, October 11, 2017 6:57 PM To: Lloyd, Scott (ACF); Wolfe, Kenneth (ACF); Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC) Cc: Wagner, Steven (ACF); Marriott, Brian (ACF); Negri, Warren A. (ACF) Subject: RE: UAC, abortion Scott, can you check your email? Not sure if you're looking at the latest version. And, t he news outlets have already been sent the response from ACF. From: Lloyd, Scott (ACF) Sent: Wednesday, October 11, 2017 6:53 PM To: Wolfe, Kenneth (ACF); Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC) Cc: Wagner, Steven (ACF); Marriott, Brian (ACF); Negri, Warren A. (ACF); Pilato, Anna (ACF) Subject: RE: UAC, abortion (Took off Charmaine to discuss within ACF). Could we consider a few changes? There are a few things that need some tweaking an~ b)(S) J I've made some comments below. From: Wolfe, Kenneth (ACF) Sent: Wednesday, October 11, 2017 5:43 PM To: Yoest, Charmaine (OS/ASPA); Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC) Cc: Wagner, Steven (ACF); Marriott, Brian (ACF); Negri, Warren A. (ACF); Lloyd, Scott (ACF); Pilato, Anna (ACF) Subject: UAC, abortion /\MERICAi\ pVERSIGHT EXT-18-248-C-000302 We have at least three media requests for comment, including Buzzfeed and the Wash ington Times, on the Texas UAC story. Please review the following draft response DRAFT - pre-decisional b)(5) DRAFT - pre-decisional For reference, here are other clips on the subject: The Trump administration is preventing undocumented immigrant minors from getting abortions Thousands of unaccompanied , undocumented immigrant minors are currently in the custody of the United States federal government , which is legally obligated to provide them with health care. In March of2017 , the Office ofRefugee Resettlement announced that federally funded shelters are barred from taking "any action that facilitates" abortion for these unaccompani ed minors without "direction and approval " from ORR Director Scott Lloyd. And according to the ACLU, Lloyd, a Trump nominee, is now prohibiting minors from accessing abortion care- and instead sending them to "crisis pregnancy centers " that urge them not to terminate their pregnancies. According to the ACLU , Lloyd, the current ORR director , has personally called pregnant minors in an attempt to talk them out of terminate their pregnancie s. Slate Magazine , NY Oct. 11, 2017 Teen detained in Texas after crossing border fights to have abortion /\MERICAi\ pVERSIGHT EXT-18-248-C-000303 Advocates for a pregnant 17-year-old girl held in a Texas facility for immigrant children who have crossed the border alone are asking a federal judge to allow her to get an abortion, over the opposition of U.S. and state officials. A federal magistrate judge in San Francisco has scheduled a hearing Wednesday on a request filed by the American Civil Liberties Union of Northern California, which accuses the U.S. Department of Health and Human Services of refusing to let the girl be taken for the procedure. Staff at the facility where she's being held refused to take her to her appointments with a doctor to seek an abortion, or let the attorney take her, even though private groups that support abortion rights have raised money for the procedure. Instead, she was taken to a crisis pregnancy center. Associated Press, TX Oct. 10, 2017 Court filing: Trump appointee blocks pregnant teen migrant from getting abortion A Trump appointee has prevented a 17-year-old migrant at a federally funded shelter in Texas from getting an abortion and directed she be sent instead to religious counseling , according to a motion filed in federal court last week. In court filings over the last few days , they've argued that changes at the Office of Refugee Resettlement are to blame and that the girl, refe1Tedto as Jane Doe, is not an isolated case. According to emails filed with the court, new ORR Director Scott Lloyd has met with a minor in federal custody to discuss her pregnancy and directed his staff to counsel girls about the risks of abortion an early sign of how Lloyd's priorities will reflect his past work in pro-life advocacy. Reveal/The Center.for Investigative Reporting, CA Oct. 10, 2017 Undocumented teenager seeks court authorization to access abortion services A pregnant, 17-yea r-old , undocumented immigrant is at the center of a legal dispute over whether unaccompanied immigrant minors have the right to an abortion in the United States. Jane Doe, as she's referred to in court filings, is currently at a shelter in Brown sville, in the custody of the Office of Refugee Resettlement (ORR), a federal agency respon sible for refugees and unaccompanied undocumented minor s. Doe is seeking an emergency court order authorizing her to access abortion services after the federal office blocked her from attending a pre-abortion medical appointment. Texas Tribune, TX Oct. 10, 2017 -Pregnant immigrant in Texas will test abortion access Officials with the ACLU and Janes Due Process, a nonprofit that helps teenagers gain access to abortion, argue that Jane Doe's experience is part of a larger pattern by the Office of Refugee Resettlement, which under President Donald Trump has refused to allow unaccompanied minors to receive abortions, referring them instead to crisis pregnancy centers which counsel women against abortions, often from a religious perspective. "T rump administration officials are literally holdin g her hostage," ACLU lawyer Brigitte Amiri said. "The interference by government officials about the most intimate and personal decision a woman can make is horrific. It's also blatantly unconstitutional. " /\MERICAi\ pVERSIGHT EXT-18-248-C-000304 Austin American-Statesman, TX Oct. 10, 2017 Trump administration blocks legal abortion for undocumented Texas minor in federal care A 17-year-old undocumented minor living in federal custody in Texas is being denied her right to an abortion by the federal government. American Civil Liberties Union lawyers, who call the move "shocking" and "straight from dystopian fiction" are requesting an emergency hearing Wednesday in a California federal court to grant her abortion access before she's too far along in her pregnancy. The girl, dubbed "Jane Doe" in court documents, is currently living in a Brownsville facility for undocumented and unaccompanied minors run by the feds where, by law, she is required access to "family planning services, including pregnancy tests and ... access to medical reproductive health services and emergency contraception." San Antonio Current, TX Oct. 10, 2017 Texas must not be a 'sanctuary state for abortions,' AG Ken Paxton says in court brief) The federal government should not give unauthorized immigrant minors the right to have abortions, Texas Attorney General Ken Paxton said Tuesday. The American Civil Liberties Union wants to add "Jane Doe," a 17-year-old unauthorized immigrant who sued in Texas to have an abortion, to an existing federal case against the U.S. Department of Health and Human Services. Paxton filed a brief in the case in response, arguing that unauthorized minors do not have the right to have abortions. The ACLU argues that restricting reproductive and abortion care is unconstitutional, but Paxton said the case could establish Texas as a "sanctuary state for abortions." Dallas Morning News, TX Oct. 10, 2017 Teenae;e illee;al immigrant crosses border to get abortion. Now it's up to a judge if she can. A judge is deciding Wednesday whether the state of Texas must help a teenage illegal immigrant get an abortion - a case that could have serious ramifications. Even though the 17-year-old illegal immigrant received a judicial waiver allowing her - a minor - to get an abortion, the officers detaining her refuse to take her to an abortion clinic American Civil Liberties Union (ACLU) lawyer, Rochelle Garza, told The Associated Press on Tuesday. "I feel like they are trying to coerce me to carry my pregnancy to term," the girl told a federal court earlier in October, explaining that she was taken to a crisis pregnancy center instead of an abortion clinic. Daily Caller, DC Oct. 11, 2017 Wolfe, Kenneth (ACF) /\MERICAi\ pVERSIGHT EXT-18-248-C-000305 "Marr iott, Brian (ACF) "; "Lloyd, Scott (ACF) "; "Pilato, Anna (ACF) "; "Wynne, Maggie (HHS/IOS) "; "Bowman, Matthew (HHS/OGC) "; "Wagner, Steven (ACF) "; "Negri, Warren A. (ACF) " Sent Date: 2017/10/11 22 :13:52 Delivered Date: 2017/10/11 22:13:53 /\MERICAi\ pVERSIGHT EXT-18-248-C-000306 From (b)(6) l§liestex.org> "Lloyd, Scott (ACF) " Subject: Re: State Court hearing Date: 2017/10/11 23:33:33 Priority: Normal Type: Note Thank you, received and have a restful evening Sir. l(b)(6) From: Lloyd, Scott (ACF) Sent: Wednesday, October 11, 2017 10:30 PM To:l (b)(6) I Subject: Re: State Court hearing I see now-- I defer to the program's judgment on whether monitoring is advisable in this situation given the allegations of abuse. 5 >< _>___________ On: 11 October 2017 23:19, ~~b_ ~@iestex.org> wrote: Thank you so much for this, I wanted to be sure to inquire regarding phone call with mother because of allegations of abuse noted in legal proceedings and SIR. Just to provide brief clarification as I hope my previous message did not imply some sort of infringement on UAC. As you know, at time UAC in care allege abuse, neglect or mistreatment at the hands of previous caretakers then ask to speak to same individuals, in these cases, we may take temporary precautionary measures (with proper approval and after staffing with all involved stakeholders) not explicitly addressed in ORR policy ...it is more along the lines of ensuring that the persons that have contact with UAC in these cases are not known/alleged perpetrators of abuse/mistreatment. Therefore, arrangements can be made for UAC to be brought to the clinical office or case management office (private office) and either the assigned Clinician or assigned Case Manager is in the room while the UAC speaks with person on phone (not on speaker, UAC sits on one end of office and staff continue working while UAC conducts phone call). This allows CM or CL to monitor UAC"s demeanor and ensure that nature and tone of call is appropriate and not affecting UAC in a negative manner, this can also be done from outside the room the UAC remains in line of sight but the staff will not overhear any portion of the discussion. Please rest assured we will adhere to all governing policies and ensure ORR remains informed of all information related to the case of this minor. /\MERICAi\ pVERSIGHT EXT-18-248-C-000307 I will ensure program proceeds as directed, UAC will be granted telephone call with her mother as requested, again I appreciate your patience and guidance!!! Will standby for further guidance on other matters. From: Lloyd, Scott (ACF) Sent: Wednesday, October 11, 2017 9:22 PM To: (b)(6) Cc: 1te, onat an ACF); Brooks, Teresa (ACF); Bowman, Matthew (HHS/OGC) Subject: Re: State Court hearing l(b)(6) ~hank you for the update. se reason. I will address your other questions after double- checking. Thank you, Scott On: 11 October 2017 21:54, f~b_ )<6_>___________ Good Evening, ~~iestex.org> wrote: Please be advised that UAC attended follow -up appointment with Obstetricia~~~)(5_> fb)(6) 1atRGVWomen's Health Center on Monday, October 9th, 2017. . . • ~ b)(6) UAC was accompanied by program's Medical Coordinato on this visit . 6 Hours prior to departing from program, Medical Coordinator (b)() met with UAC to discuss follow -up appointment to ensure her understanding and obtain UAC's consent to attend. Medical Coordinator informed the UAC that the purpose of visit was to inquire about the possibility of obtaining medial clearance for UAC to increase physical activity in order to partake in light to moderate group dance exercise. UAC stated she understood and verbally consented to attending scheduled follow-up appointment with OB/GYN. Previously UAC requested care provider seek medical clearance from OB in order for her to partake in "Zumba", UAC was having difficulty adjusting to medical restrictions and verbally requested restrictions be reviewed and reconsidered by OB/GYN. However, as previously stated, Dr. Torres issued the following " UAC must remain no NO PHYSICALACTIVITYuntil further notice. NO SWIMMING , NO /\MERICAi\ pVERSIGHT EXT-18-248-C-000308 RUNNING, NO ZUMBA, NO DANCING, NO STRENUOUSEXERCISE.UAC MAY take BRISK WALKS. II Medical Coordinator informed program administration tha~bl(6l ~lso informed UAC of lab results (drawn on 9/11/17) returned within normal limits and that ZIKA test (conducted on 9/11/17) had returned "Negative". NO ultrasound or sonogram was completed during visit on 10/9/17. 5 To conclude the visit on 10/9/17j (b}( ) pnd his Nurse, informed UACthat during the first trimester between 11-14 weeks gestation (UAC is currently 14 weeks) it is recommended that ALL pregnant females undergo "1st Trimester NT (nuchal translucency screening)".fbl(6) ~xplained to UAC in the presence of his nurse and program Medical Coordinator that the screening involves undergoing an ultrasound to screen for fluid build-up in the fetuses upper spine/neck to detect cardiovascular abno rmaliti es, Down Syndrome and other abno rmaliti es in t he fetu s. UAC was given the opportunity to ask questions and/or voice concerns. UAC stated she understood the information provided to her, stated she had no concerns or questions and voiced agreement and verbally consented to the screening/procedure. The nurse informed UAC and Medical Coordinator that the UAC would be referred to Driscoll Maternal and Fetal 6 lfor 1st Trimester Screen (NT Screen). Nurs~.... ~)C _l _ __. Medicine wit~ b)(5) explained she would provide specialty appointment time and date prior to UAC departing from medical office. 5 On 10/9/171Cb)(5l hurse}bl( l !LvN confirmed specialty appointment for 10/11/2017 at 2:30PM. Please be note, UAC agreed to 1st Trimester Screen (NT Screen) during medical visit with OB/GYN on 10/09/17 and also issued consent to screening during inital OB visit on 09/11/2017. On 10/11/17 , UAC attended speciality appointment at Driscoll Maternal Fetal Medicine for the sole purpose of undergoing 1st Trimester NT screenin Nuchal translucensy 5 screening). UAC was accompanied by Medical Coordinato b)( l UAC consented to screening and was informed results would be reviewed with her at during next bhe stated she understood and denied having any OB/GYN appointment wit~(b)(5l questions or concerns. Following the NT screening/scan , labwork was conducted as part of the NT screening. UAC was off erred the opportunity to ask questions and share concerns, she denied having any questions or concerns. Please note that NT (nuchal translucency) is a standard first trimester screening (11-14 weeks gestation) that all pregnant females undergo it is considered a stanadard screening during prenatal care, more specifically any and all UAC in care undergo this screening as recommended by OB/GYN. Please be rem inded that OB/GYN has not been informed of legal proceedings invovling this UAC and/or her request to /\MERICAi\ pVERSIGHT EXT-18-248-C-000309 terminate preganancy. Care provider is still pending guidance from ORR/OGCon this matter, we will NOT inform medical provider unless authorized to do so by ORR. On a seperate note, please be advised that UAC continues to request to make telephone contact with her mother in home country, she issued request yesterday 10/10 and today 10/11. At this time we are pending response from ORR and/or OGC as to whether the UAC may make contact with her mother and whether telephone contact must be monitored by care provider. Finally, please be advised that I was contacted by Regional Supervisor of Residential Child Care Liscencing (Cristina Lowenberg) regarding this UAC and the increasing media coverage, specifically article publised on 10/11/17 in the Texas Standard htt ps://www .texastribune .org/2017/10/10/undocumented -teenager -seeks-courtauthorization -abortion -after -federa l Mrs. Lowenberg explained that residential liscencing understands that the nature of this situation is critical and delicate, she explained that liscensing is responsible for ensuring we are NOT forcing any child in care to undergo pregnancy termination, however RCCLalso has the duty to ensure the health, safety and overall well-being of all children in care at liscenced residential facilities. Mrs. Lowen berg has requested that I provide a detailed synopsis of this UAC and legal proceedings surrounding her request to terminiate pregnancy. The purpose of her request is to ensure her office is prepared to respond to any formal inquiries regarding the placment and care minor is recieveing in our residential facility. My plan is to issue liscensing a brief biographical/historical summary of the minor and her family, reunification status and mary of legal proceedings up to this point. Mrs. Lowen berg specifically requested ORR policy on this matter, however I understand that specific polciy on this matter is not available therefore, I wanted to touch base with you to inquire about the possibility of sharing the ORRofficial Memo (Mar 21 2008) "Medical Services Requiring Heightened ORR Involvement" , please advise. Please do not hesitate to cotnact me should you have any questions or concerns, I will wait for further guidance on these matters, thank you!! From: Lloyd, Scott (ACF) Sent: Monday. Octob er 9, 2017 12:48 PM/ 17 To~ (b}(6) I Cc: White , Jonathan (ACF); Brook s, Tere sa (ACF) ; Bowman , Matthew (HHS/OG C); Wagner, Steven (ACF) Subject: RE: State Court hearing rb )(6) /\MERICAi\ pVERSIGHT EXT-18-248-C-000310 Regarding the appointment today: Make sure that the UACknows that this is to get an update on whethe r it is really necessaryto have her exercise so severely restricted-to find out if it might be possible to allow her to do more. Pleaseget her to consent to the appointment. If she does not want it, she does not have to go-we arranged it to accommodate her distress over lack of physical act ivity. This was a concern she voiced to the program and that we noticed in her record. We are trying to be responsive to her concerns with this request. If they offer her a sonogram at the appointment, please remind the doctor that she has already had two and suggest that it is not necessary,and that it should not happen in any case if she does not give consent. Regarding your other questions-if she has a counseling session today, please contact me. If not, let's wait for DOJ'sresponse. Let me know if you have any questions. Thank you, Scott From=rb)(6) [mailtq~b_)<6_>---~ ~iestex.org] Sent: Monday, October 09, 2017 1:14 PM To: Lloyd, Scott (ACF) Cc: White, Jonathan (ACF); Brooks, Teresa (ACF) Subject: Fw: State Court hearing Good Morning Mr. Lloyd, I am writing to request further guidance regarding the following, I realize now I may have missed the opportunity to ask t hese questions to Mr. Wagner (AUSA) during our debriefing and i apologize for that but the following matters have ar ise and I am in need of guidance ... • • Since the "Jane Doe Due Process" case has been transferred to federal court, does any portion of the previously issued state court restraining order remain in place?? Such as the st ipula t ions prohibiting care provider from o • "Disturbing the peace of the child Petitioner" ...this was explained to us by UAC's attorneys as all care provider staff must refrain from speaking with UAC about her pregnancy, "her baby", or her "decision to terminate"examples provided by attorneys were • /\MERICAi\ pVERSIGHT • No sonograms EXT-18-248-C-000311 • • No forcing UAC to list en to baby's heart rate • • No referring to UAC's baby or seeking discussion or making comments about her gestational period , her pregancy expectations, her feelings, etc ... • • No "encouraging" her to discuss or make contact with her parents • • No "religion based" counseling regarding o • Care provider must refrain from "Making remarks to child petitioner's family that concern petitioner's pregnancy" .... o • "Discussing any lit igation concerning the child Petitioner in the presence or within hearing of the child Petit ioner or on any form of social media" • • UAC has a OB/GYN appointment for basic prenatal care with Dr. Torres this afternoon at 2:30p.m. (CST),please note that OB Dr. Torres is not aware UAC has requeted to terminate preganancy, Dr. Torres is not aware of current litigat ion regarding the case of this minor, is care provider to discuss these matters directly with Dr. Torres??? Should the child be informed that care provider will discuss her request to t erminate and current litigation with OB? • • If UAC attends this prenatal care appointment, is the doctor to proceed with sonogram ??? • • Is child allowed to contact parents?? Her parents are named in the suit as "inflict ing abuse on minor " is UAC able to make contact despite this claim " If UAC requests to make contact with mother/father is care provider to allow contact, if allowed is all contact to be monitored or may the UAC make contact with out monitoring? Please advise, thank you so much in advance for your guidance! From: Lloyd, Scott (ACF) Sent: Monday, October 9, 2017 10:02 AM To: Brooks, Teresa (ACF); White , Jonathan (ACF);Jessica Martinez Cc: Wagner, Steven (ACF);Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC); Haas, Alex (CIV) Subject: RE:State Court hearing Teresa, Many thanks for you r work on this, and thank you for the update. I was very much reassured to know that you would be present this morning . Barring any additional need to wrap things up w ith IES,please return to the rest of your day off . Let us know if you need anything - I am sure things will continue throughout the week. /\MERICAi\ pVERSIGHT EXT-18-248-C-000312 Sincerely, Scott From: Brooks, Teresa (ACF) Sent: Monday, October 09, 2017 10:57 AM To: Lloyd, Scott (ACF); White, Jonathan (ACF); Jessica Martinez Cc: Wagner, Steven (ACF); Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC); Haas, Alex (CIV) Subject: Re: State Court hearing Please be advised that at approximately 8:35 am CT, the Cameron County Judge, attorneys from Garza and Garza, who are/were representing the UAC at the State level, the UAC, and Mr. Paxton Warner , AUSA from the DOJ met in the Judge' s chambers in a closed proceeding. Mr. Lucio, attorney for the IES staff, was also in chambers, as an observer to the proceeding as he has clients who have been affected by the legal process 5 > jwas present at the Courthouse, of the matter. DHS ICE ERO Officer r >< outside of the courtroom and chambers. I was asked to wait immediately outside of the Judge's chambers. During the discussion in chambers , Mr. Warner left chambers to inquire as to if the UAC had been "forced" to speak to her parents. I advised that the UAC had been afforded the right to speak to either or both of her parents since arriving into ORR custody , but to my awareness had not chosen to do so to date. It should be noted that the IES program did obtain a contact number for the UAC's father as the UAC had stated that she wished to speak to him at one time. Mr. Warner also asked if the IES program could provide the UAC could be provided with a new case manager as the UAC has stated that the current case manager was not effectively managing the UAC's case. (This is presumed to be referring to a possible family reunification case. At this time, it is my understanding that no viable sponsor has been identified for the UAC.) I informed Mr. Warner that IES would identify an appropriate case manager to assume oversight of the UAC's case. Finally, Mr. Warner stated that the attorneys for the UAC were concerned that an IES staff member was always within a visual "line of sight" of the UAC and the attorneys felt that this was not allowing the client sufficient privacy. I explained to Mr. Warner, that in accordance to TDFPS licensing standards, the attorneys are not considered trained child care providers, and in order to maintain standards of care, the staff needed to maintain sight of the UAC, but were not in able to hear/overhear any confidential attorney- client communication. Mr. Warner took the information back to chambers. When Mr. Warner returned he advised that the UAC should be returned to her placement at the IES shelter program in Los Fresnos, TX. Mr. Warner stated that the case, in its entirety , had been moved to a Federal court venue. Mr. Warner advised that the attorneys from Garza and Garza would continue to represent the UAC in the case. /\MERICAi\ pVERSIGHT EXT-18-248-C-000313 Mr. Lucio conferred with the IES staff, whom he was representing today. Mr. Warner thanked the IES staff for their efforts in caring for this UAC and all of the UAC that IES cares for. All parties were advised that they/we were free to leave the courthouse. I thanked the OHS ICE ERO Officer for her support, and instructed IES to transport the UAC back to the program site. All parties exited the courthouse at approximately 9:45 am CT. Please advise as to if there are any questions or if additional information is needed regarding this message. Teresa Teresa Brooks Supervisory ORR Federal Field Specialist HHS ACF ORR DUCO 202.631.3775 Teresa.Brook s@acf.hhs.gov On: 08 October 2017 18:58, "Brooks, Teresa (ACF)" wrote: Please see the attached with regard to the request to OHS ICE EROfor the presence of a OHS ICE ERO Officer at the 107 th District Court in Cameron County Texas on Monday, October 9, 2017 . Please advise as to if there are any questions concerning the OHS ICE ERO request or response . Please be advised that, to remain in compliance with Texas Department of Family Protective Services Residential Child Care Licensing Standards, appropriate IESstaff will be transporting the UAC from the IESShelte r Program to the Courthouse building. Additional IESstaff who are required to be present at the District Court will arrive to the Courthouse apart from the UAC. will be meeting with all of the IESstaff and with the OHS ICE ERO Officer, either immediately outside of the Court building, or in the lobby of the building. We will then proceed to the identified area of the Courthouse . Please advise of any additiona l instruction as is felt appropriate. Sincerely, Teresa Teresa Brooks Federal Field Specialist Supervisor, South Texas HHS ACF ORR DUCO 202.631.3775 Teresa.Brooks@acf.hhs.gov /\MERICAi\ pVERSIGHT EXT-18-248-C-000314 From: Brooks, Teresa (ACF) Sent: Sunday, October 08, 2017 5:20 PM To: Lloyd, Scott (ACF); White, Jonathan (ACF); Jessica Martinez Cc: Wagner, Steven (ACF); Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC); Haas, Alex (CIV) Subject: Re: State Court hearing I can be at the Courthouse at 8:30 am CT as requested. I can attempt to reach Officer Cortez, who is the covering Officer for the FOJC now to see if there is an ICE Officer who is able to be present at the Court tomorrow morning. I wi ll update all appropriate partie s of outcome of the contact with ICE. Teresa Teresa Brooks Supervisory ORR Federa l Field Spec ialist HHS ACF ORR DUC O 202.631.3775 Teresa.Brooks@acf.hhs.gov On: 08 October 2017 16:46, "Lloyd, Scott (ACF)" wrote: Hello eve1yone, Please see below. There should be no hearing tomorrow. However, there is need to have the UAC brought to the courthouse at the t ime appointed, to avo id contempt while we confirm that the state court knows the case has been removed. Te resa I'd like you there if at all possible, or field staff in the alternative. I will ask that DOJ contact us if they receive confirmation and this becomes unnecessary. Teresa, are you in contact with anyone from DHS (ICE seems most appropriate) who could ride along? If you need help I can help get someone. If she goes to the courth ouse the point wo uld be to inform them that the case has been removed . There shou ld be no transfer of custody and federa l law enforcement could help us reinforce that point. Please let me know if you have any questions. Thank you, Scott /\MERICAi\ pVERSIGHT EXT-18-248-C-000315 Begin Fo1warded Message : From: "Haas, Alex (CIV)" Subject: State Court hearing Date : 08 October 2017 17:25 To: "Bowman, Matthew (HHS/OGC)" , "Lloyd, Scott (ACF)" Cc: "Ricketts, Jennifer D (CIV)" , "Hu, Daniel (USATXS)" , "Warne r, Paxton (USATXS)" , "Fabian, Sarah B (CIV)" Matt/Scott , Our colleagues from the USAO just filed the removal papers in federal court and also filed a notice electronically in state court. While this should be enough to deprive the state court of jurisdiction , we are also sending a AUSA to hand a copy to the judge as well. Because the state court order is directed to individuals working at IES who could still be held in contempt (potent ially), our strong recomme ndatio n would be for the minor to be sent with the federa l field spec ialist to the court proceeding. With that federal officer there and the AUSA we think there is a very small likelihood of any shena nigans. You could also potentially ask someone from ICE or CBP to attend to the transport. Please let me know if you'd like to discuss Alex Sent from my Verizon, Samsung Galaxy smartphone Sender Recipient: b)(6) ~ iestex.org> "Lloyd, Scott (ACF) " Sent Date : 20 17/ 10/11 23:33:12 Delivered Date: 20 17/10/11 23 :33:33 /\MERICAi\ pVERSIGHT EXT-18-248-C-000316 From: Bulletin Intelligence To: "HHS@bulletinintelligence.com" Subject: HHS News Briefing for Thursday, October 12, 2017 Date: 2017/10/12 07:34:42 Priority: Normal Type: Note HHS NEWS BRIEFING This document and searchable archives are avai lable at hhs.bulletinintelligence.com. TO : THE SECRETARY AND SENIOR STAFF DATE: THURSDAY, OCTOBER 12, 2017 7:30 AM EDT TODAY'S TABLE OF CONTENTS LEADING THE NEWS : + Trump To Sign Executive Order To Erase Health Insurance Rules Under ACA. + Families, States Waiting For Children 's Health Insurance Program Reauthorizat ion. THE SECRETARY IN THE NEWS : + Trump Appoints Eric Hargan As Act ing HHS Secretary. + Former HHS Secretary Says US Soccer Needs A Revolution. HHS IN THE NEWS: + ACOG , Other Women's Advocates Challenge Scientific Basis Of Trump Administration's New Contraception Rules. + HHS ' Use Of "Life At Conception " Criticized. + Two Experimental Ebola Vacc ines Show Promise In 12-Month , 1,500-Patient Study. + Op inion: President Trump Has Done More To Roll Back Opio id Efforts Than Improve Them. + Senate Democrats Call For NIH To Renew Funding For Gun Vio lence Research. + HHS , NIH Say They Were Not Impacted By Deloitte Breach. + Scient ists Urge Investigation Into Differences That Cause More Aggressive Cancers In Men Of African Descent. + NIH-Supported Project Collecting Data On Gene Expression From Different Types Of Tissue . + CDC 's 2016 STD Surveillance Report Shows Georgia In Top 5 For Chlamyd ia, Syphilis . + Supporters Hope Gottlieb Stays At FDA. + FDA Finalizes Guidance Banning Free Samples Of E-Cigarettes . + FDA Digital Innovation Plan Aims To Improve Medical Innovation Approval Process. + FDA Urges Consumers To Use Caution When Buy ing Medication For The ir Pets Online. + FDA's Unapproved Drug Initiative Led To Higher Prices, Drug Shortages , Study Finds. HEAL TH REFORM: + Trump , Many GOP Lawmakers At Odds Over Cont inued Payment Of ACA Subsidies. + Poll: The Contraceptive Coverage Rule Is "Pretty Popu lar ." + ACA Navigator Groups To Shrink Services Following Funding Cuts By Trump Adm inistration. + Liberal Groups To Target Vulnerable GOP Lawmakers Over Trump Contraception Rules . + Trump Blames Obama For ACA's Woes. + Covered Cal ifornia Adds 12.4% Surcharge To Some Plans Because Administration Has Not Guaranteed ACA Subsidy Payments . + West Virginians To Be Charged Double-Digit Premium Increases For ACA Plans . /\MERICAi\ pVERSIGHT EXT-18-248-C-000317 + + + + + + + Pennsylvania AG Suing Administration Over Contraception Rules . Connecticut's Exchange Preparing For Tough ACA Enrollment Period. Cigna, Vanderbilt Health Reach Agreement On In-Network Status . Iowa Health Insurance Market Awaits Decision On Stopgap Measure. Nonprofit Says Utahns Earning Too Much For Subsidies Could Face Large Premium Hikes. Report Says New Jersey To Lose 60 Percent Of Federal Funding To Expand ACA Enrol lment. Commentary Considers Health Reform. OPIOID NEWS : + VA Accused Of Fueling Opioid Crisis Among Veterans. + Nancy Pelosi Provides Rare Testimony In Opioids Hearing, Urges Expanded Medicaid . + Senator Claire McCaskill Says Pharmaceutical Industry Holds Responsibility For The Opioid Epidemic. + Indiana University Launches $50M Program To Battle Opioid Addiction. + Montgomery County Overdose Response Project Gets $2 Million Federal Grant. + New Jersey Expands Opioid Prescription Monitor ing To Include Veterinarians. + Innovative Medica l Procedures Offer Potential For Non-Opioid Pain Relief. HEALTHCARE FRAUD: + Opinion: Electronic Visit Verification Enables North Carolina To Fight Medicaid Fraud. HEALTHCARE NEWS: + ACLU, Planned Parenthood File Lawsuit Over Missouri's New Abortion Law. + OneCare Vermont's New Fixed Payment Health Spending System Expanded To Cover More Patients . + Judge Rules North Carolina May Owe $20 Million To Healthcare Providers For Vaccines. HEALTH INFORMATION TECHNOLOGY : + HIMSS Officials Express Optimism About Progress Of Their Congressional Goals. HUMAN SERVICES NEWS : + Judge Declines To Order Officials To Al low Abortion For Immigrant Teen. + Editorial: Haitians Stil l Need Temporary Protected Status. + Kansas' Foster Child Runaway Rate Is Simi lar To The National Average . FOOD & IMPORT SAFETY: + Commentary Considers Why Tracking Food Poisoning Outbreaks Is Difficult. + Salmonella Outbreak Connected To September Chili Cook-Off Spreads To Attendees From Eight States. EMERGENCY RESPONSE AND PANDEMIC PREPAREDNESS: + Editorial Calls For New Texas Policies On Disaster Preparedness In Nursing Homes. + Letter: FHCA Plays Important Role In Emergency Preparedness Among Diligent Nursing Homes. NUTRITION & OBESITY : + Chicago-Area Soda Tax Repeal Threatens Future Of Simi lar Regulations. MEDICARE : + CMS Releases Star Ratings For Medicare Advantage And Prescription Drug Plans. MEDICAID & CHIP : + Opinion: Medicaid Expansion Is An Opportunity To Address Healthcare Inequality In Maine . HEAL TH & MEDICAL NEWS : + FDA To Consider Experimental Gene Therapy For Blindness. /\MERICAi\ pVERSIGHT EXT-18-248-C-000318 + Experimental Glaucoma Drug Effectively Lowers Eye Pressure, FDA Preliminary Review Concludes . + Legislat ion To Estab lish Diabetes Commission Heads To White House . + Smallpox Vaccine Made Of Horsepox , Not Cowpox , Research Indicates . + Sanofi To Invest $202 Million To Expand French Vaccine Facility. + San Diego School District Considers Later Start Times. + Study Suggests Prostate Cancer Patients Are Unclear On Differences Among Treatments. + Fred Hutchinson, MD Anderson Examine Toxic Side Effects Of CAR-T Therapy. + Expert Panel Discusses Future Of Cancer Research And Treatment. + Puerto Rico Investigating Possible Cases Of Leptospirosis. + Syracuse University Mumps Outbreak May Surpass 18 Cases. + Washoe County Officials Confirm First Hantavirus Fata lity Since 1995. + States Acting On Drug Prices After Federal Inaction. + Op inion: Federal Policies Obstruct Value -Based Pricing For Prescription Drugs. + Shortage Of Physicians Specia lizing In Genetics, Despite Boom In Research. + Problems Remain At Johnson & Johnson Pharmaceutical Facilities In Puerto Rico. + Pennsylvania Governor Signs "Right To Try" Law. + Merck To Discontinue Market ing For Cholesterol Treatment. + Ardelyx Announces IBS Treatment Succeeds In Late-Stage Trial. + Pharmaceutical Industry Appeals South Dakota Decision On Prescr iption Payment Ballot Measure . + Distr ict Judge To Determine Whether Allergan Patent Transfer Constitutes "Sham" Deal. + Consumers May Not Recognize Drug Side Effects When Ads Contain Long Lists Of Risks, Study Suggests . + CicloMed Gains FDA Approva l To Begin Clinical Trials For Bladder Cancer Treatment. + Amazon Entering Pharmacy Space Could Lower Drug Prices , Morgan Stanley Says . + Hypertensive Women In Their 40s May Be At Increased Risk For Dementia In Later Years , Study Indicates. + Tai Chi May Be Useful Way To Introduce Reluctant People To Exercise After A Heart Attack , Study Indicates. + Prevalence Of Hospital Admissions For Stroke That Had Concomitant Hypertension , Diabetes , And Dyslipidemia Increased More Than 200% Between 2004 And 2014, Study Finds. + Conference Focuses On Preventing Youth Suicide Among Native Amer icans. + Researchers Identify Factors To Help Predict Severe Toxicities Among Patients Receiving CAR-T Infusions. + San Antonio Joins Initiative To Reverse Increase In HIV . GLOBAL HEAL TH: + Madagascar Says Plague Outbreak Has Spread To Seychelles. + Study Maps Risk Of Fatal Fever Epidemics Across Africa. + Experts Disagree About Global Danger Of Drug -Resistant Malaria Spread ing In Southeast Asia. + Botswana Officials Detect Anthrax In Dead Hippos Following Similar Outbreak In Namibia . + Alberta To Ban Minors From Using UV Tanning Beds. + Italy To Cull Birds In Response To Five October H5N8 Avian Flu Outbreaks . + Prom inent UK Researcher Warns Lack Of Post-Brexit Clarity Could Jeopardize Pharmaceutical R&D . NATIONAL NEWS: + Media Analyses : Trump Th reatens Free Press With Reaction To NBC Report . + Trump Pitches Tax Plan To Truckers In Pennsylvan ia. + Adm inistration Official: Long-Term Puerto Rico Recovery Plan Is In The Works. + OHS: One Ship Traveling To Puerto Rico Under Jones Act Waiver Delivering FEMA Aid . + House To Vote On Disaste r Aid Bill Thursday. + San Juan Mayor Comments On Feud With Trump. + Tenth Consecutive Atlantic Hurricane Forms For First Time Since 1893. /\MERICAi\ pVERSIGHT EXT-18-248-C-000319 + Trump : If NFL Had Suspended Kaepernick, League "Would Never Have Had A Prob lem ." + Trump Announces $1 Million In Federal Funds For Las Vegas Law Enforcement. + Trump Touts $5.2 Trillion Stock Market Gain. + Trump To Meet With Economist, Fed Hopeful John Taylor This Week . + Democrat Green Pulls Back From Forcing House Vote On Trump Impeachment. + Longtime Trump Friend "Shocked " And "Stunned " By President's Rhetoric And Tweets. + Trump : Democrats Used Russia As "An Excuse" After Los ing Election. + Democratic Senators Tell Sessions They Want Answers On Trump Conversations. + After White House Bemoans Congress ional Breaks , House Votes To Leave Early For Vacation . + McConnel l Says He'll Move Forward On Judges W ithout Democrat ic "Blue Slips." + Leaders Of Conservative Groups Call For McConnel l, His Deputies To Resign. + Kushner Reportedly Sent Approving Text After Bannon "Dec lare[d] War" On GOP Senators . + Trump To Speak At Values Voter Summit On Friday. + Federal Court Upholds Congressional Prayer. + Group Of Ex-Obama Lawyers Files Injunction Against Trump Voter Commission. + FBI Opens Investigation Into Weinstein. + WPost A1: Private Deal Guaranteed Moore $180K Annually For Part-Time Work At Charity . + Obama To Stump For Northam In Richmond On Oct. 19. + The Hill: Retirements Complicating Democrats' Effort To Reclaim House. + Cruz Edges Democrat O' Rourke In 03 Fundraising , Holds Large Cash Advantage. + Flake Primary Foe Ward Raises $690K In 03 . + GOP Montana Senate Hopefu l Rosenda le Raises Over $400K In Two Months. + Democrat Brown Raised $2 .6M In 03 , Has $8.3M Banked For Reelection Race . + Manchin Easily Bests GOP Chal lengers Jenk ins, Morrisey In 03 Money Race. + Blackburn Hails Twitter Reversal On Ad As "Our First Senate Conservative Victory ." + Prosecution Rests In Menendez Trial ; Defense Asks Judge To Dismiss Case . + Judge Orders Release Of Gianforte's Mugshot. + GOP Hopeful Rossi Raises $575K In Nine Days. + Kerry Endorses, Stumps With New Jersey Gubernatorial Candidate Murphy . + Maryland's Rockeymoore Cummings Joining Crowded Democratic Primary . + Politico Mag Examines Differences Between Macomb County Natives Eminem, Kid Rock. + Judge Allows Dakota Access Pipeline To Continue Operations. + Californ ia Wildfires Continue To Rage As Death Toll Rises To 21. + Charlottesville Schools On "Modified Lockdown " Following Threatening Message Board Post. + Supreme Court Weighs Immunity For Corporations In Overseas Human Rights Suits. + Boy Scouts To Allow Girls To Join. + Experts See 2017 As Beginning Of End Of Internal Combustion Engine . + Alec Baldwin Has "Another Epic Meltdown " On New York City Streets . + Rove: Trump Hurting Himself By Attacking Corker . + WPost: Pruitt Destroys Clean Power Plan . + WPost Criticizes Trump Cabinet For Using Private Planes. + NYTimes: New York Mayora l Debate Offered Little. + WSJournal: GOP 's Air-Traffic Control Plan Would Help Both Economy And Traveling Publ ic. EDITORIAL WRAP-UP: + New York Times . + Washington Post. + Wal l Street Journal. THE BIG PICTURE : + Head lines From Today 's Front Pages . LAST LAUGHS : + Late Night Politica l Humor. Leading the News: /\MERICAi\ pVERSIGHT EXT-18-248-C-000320 TRUMP TO SIGN EXECUTIVE ORDER TO ERASE HEALTH INSURANCE RULES UNDER ACA. The Wall Street Journal (10/11 , A1 , Radnofsky , Armour, Mathews , Subscription Publication, 6.45M) reports on its front page that President Trump plans to sign an executive order Thursday wh ich will attempt to reverse provisions in the Affordable Care Act that placed limits on sales of short-term insurance and will expand alternative insurance arrangements to allow small businesses to associate together for the purpose of buying insurance. In a front-page article, the New York Times (10/11, A 1, Pear, Abelson , Subscr iption Publication, 13.56M) reports that whi le Trump "has been telegraphing his intentions for more than a week, Democrats and some state regulators are now greeting the move with increasing alarm , calling it another attempt to undermine President Barack Obama's signature health care law." The Hill (10/11, Sullivan , 1.68M) reports that the order "will direct the Department of Labor to 'modernize ' rules to allow small employers to create association health plans .... if they are within the same state, in the same 'line of business ,' or are in the same trade association. " The order will also erase "limits on short-term health insurance plans , allowing the plans to last as long as 12 months and be renewed," which some fear will cause healthier people to move to short-term plans, "leaving only sicker people in ObamaCare plans and driving up premiums." The Hill adds that the order will "allow people to use tax-advantaged accounts known as Health Reimbursement Accounts to pay for their premiums." Reuters (10/12, Pierson, Raymond) reports that the executive order "will almost certainly be challenged in court, several legal experts said." The piece adds that state attorney genera ls "would likely be among the first to legally challenge Trump 's order or regulations, " and that Massachusetts Attorney General Maura Healey said Wednesday that she "will oppose any attempt to undermine" her state's residents ' access to healthcare. The Huffington Post (10/11, Cohn , 5.74M) reports that the order "could rattle the Affordable Care Act's private insurance markets by allowing a proliferation of cheaper, less comprehensive plans that would undermine rules about who and what insurers must cover ." Also reporting are the Washington Examine r (10/11, Chaitin, 465K), CNBC (10/11, Kleponis, 3.48M), and the New York Daily News (10/12, Chia , 3.61 M). FAMILIES, STATES WAITING FOR CHILDREN'S HEALTH INSURANCE PROGRAM REAUTHORIZATION. CBS News (10/11, Konrad , 4.42M) reports on its website that families who rely on CHIP are taking a "wait-and-see attitude" towards CHIP reauthorization as it has become "the latest pawn in the Congressional wrangling over health care." Jesse Cross-Call, Senior Policy Analyst at the Center for Budget and Policy Priorities said that because CHIP "has always had bipartisan support ," it has "really been a surprise that it's taking this long to get it funded. Congress has never blown past the deadline before, so we're in uncharted territory ." The article adds , "Most states have passed final budgets for the next fiscal year with the assumption that CHIP would be reauthorized and they would be receiving federal funds." CBS News reports that "Chances are Washington w ill come through, eventually ," however, the House bill is "complicated " by disputes between lawmakers regarding funding offsets wh ich affect Medicare , Medicaid , and the ACA . The Hill (10/11, Weixel, 1.68M) reports the New York health department said Wednesday that the state will have to hold a special legislative session to address the funding shortfall if CHIP is not reauthorized w ithin weeks. In a letter to Acting Health and Human Services Secretary Eric Hargan , the New York health commissioner explained, "it is unlikely the Legislature can fill a $1 billion hole left by the federal government to continue to provide coverage to all the children currently enrolled in CHIP .. .. The inaction of Congress and the Admin istration has jeopardized the health care of millions of the nation's children, 350,000 of whom live in New York." /\MERICAi\ pVERSIGHT EXT-18-248-C-000321 The New York Daily News (10/11, Blain, 3.61 M) reports New York Gov. Andrew Cuomo (0) slammed Congress' inaction Wednesday , saying , "It is unconscionable that the federal government is implementing draconian health care cuts that target our children and the most vulne rable among us." Senate Minority Leader Chuck Schumer also said Wednesday , "No fam ily in New York or elsewhere should ever have to make the agoniz ing dec ision between tak ing their child to the doctor and footing the cost of exorbitant medical bills they cannot afford." The Washington Examiner (10/ 11, King, 465K) reports that bipartisan negotiations in the House "got off to a rocky start Wednesday " when Rep. Frank Pallone, Jr. (D-NJ), the top Democrat on the House Energy and Commerce Committee, said , "I can't accept these [Affordable Care Act] cuts and so far there isn't any willingness to not include them. " Also covering the story is Fierce Healthcare (10/11, Small, 146K). Opinion: Hiltzik Wonders Why Washington Has Not Renewed CHIP Funding. Michael Hiltzik writes in the Los Angeles Times (10/11, 4.49M) that "We know that Congress is just unimaginably busy right now, so perhaps it's understandable that 11 days after fund ing for a crucial children's healthcare program expired, the lawmakers still haven't gotten around to restoring it." The column points out that while President Trump "has been picking fights" with the NFL, Sen. Bob Corker (RTN), and the mayor of San Juan, Puerto Rico, "there's still no schedule for a vote on CHIP in either chamber on Capitol Hill." Editorial: Congress Puts Children At Risk By Letting CHIP Expire. The New Orleans TimesPicayune (10/11 , 71OK) edito rializes that 'Thousands of famil ies no longer have to worry about how to pay for a doctor visit for their children . And tens of thousands of youngsters are healthier because of it" in Louisiana as a result of CHIP. Louisiana will run out of funding in February 2018 if CHIP is not renewed . The editoria l concludes , "Now fam ilies who depe nd on CHIP are left wondering how to take care of sick children. Congress shouldn 't leave them hanging ." The Secretary in the News: TRUMP APPOINTS ERIC HARGAN AS ACTING HHS SECRETARY . In continuing coverage, the Los Angeles Times (10/11, Kama l, 4.49M) reports that on Tuesday , President Trump "announced that Eric Hargan , an attorney from Illinois, would serve as acting secretary of Health and Human Services , following the resignation of ' former HHS Secretary Tom Price late last month. Hargan was confirmed as Deputy HHS Secreta ry just last week . In response to Hargan's appointment, former Acting HHS Secretary Don Wright said, "His commitment to public service and vast exper ience in the healthcare field will help guide the department as we advance President Trump 's agenda on behalf of the American peop le." Politico (10/11, Diamond , 3.6M) reports that Wright had been Acting HHS Secretary since Price resigned on September 29. The article adds that this is "Hargan 's second go-around at HHS: He served in several roles from 2003 to 2007 , including as acting deputy secretary , before leaving government work to practice law in Chicago ." On its webs ite, CBS News (10/11, Tillett , 4.42M) reports that Wright also said Hargan "brings a wealth of knowledge, expertise, and leadership experience to HHS." Modern Healthcare (10/11, Subscription Publication , 238K) and Fierce Healthcare (10/11, Minemyer , 146K) also cover the story . FORMER HHS SECRETARY SAYS US SOCCER NEEDS A REVOLUTION. The AP (10/11 , Blum) reports that the US "will be glaringly absent" from next year's soccer World Cup in Russia. The article says , "A bumbling, stumbling , tumbling Wor ld Cup qualify ing campaign ended Tuesday night with a calamitous 2-1 loss to already eliminated Trinidad and Tobago , the 99thranked natio n in the world, when merely a tie was necessary to eke out the final automatic World /\MERICAi\ pVERSIGHT EXT-18-248-C-000322 Cup berth from one of soccer's weakest regions ." Former HHS Secretary Donna Shalala, a US Soccer Federation board member , tweeted , "Unacceptab le .... For us in US Soccer more than a wake-up call. Time for revolution . Need long term plan that is smart ." HHS in the News: ACOG, OTHER WOMEN'S ADVOCATES CHALLENGE SCIENTIFIC BASIS OF TRUMP ADMINISTRATION'S NEW CONTRACEPTION RULES . The AP (10/11, Alonso-Zaldivar ) reports that some experts on women's health are quest ioning the Trump Adm inistration 's new rule on birth control, argui ng that "it overlooks known benefits of contraceptio n while selectively citing data that raise doubts about effectiveness and safety ." For instance, Dr. Hal Lawrence, CEO of the American Congress of Obstetricians and Gynecologists , said , ''This rule is listing things that are not scie ntifica lly validated , and in some cases things that are wrong , to try to justify a decisio n that is not in the best interests of women and society ." The article says the rules would "allow more employers to opt out of covering birth contro l as a free preventive benefit for women under the Obama health care law." Comment ing on the matter, HHS spokeswoman Caitlin Oakley stated, ''The rules are focused on guaranteeing religious freedom and conscience protect ions for those Americans who have a religious or moral objection to providing certa in services based on their sincerely held beliefs." HHS' USE OF "LIFE AT CONCEPTION" CRITICIZED. Huffinqton Post (10/11, 5.74M) editor Jenavieve Hatch criticizes the HHS' strategic plan for 2018 to 2022 , released last month, for using the phrase "life at conception " five times. Hatch says this "idea has long been used by the anti-abortion community as justification for its protests. " Hatch asserts that in contrast, "more neutral sources ...and the medical community at large, are rightly not interested in arguing about the moment 'life' starts." TWO EXPERIMENTAL EBOLA VACCINES SHOW PROMISE IN 12-MONTH, 1,500-PATIENT STUDY. AFP (10/11) reports that a phase II study of experimental vaccines rVSV-ZEBOV and cAd3-EBOZ showed promise in protecting against Ebola. The 12-month study of 1,500 people in Monrovia, Liberia, published Thursday in the New England Journal of Medicine , found that "after one month , 84 percent of rVSV-ZEBOV recipie nts developed an antibody response, " and "at one year , 80 percent still had this protectio n." For cAd3-EBOZ , "71 percent developed an antibody response, and 64 percent still had such a response at one year, when the trial ended ." NIAID Director Dr. Anthony Fauci said, ''This clinical trial has yie lded valuable information that is essential for the continued development of these two Ebola vaccine cand idates and also demonstrates that well-designed , ethically sound clinical research can be conducted during an epidemic. A safe and effective vaccine would be a critically important addition to classical public health measures in controlling inevitable future Ebola outbreaks ." The Wall Street Journal (10/11, Burton , Subscript ion Publication , 6.45M) says this is the first placebo-contro lled study of Ebola vaccines , and it suggests the vaccines could be powerfu l tools to save lives. NIH scientists are now evaluating antibody levels at two years out. The article quotes Dr. H. Clifford Lane, deputy director for clinica l research at the NIAID and a principal investigator in the study as saying there exists a "reasonable chance that either of these vaccines would play a role in preventing infection." HealthDay (10/11, Norton , 11K) notes that rVSV-ZEBOV "made headlines last year when it appeared highly effective at preventing Ebola disease in a large clinical trial." Yet "researchers were not able to study the vaccines ' ability to prevent the disease because the Liberia epidemic ended before the trial got to that stage ." Dr. Lane said, "We don't know what level of antibody response is needed to prevent Ebola disease ." Med Page Today (10/11, Smith, 60K) also quotes Lane as saying, "Even though the trial began in early February 2015 , once an infrastructure for the trial had been establ ished and the vaccines became available , too much time had elapsed " to permit a conclusion about efficacy . /\MERICAi\ pVERSIGHT EXT-18-248-C-000323 Nonethe less, the researche rs concluded the trial "extended our knowledge of (the vacci nes') safety and immu nogen icity ." MedPage Today adds , "There were more numerically serious adverse events ove r the year in the placebo group - 40 in the cAd3 -EBOZ group , 47 in the rVSVZEBOV -GP group , and 59 among placebo participants - with 71 % of those events attributed to malaria." OPINION : PRESIDENT TRUMP HAS DONE MORE TO ROLL BACK OPIOID EFFORTS THAN IMPROVE THEM . Dana Milbank writes in an op-ed for the Was hington Post (10/11 , 10.38M) that despite President Trump 's "endless" campaign prom ises to so lve the opioid crisis, 175 Amer icans continue to die daily from opio id overdoses with only a "farce " of a response by Trump. Milbank asserts that Trump is actually taking steps backward by "proposing or backing cuts to the Centers for Disease Contro l and Prevention , the National Institutes of Health , the Department of Hea lth and Human Serv ices and the Medicaid program. " SENATE DEMOCRATS CALL FOR NIH TO RENEW FUNDING FOR GUN VIOLENCE RESEARCH . The Hill (10/11 , We ixel, 1.68M) reports , "Senate Democrats are calling on the Nationa l Institutes of Health to renew recently-lapsed fund ing for gun vio lence researc h following the Las Vegas concert shooting." Sens. Elizabeth Warren (D-MA) , Chris Murphy (D-CT} , and 21 others wrote a letter to NIH Director Dr. Francis Collins, "saying that co nti nuing the program is urgent." The Washington Exa miner (10/11 , Leona rd , 465K) reports the letter sa id in part, "In spite of the toll of gun violence on Americans ' health and safety, a dearth of scientific research has hindered efforts to reduce gun-related fata lities and inju ries ." The Las Vegas Rev iew-Jo urnal (10/11 , Martin, 458K) also covers the story . HHS, NIH SAY THEY WERE NOT IMPACTED BY DELOITTE BREACH . Fierce Healthcare (10/11 , Sweeney , 146K) reports that representatives of the Department of Health and Human Services and the Nationa l Institutes of Health said that data from the ir agencies was not affected by the recently reported breach at Deloitte . The article exp lains that there were claims that the agencies may have been affected by the breach. SCIENTISTS URGE INVESTIGATION INTO DIFFERENCES THAT CAUSE MORE AGGRESSIVE CANCERS IN MEN OF AFRICAN DESCENT. The Boston Globe (10/ 11, Levenson , 969K) reports that Harvard Professor of Epidemio logy Timot hy Rebbek sa id that unequal access to healthcare "doesn 't fully exp lain" why the death rates for black men w ith prostate cancer are 2 .5 times higher than rates among white men. Speak ing at a discussion Wednesday , Rebbek said, "There are probably biological differences that lead to more aggressive cancers in men of African descent in general." Rebbek sa id the NIH and NCI are trying to diversify cancer research, pointing "to the NI H's 'All of Us' program, wh ich aims to gather data on more than 1 million Amer icans to improve research and health outcomes. " Rebbek added , "We shou ld have been doing this 20 years ago , but at least there are large efforts trying to find out how to make this happen now, so we shou ld be optimistic about what can happen in the future. " NIH-SUPPORTED PROJECT COLLECTING DATA ON GENE EXP RESSION FROM DIFFERENT TYPES OF TISSUE . Nature News (10/ 12, Callaway, 177K) reports the "GenotypeTissue Expression (GTEx) project is amassing data about gene sequences and activity , and other information , across 44 types of tissue , from blood vessels to 1O d ifferent brain regions ." The project is supported by the National Institutes of Health . The article explains that some have raised ethical concerns abou t whether or not the projec t should share certain resu lts with the fam ilies of donors , and "Nicole Lockhart , a programme d irector at the Nat ional Human Genome Research Institute in Bethesda, Maryland , who coordinated the ethical , lega l and socia l aspects of GTEx , says that future tissue-donat ion stud ies mig ht cons ider prov iding families with medically important results." /\MERICAi\ pVERSIGHT EXT-18-248-C-000324 CDC'S 2016 STD SURVEILLANCE REPORT SHOWS GEORGIA IN TOP 5 FOR CHLAMYDIA, SYPHILIS. The Atlanta Journal-Constitution (10/11, Pirani, 1.16M) summarizes the CDC's 2016 STD Surveillance Report, released in late September, that found "Georgia ranked among the top five states in America with the highest rates of chlamydia , gonorrhea and syphilis ." CDC's STD prevention div ision director Gail Bowan stated, "Together, we can make a difference, but it will take all of us - CDC, health departments, healthcare providers, community organizations, and individuals. " SUPPORTERS HOPE GOTTLIEB STAYS AT FDA. In continu ing coverage , Fierce Pharma (10/11, Sagonowsky) reports that Food and Drug Administration Commissioner Dr. Scott Gottlieb "downplayed the possibility of taking up the top HHS post in a Reuters interview, saying he believes he can be 'most effective' at the FDA." According to the article , "during a recent discussion at FierceBiotech's Drug Development Forum in Boston, three industry executives agreed that the FDA had been taking steps to facil itate faster approvals prior to Gottlieb 's arrival, and that he's the right person to build on that progress." Congressional Quarterly (10/11, Siddons, Subscription Publication , 967) reports that although Gottlieb "is considered to be a leading contender" for the HHS Secretary position, "many of his fans and allies would lament his departure from FDA." According to CQ, "Underlying the praise for Gottlieb is a concern that whoever takes over at FDA next would be far less qualified , even dangerous. " FDA FINALIZES GUIDANCE BANNING FREE SAMPLES OF E-CIGARETTES . The Hill (10/11, Wheeler, 1.68M) reports that the Food and Drug Administration "finalized guidance Wednesday that includes electron ic cigarettes in its ban on free tobacco product samples ." In a statement, FDA Comm issioner Scott Gottlieb said, "One of the most important provisions to help reduce youth access to tobacco products is the prohibit ion on free samples of tobacco products . With more youth using e-cigarettes than any other tobacco product, it's critical that manufacturers and retailers understand how we intend to enforce this provision ." FDA DIGITAL INNOVATION PLAN AIMS TO IMPROVE MEDICAL INNOVATION APPROVAL PROCESS. The Motley Fool (10/11, Vena , 605K) reports the FDA recently announced its Digital Health Innovation Action Plan, a pilot project intended to update its approval process for softwarebased medica l app lications and devices , and selected nine companies out of more than 100 applicants to participate. FDA Commissioner Dr. Scott Gottlieb said the agency aims to use the program to "recognize the unique and iterative characteristics of these products," adding that the FDA seeks to "modernize our regulatory framework so that it matches the kind of innovation we're being asked to evaluate." The article says the program "may help speed up a process that has long been seen as plodding and failing to keep up with recent innovations. " FDA URGES CONSUMERS TO USE CAUTION WHEN BUYING MEDICATION FOR THEIR PETS ONLINE. The Connecticut Post (10/11, Cuda, 199K) reports that the Food and Drug Administration is warn ing about websites which "sell unapproved pet drugs and counterfeit pet products, make fraudu lent claims , dispense prescription drugs without requir ing a prescription, and sell expired drugs ." In its warning , the agency provides consumers with guidelines about how to identify websites that may be questionable . FDA'S UNAPPROVED DRUG INITIATIVE LED TO HIGHER PRICES, DRUG SHORTAGES , STUDY FINDS . STAT (10/11, Silverman, 43K) reports that a study published in the Journal of Managed Care & Specialty Pharmacy suggests that the Food and Drug Administration's Unapproved Drug Initiative, launched in 2006 , led to higher prices and shortages with "no new clinical evidence to support the vast majority of the medicines that were approved. " The researchers "suggest grace periods should only be granted when a drug maker guarantees supply and sets a fair price, and that grace periods shou ld be lengthened to allow companies extra time to win approva ls." They also recommend wo rking with the National Institutes of Health "to fund or help companies conduct literature reviews and bioequivalence studies, which /\MERICAi\ pVERSIGHT EXT-18-248-C-000325 presumab ly would make it easier to win regulatory approval ," among other options . Health Reform: TRUMP, MANY GOP LAWMAKERS AT ODDS OVER CONTINUED PAYMENT OF ACA SUBSIDIES. The Wall Street Journa l (10/11, Radnofsky, Peterson , Subscr iption Publication , 6.45M) reports that President Trump 's policy changes are putting congressional Republicans in a tough position . Iran is the latest example of such a policy shift , but the same can be said about efforts to repeal the Affordable Care Act. The article says while the GOP was attempt ing to repea l the healthcare law, Trump repeated ly threatened to eliminate subsidy payments to insurers . However , many Republican lawmakers argued that the Trump Admin istration should continue to make those payments until the ACA 's fate was decided ; otherwise , insurance markets could be destabilized . That remains their stance up to now. POLL: THE CONTRACEPTIVE COVERAGE RULE IS "PRETTY POPULAR." The Huffington Post (10/11, Edwards-Levy , 5.74M) reports a HuffPost/YouGov poll finds that Americans largely support the rule requiring employers to offer health insurance that covers the cost of contraceptives by 45 percent to 32 percent. By a percentage of 43 to 35 percent, respondents also believe that "private businesses should be required to provide plans cover ing contraceptives even if the owners object to birth control on religious grounds." Nearly half - 48 percent - oppose Trump's decis ion to roll back the rule. The poll also found that the views were divided along political lines, with 78 percent of Clinton voters supporting the contraception mandate and 78 percent of Trump voters approving of the Administration 's roll back. ACA NAVIGATOR GROUPS TO SHRINK SERVICES FOLLOWING FUNDING CUTS BY TRUMP ADMINISTRATION. The Hill (10/11, Hellmann , 1.68M) reports local advocacy groups which provide assistance with ACA enrollment "say they will likely have to reduce their services following funding cuts from the Trump administration." Officials argue that these navigator groups ' funding was cut significantly because they have been "ineffective. " But the article points out that a Kaiser Family Foundation survey of the groups found "49 percent said they received no rationale from the federal government for the cuts, while 40 percent said the reasoning was very or somewhat unclear." The Washington Examiner (10/11 , King, 465K) reports Democratic lawmakers and critics contend that "the cuts, coupled with a 90 percent cut to ad funding , are part of a strategy from the Trump administration to sabotage Obamacare ." LIBERAL GROUPS TO TARGET VULNERABLE GOP LAWMAKERS OVER TRUMP CONTRACEPTION RULES. The Washington Post (10/11, Viebeck, 10.38M) reports that "liberal groups," including Planned Parenthood Action Fund and Emily's List, "are seizing on Republican attempts to roll back health coverage and limit access to birth control , as they seek to galvanize women voters ahead of next year's midterm elections ." The groups believe the Administration "handed them a potent political issue Friday" when it announced except ions to the ACA's contraception mandate, and they "plan to link this action to congress ional Republicans' repeated attempts to undercut the ACA ...as part of a broader strategy focused on defeat ing moderate GOP members and buttressing vulnerable Democrats. " TRUMP BLAMES OBAMA FOR ACA'S WOES. The Washington Examiner (10/11, Leonard, 465K) reports that this week, President Trump "defended his recent actions on Obamacare , saying that the problems the law was facing were the result of his predecessor, former President Obama. " During an interview with Forbes, Trump stated, "Well, we're actually, what we're doing is trying to keep it afloat , because it's fa iling." He added, "I mean the insurance compan ies are fleeing and have fled. They fled before I got here. But with that being said, no, Obamacare is Obama's fault. It's nobody else's fault. " COVERED CALIFORNIA ADDS 12.4% SURCHARGE TO SOME PLANS BECAUSE /\MERICAi\ pVERSIGHT EXT-18-248-C-000326 ADMINISTRAT ION HAS NOT GUARANTEED ACA SUBSID Y PAYMENTS . The Los Ange les Times (10/11, Terhune) carries a Kaiser Health News article wh ich reports that Covered California, the state's ACA health exchange, announced on Wednesday that "it has ordered insurers to add a surcharge to certa in policies next year because the Trump administration has yet to commit to paying a key set of consume r subsidies under the Affordable Care Act." Officials expla ined that t his move "to impose a 12.4 percent surcharge on silver-leve l health plans in 2018 means the tota l premium increase for them will average nearly 25 percent." The piece says the federal government , not individual consumers , will pay for much of these increases through subsidies. CNBC (10/1 1, Manga n, 3.48M) reports on its website that without the surcha rge, "silver plans sold on Covered California ...would have risen an average of j ust 12.5 percent next year , officia ls said as they revealed overall prices statewide." For individual insurers, surcharges per plan will reach "anywhere from 8 percent to 27 percent." The Washington Examiner (10/1 1, King, 465 K) also covers the story . WEST VIRGINIANS TO BE CHARGED DOUBLE-DIGIT PREMIUM INCREASES FOR ACA PLANS . The Washington Examiner (10/1 1, King, 465K) reports that West Virg inians who purchase ACA plans will be subject to doub le-digit premium increases for 2018 . On Tuesday , the state's insurance regulator announced , in the article's words, "that premiums for Highmark West Virginia will rise by about 25 percent, and the only other insurer, CareSource , will see hikes of 19.6 percent." PENNSYLVANIA AG SUING ADMINISTRATION OVER CONTRACEPTION RULES . The Philadelphia Inquirer (10/11, McCullough , 1.71 M) reports that on Wednesday, Pennsy lvania Attorney General Josh Shapiro sued the Trump Administration "over its move to roll back the Affordable Care Act's birth control coverage mandate." Several other state AGs have also filed suits against the Administration over the issue. Shapiro is quoted as saying , "Millions of women could be denied needed contraceptive care against the advice of science, public health and medical professiona ls." CONNECTICUT 'S EXCHANGE PREPARING FOR TOUGH ACA ENROLLMENT PERIOD . Connecticut Public Radio (10/11, Jones) reports that Connect icut's insurance exchange , Access Health CT, is preparing for a difficult ACA open enrollment period. The article says ACA marketplaces are facing some challenges this year. For instance, the open enrollment period has been cut from about three months last year to 45 days. Jim Wadleigh , CEO of Access Health CT, explained that this "means his staff must work harder to reach out" to encourage consumers to sig n up for coverage . CIGNA , VANDERBILT HEAL TH REACH AGREEMENT ON IN-NETWORK STATUS . The Tennessean (10/11, Fletcher , 499K) reports that Cigna and Vanderbil t University Medical Center have reached an agreement that will allow "people in Davidson and eight surrounding counties" next year "to see VUMC doctors in-network via the Cigna Connect plans." The article adds that "this is the second year in a row a Nashville-based health system has struck a nearly 11th-hour agreement to be in-network with Cigna ." It explains that last October, "Saint Thomas Health scrambled to arrange a dea l with the insurer ...when, after a dec ision by BlueCross BlueShield of Tennessee , TriStar Health was set to be the only Nashville-area health system covered on the exchange ." IOWA HEAL TH INSURANCE MARKET AWAITS DECISION ON STOPGAP MEASURE . The Des Moines (IA) Registe r (10/11, Leys , 324 K) reports that with just three weeks to go before open enro llment , residents, state officials , and insurers are still await ing a decision by the Centers for Medicare and Medicaid Services on Iowa's proposed "stopgap" proposal to "shore up Iowa's health- insurance market." The piece covers a 61-year old Cedar Rapids resident , an insurance agent , and an executive at Medica - the sole insurer on the exchange - and their perspect ives on /\MERICAi\ pVERSIGHT EXT-18-248-C-000327 the uncertainty . Although reports surfaced last week that President Trump "demanded his administrators reject the proposal ," "Iowa officials, includ ing Gov. Kim Reynolds, continue to lobby the Trump administration to approve the plan, and they say the state could implement it quickly ." NONPROFIT SAYS UTAHNS EARNING TOO MUCH FOR SUBSIDIES COULD FACE LARGE PREMIUM HIKES. The Salt Lake (UT) Tribune (10/12, Gifford, 337K) reports an analysis by nonprofit Utah Health Policy Project finds that Utahns earning over 400 percent of the federal poverty level - or $97,000 for a family of four- could see premium increases as much as 63 percent next year. Jason Stevenson of UHPP said, "Those Utah consumers who earn too much to receive monthly subsidies will face higher premiums mostly due to the deliberate policies of confusion and sabotage being practice[d] in Washington DC." REPORT SAYS NEW JERSEY TO LOSE 60 PERCENT OF FEDERAL FUNDING TO EXPAND ACA ENROLLMENT. NJ Spotlight (10/12 , Stainton) examines a report released Wednesday by the nonprofit Kaiser Family Foundation which finds that New Jersey will lose more than 60 percent of its federal funding to "help enroll vulnerable citizens in health insurance plans," after the Centers for Medicare and Medicaid Services cut funding for navigators under the ACA. Further, "Kaiser found most organizations plan to continue operating, despite the funding cuts, but will likely have to scale back their service area and limit help to rural residents." Linda Schwimmer, president and CEO of the New Jersey Health Care Quality Institute , added , "There will be fewer navigators to help people figure out the best plan for them - it's a lengthy and complex process - and confusion reigns due to the multiple failed attempts to repeal the ACA." COMMENTARY CONSIDERS HEALTH REFORM . Several outlets offer opinions on health reform . Linda Greenhouse writes in the New York Times (10/11, Subscription Publication, 13.56M) that while "Saudi women are gaining the right to drive," women in the US "are losing the right to employer-provided birth control." Greenhouse says the list of "religious objectors" includes "anyone" in the workplace, and she adds, "It's hard to overstate the radical nature of what has just happened." She reviews the history of the birth control coverage conflict and the US Supreme Court's Hobby Lobby decision, and concludes, "The Trump administration's rescission of the government's birth control mandate, not only for these organizations but also for others that never even got around to asking for it, is thus a reward for intransigence matched only by the Senate's blockade of the Supreme Court vacancy intended for Merrick Garland that it eventually handed to Neil Gorsuch. " E.J. Dionne, Jr writes in the Washington Post (10/11, 10.38M) Hillary Clinton's tweets this week on CHIP "offered a glimpse of why more Americans chose Hillary Clinton over Donald Trump as the appropriate person to be president of the United States." Her tweets "expressed a proper outrage over the failure of the House and Senate to renew a valuable piece of the government's health-care safety net that provides insurance to some 9 million Americans under the age of 18." Dionne concludes, "In fact, Trump cares and thinks little about policy, and the big news this week may be that the Washington consensus is finally coming around to the obvious: that Trump is utterly unfit to be president, which is what a plurality of the voters thought in the first place ." Robert Gebelhoff writes in the Washington Post (10/11, 10.38M) in its "Post Partisan" blog that the Trump Administration 's roll back of birth control mandates ignores substantial evidence "that access to contraception does significantly reduce unplanned pregnancies." The piece compares Chile's "perfect natural experiment" for Trump's policy on what happens when prices for contraception increase: "The result was a public health disaster, as detailed in a new paper distributed by the National Bureau of Economic Research." Gebelhoff concludes, "What isn't up for reasonable debate is whether access to contraception helps prevent unintended pregnancies . The evidence shows that it does - in the United States as well as in Chile." Paige Winfield writes in the Washington Post (10/11, 10.38M) "The Health 202" that /\MERICAi\ pVERSIGHT EXT-18-248-C-000328 congressional Repub licans "aren't off the hook for fa iling to make good on their promise to repeal Obamacare, even with the shiny new execut ive order President Trump is preparing to roll out this week , conservative act ivists insist." She adds that "conservative groups were severely disappointed as the GOP-led Congress they'd helped elect crashed and burned on their dearest legislat ive priority - repealing and replacing President Barack Obama 's 2010 Affordable Care Act." Jon Healey writes in the Los Angele s Times (10/11, 4.49M) that the Trump Administration's "waffl ing" on cost sharing reduction payments will cause premiums for Californians to rise by an add itional 12.4 percent. Healey adds , "In sum , the administration act ions are shifting the burden of the cost-sharing reductions from taxpayers to insurers to consumers, the vast majority of whom will pass the cost back to taxpayers. " The column conc ludes, "If critics want to stop the reimbursements , they should repeal the requirement that insurers give low-income customers a break on their out-of-pocket expenses. Failing that, the administration - or better yet, Congress needs to commit to paying the reimbursements and stop the senseless cost-sh ifting." Laurie T. Martin, Senior Policy Researcher at the RAND Corporation, writes in The Hill (10/11, 1.68M) that accord ing to recent research she conducted, wh ile advertising for the ACA "is helpful in raising awareness , it provides little practical help to those try ing to obtain coverage." Martin's "research did not shed light on whether cutting the ACA 's advertising budget would have discernible effects on enrollment." The piece concludes ,"One potential solution would be to provide the necessary funding to train navigators and others who already provide in-person assistance to enrollees to take a natural next step - and continue giving support once enrollment is completed " and that "Funding for such assistance needs to be strengthened not cut." Terry Connelly , Dean Emeritus of the Edward S. Ageno School of Business at Golden Gate University, writes in the Huffington Post (10/11 , 5.74M) that the Trump Admin istration's exceptions for contraception coverage for religious objections may vio late the Establishment Clause of the US Constitution. Connelly contends that the HHS rule "establishes those particular religion's beliefs about contraception as a sufficient legal basis for individuals and corporate entities espousing those particu lar faith-based persuas ions to deny their employees a Federal benefit under a statute (the Affordable Care Act) and rule-making thereunder. " Connelly also challenges the rule as discriminatory against women. Connelly concludes that "the most dangerous (for the Trump Adm inistration) reaction to the contracept ion except ion" would be increased support for single-payer healthcare . Ramesh Ponnuru writes in his column in Bloomberg View (10/11, 4.52M) that President Trump may issue an executive order that "would dramatically reduce enforcement of' the Affordable Care Act's "fines on people without insurance ." Ponnuru argues that wh ile he is against the individual mandate, he doesn't "think the executive branch should just stop enforcing the fines." Dylan Scott writes in a Vox (10/11, 1.54M) piece that while President Trump has not yet succeeded in repea ling the Affordable Care Act, "his administration is doing its best to force the law to fail." He says the open enrollment period is a "critical time" for the ACA; however, this year, it "is in the hands of a White House that's openly hostile to the Affordable Care Act - and the Trump admin istration is taking advantage of the best opportunity it has to undercut the law." Andrew Prokop writes in a Vox (10/11, 1.54M) piece that Republicans are still playing "a blame game for the fai lure of Obamacare repeal , and more and more of it is falling on Senate Majority Leader Mitch McConnell" (R-KY) . Prokop says some conservative activists want McConnell and his leadership team to resign. They stated that McConnell's "'greatest betrayal ' was his 'fa ilure to repeal Obamacare, the single most devastat ing piece of legislation against freedom ever crafted ."' Prokop argues that the activists' critique is somewhat "oversimp lified and self-serv ing," and that they are attempting to use McConnell as a "scapegoat." Dr. Jason James , Baptist Hospital of Miami's Chairman of the Ob-Gyn Department , writes in the /\MERICAi\ pVERSIGHT EXT-18-248-C-000329 South Florida Sun Sentinel (10/11, 530K) that President Trump's "recent announcement of a possible rollback in contraception coverage represents a huge blow to health care for America's women ." Dr. James says that the proportion of women who have "no-cost contraceptive coverage" dropped from 21 percent before the ACA to just three percent. The piece mentions that the "American Congress of Obstetricians and Gynecologists (AGOG) advocates the use of LongActing Revers ible Contraception (LARC) methods such as IUDs as the most effective way of reducing unintended births." The column conc ludes, "We must not allow our current administration to reverse the significant progress we have made in advancing health care for women in our nation, not to mention this proposal screams gender bias since contracept ion is disproportionately the responsibility of women. " Central Maine (10/11) editorializes that by rolling back birth control coverage , "the Trump administration is catering to one group of Americans at the expense of another" because "whether or not women employees share their bosses' religious beliefs, they're being forced to accommodate them." The piece adds , "What's particularly maddening is that the ACA has never brushed off religious objections to the birth control mandate. Religious nonprofits have long been allowed to opt out of it" by notifying the US Department of Health and Human Services. Hadley Heath Manning , a senior policy analyst and director of policy at the Independent Women's Forum , writes in an opinion piece in the Washington Examiner (10/ 11, 465K) that the House Ways and Means Committee approved a bill that would repeal the Independent Payment Advisory Board . Manning says that two Democrats voted for the bill, and argues that the bill "represents a real opportunity for bipartisan health reform in the right direct ion." Tim Worstall, a senior fellow at the Adam Smith Institute , writes in an opinion piece in the Washington Examiner (10/11, 465K) that "using insurance to pay for contraception is simply insane ." Worstall argues that "using insurance to pay for any predictable and ongoing expense, not j ust birth control, is insane." Joel S. Weissman, PhD, the chief scientific officer for Brigham and Women 's Hospital's Center for Surgery and Public Health, Amanda J. Reich , PhD, a research scientist and senior project manager at the Center for Surgery and Public Health, and Marc A. Cohen, PhD, the research director at the Center for Consumer Engagement in Health Innovation, write in STAT (10/11, 43K) "First Opinion" that "wh ile the Trump administration and the Republican-led Congress failed to repeal and replace the Affordab le Care Act , a number of ACA-weakening strategies put forward by the administration are already underway." The three authors argue that "an unintended consequence of these strategies is likely to be an increase in the amount of uncompensated care provided by America 's hospitals." Opioid News: VA ACCUSED OF FUELING OPIOID CRISIS AMONG VETERANS . Newsweek (10/12, Levine, 991 K) reports that the Department of Veterans Affairs "recklessly overprescr ibed opiates and psychiatric medications" until mid-2012 when it "swung dangerously in the other direct ion, ordering a drastic cutback of opioids for chronic pain patients." The VA is now "bungling that program and again putting veterans at risk." The article goes on at length to criticize the VA's handling of opioid addiction among veterans and warns that "the disaster is likely to worsen under the Trump admi nistration because of its assaults on Medicaid and Obamacare, " since fewer than half of the 22 million US veterans receive their care from the VA . NANCY PELOSI PROVIDES RARE TESTIMONY IN OPIOIDS HEARING, URGES EXPANDED MEDICAID. The Washington Examiner (10/11, Leonard , 465K) reports that Nancy Pelosi, House Minority Leader, made a rare testimonia l appearance at a Wednesday hearing focused on addressing the opioid crisis . Pelosi said it was "only the second time" she had "ever testified as leader ...because this issue rises to level , as you know, of life and death ." In her remarks , Pelosi urged more states to seek expanded Medicaid under the Affordable Care Act. /\MERICAi\ pVERSIGHT EXT-18-248-C-000330 SENATOR CLAIRE MCCASKILL SAYS PHARMACEUTICAL INDUSTRY HOLDS RESPONSIBILITY FOR THE OPIOID EPIDEMIC. In an interview with German Lopez of Vox (10/11, Lopez, 1.54M), Sen. Claire McCaskill (D-MO) says pharmaceutical companies "ought to begin looking over their shoulder and wondering whether or not they've gone too far in terms of some of their conduct" in causing the opioid epidemic. McCaskill describes the companies' marketing practices and suggests that some may have committed fraud to get physicians to prescribe opioids. INDIANA UNIVERSITY LAUNCHES $SOM PROGRAM TO BATTLE OPIOID ADDICTION . Modern Healthcare (10/11, Johnson, Subscription Publication, 238K) reports Indiana University has started "a five-year, $50 million research" project to identify "the best clinical practices to address opioid addiction." The article says one of the initiative's "key area[s]" is determining "how healthcare providers can address substance use disorder in patients who visit the emergency department." MONTGOMERY COUNTY OVERDOSE RESPONSE PROJECT GETS $2 MILLION FEDERAL GRANT. The Dayton (OH) Daily News (10/11, Garbe, 141K) reports the federal Substance Abuse and Mental Health Services Administration has awarded Ohio's Montgomery County Alcohol, Drug Addiction, and Mental Health Services organization a four-year $2 million grant to provide "wider access to the opioid overdose-reversal drug naloxone" in three counties. Officials estimate the group's "Project Save Miami" will annually serve "85 law enforcement officers, 400 EMS personnel, nearly 2,000 overdose victims and more than 800 community members." NEW JERSEY EXPANDS OPIOID PRESCRIPTION MONITORING TO INCLUDE VETERINARIANS. The Wall Street Journal (10/11, King, Subscription Publication, 6.45M) reports New Jersey Gov. Chris Christie's administration on Wednesday issued guidelines aimed at preventing human abuse of pain medications prescribed to pets. The new guidelines require veterinarians who prescribe opioids, such as tramadol and oxycodone, to use the New Jersey Prescription Monitori ng Program. INNOVATIVE MEDICAL PROCEDURES OFFER POTENTIAL FOR NON-OPIOID PAIN RELIEF. KXAS-TV Dallas (10/3, Castro, 284K) reports that two "narcotic-free" pain relief procedures based on nerve-blocking have been developed by "Dr. Aaron Shiraz, a board certified anesthesiologist at ZeroNarcotics .com." The first method "is a one-time injection of numbing medication that can last 48 hours." The second technique "involves a small micro catheter near the nerves that continuously drips numbing medicine for extended periods of time." Dr. Shiraz said that "the main concept" is "using a targeted approach to patients pain control, instead of opioids, which work on the entire body." Shiraz added that "anything we can do to reduce the amount of narcotics, or opioids, is really going to be to their advantage." Healthcare Fraud: OPINION: ELECTRONIC VISIT VERIFICATION ENABLES NORTH CAROLINA TO FIGHT MEDICAID FRAUD. Sandata Technologies CEO Tom Underwood writes for the Raleigh (NC) News & Observer (10/11, Underwood, 381 K) that the 21st Century Cures Act was passed in 2016 with the "potential to significantly reduce health care fraud in North Carolina and across the country" as it mandates the use of "electronic visit verification" systems for providers billing Medicaid. This verification system aims to "reduce fraud in the home health care industry by verifying home care services billed are for actual visits made," and Underwood writes that his firm advocates for an "open model," in which "the state's Medicaid office chooses or recommends one technology vendor's EVV solution while allowing home care agencies to keep their existing systems" or change them. Healthcare News: /\MERICAi\ pVERSIGHT EXT-18-248-C-000331 ACLU , PLANNED PARENTHOOD FILE LAWSUIT OVER MISSOUR I'S NEW ABORTION LAW. The Hill (10/11, Hellmann, 1.68M) reports that the American Civil Liberties Union (ACLU} and Planned Parenthood on Tuesday filed a lawsuit against the state of Missouri regarding its new abortion law. The law "requir[es] the same physician performing an abortion to be the one" who provides "state-mandated information to a patient 72 hours before the procedure," the article says. The groups contend the requirement "severely restricts access to safe, legal abortion ." ONECARE VERMONT'S NEW FIXED PAYMENT HEALTH SPENDING SYSTEM EXPANDED TO COVER MORE PATIENTS . The AP (10/11, Ring) reports accountab le-care organization OneCare Vermont announced plans to expand a new program "that pays providers a set amount of money for its patients , rather than paying the providers for the services they provide to those individuals" beyond the original 30,000 Medicaid patients who were eligible originally to patients insured by Medicare and private insurance as well , bringing the total numbe r of Vermonters served to 120,000 . According to the AP, "OneCare said it will be working with, among other organizat ions , nine hospitals in Vermont and one in New Hampshire, 24 independent physician practices, eight home health agencies and six mental health and substance abuse agencies." A Blue Cross Blue Shield of Vermont spokespe rson said they we re working with OneCare to deve lop a similar program for their customers that would begin on January 1. JUDGE RULES NORTH CAROLINA MAY OWE $20 MILLION TO HEALTHCARE PROVIDERS FOR VACCINES . The Fayetteville (NC) Observer (10/11, Woolverton , 196K) reports North Carolina "may owe more than $20 million to medical practices throughout the state because a Superior Court judge ruled last month that the government underpaid them for the cost of giving vaccines to lower-income children." Superior Court Judge Beecher Gray of Durham ruled that the state Department of Health and Human Services was federally required to pay the doctors ' offices $20.45 for each vaccine administered in the federa l Vaccines for Children program in 2013 and 20 14. The state had paid providers $13.71 per vaccine, a provision in the Affordab le Care Act raised the payment to $20.45. Health Information Technology: HIMSS OFFICIALS EXPRESS OPTIMISM ABOUT PROGRESS OF THEIR CONGRESSIONAL GOALS . Fierce Healthcare (10/11, Minemyer , 146K) reports that HIMSS officia ls have "three legislative goals" entering the new year: develop "a cybersecuri ty role within the Department of Health and Human Services"; enable the "pass[age] of the CONNECT for Health Act"; and "invest in infrastructure to support the 21st Century Cures Act." The article says that HIMSS has pressed HHS "to raise its chief information security officer to be on par with the chief information officer" as a means of improving cybersecurity leadership , and HIMSS expressed optimism that the goal, and others, are progressing. Human Services News: JUDGE DECLINES TO ORDER OFFICIALS TO ALLOW ABORTION FOR IMMIGRANT TEEN . The AP (10/12, Thanawala, Merchant) reports a federal judge in San Francisco "said Wednesday that the government cannot prevent a pregnant 17-year-old at a Texas faci lity for unaccompanied immigrant children from getting an abortion ," but dec lined to bar US Department of Health and Human Services officials from interfering in the unnamed girl's access to the procedure . US Magistrate Judge Laurel Beeler said the complaint by the American Civil Liberties Union of Northern California was not filed in the right court. US Department of Justice lawyer Peter Phipps said Wednesday that the government might propose having the girl's case heard in Texas or Wash ington, D.C. EDITORIA L: HAITIANS STILL NEED TEMPORARY PROTECTED STATUS. The Boston Globe (10/12, 969K) editoria lizes that the Trump Administration should further extend the federa l /\MERICAi\ pVERSIGHT EXT-18-248-C-000332 government's grant of temporary protected status (TPS) to some 86,000 Haitians in this country when it expires in January. The Globe examines conditions in Haiti which "have not recovered" since a "devastating 2010 earthquake, " plus recent hurricanes as recently as Hurricane Irma in September . The Globe quotes President Trump's campaign speech when he visited Little Haiti in Miami where he said that "the truth is Haiti is still suffering very badly." The editorial concludes , "The question remains whether Trump will use many thousands of Haitians as political props rather than show the kind of compassion that allowed them to find refuge here in the first place." KANSAS' FOSTER CHILD RUNAWAY RATE IS SIMILAR TO THE NATIONAL AVERAGE. The AP (10/11) reports that there are "more than 70" missing foster children in Kansas, accord ing to information supplied by foster care contractors in an oversight panel meeting Tuesday . The article says that accord ing to US Department of Health and Human Services data, approximate ly 1.1 percent of over 400,000 total chi ldren in foster care were categorized as runaways in the 2015 fiscal year. Roughly one percent of Kansas ' foster children are missing, the article adds, placing the state's figure near the nation's average. Food & Import Safety: COMMENTARY CONSIDERS WHY TRACKING FOOD POISONING OUTBREAKS IS DIFFICULT. The Boston Globe ( 10/11, Jangi , 969K) features commentary from gastroenterologist Dr. Sushrut Jang i concerning the difficulty that medical professionals and public health officials have in tracking and identifying the sources of food poisoning outbreaks. Accord ing to Jang i, "The true story of outbreaks is that cases are often scattered and splintered, with only subtle patterns in all of the noise," with bacterial epidem iology researcher William Hanage telling him many food poison ing outbreaks "are never solved" due to the dead ends that emerge when trying to identify a source food provider or food item. Jangi concludes, "Food outbreaks are unlikely ever to be completely preventab le; indeed , they are our most pointed reminders of commu nal risk," and that often, the best tool available to physicians and health officials fighting food poisoning outbreaks is their ability to notice and identify connect ions. SALMONELLA OUTBREAK CONNECTED TO SEPTEMBER CHILI COOK-OFF SPREADS TO ATTENDEES FROM EIGHT STATES . The AP (10/11) reports roughly 150 people across eight states were infected with salmonella after they atte nded a chili cook-off in Virginia on September 30. According to the AP, "Dr. David Matson , director of the state's Eastern Shore Health District, said by phone Wednesday that half of them have sought medical treatment. Some have been hospitalized ." Officials are conducting a survey of cook-off attendees to identify possible sources of the outbreak . Also reporting is USA Today (10/ 11, Vaughn). Emergency Response and Pandemic Preparedness: EDITORIAL CALLS FOR NEW TEXAS POLICIES ON DISASTER PREPAREDNESS IN NURSING HOMES. In an editorial, the Dallas Morning News (10/11, 984K) decries Texas policies that do not require nursing homes to evacuate fac ilities during disasters , but rather require them to subm it emergency plans for review, but not file them with the state . The News further castigates nursi ng home administrators such as those of the Lake Arthur Place facil ity, who left '70 residents in a building filled with a foot of water and smelling of urine and feces" during Hurricane Harvey and "rebuffed" volunteers from trying to remove them . LETTER: FHCA PLAYS IMPORTANT ROLE IN EMERGENCY PREPAREDNESS AMONG DILIGENT NURSING HOMES. John C. Simmons , president of the Florida Health Care Association, writes in a letter to the Miami Herald (10/11, 701 K) that Carl Hiaasen's October 1 column assert ing the deaths of the 14 residents at the Hollywood Hills nursing home were inevitable due to neglect "does a great injustice to the thousands of highly skilled professiona ls /\MERICAi\ pVERSIGHT EXT-18-248-C-000333 who ded icate themse lves to caring fo r some of our state 's most fragi le residents ." Simmons lists "some facts " to illustrate the FHCA's role in assisting facilities with emergency preparedness, and notes the Hollywood Hills facility "isn't even a membe r of our association ." Nutrition & Obesity: CHICAGO-AREA SODA TAX REPEAL THREATENS FUTURE OF SIMILAR REGULATIONS. USA Today (10/11 , Bomey, 8.62M) reports that "a Cook County board committee 's" 15-2 vote to repeal the county 's soda tax places "the future of similar measures across the U.S. in jeopardy ." The article says the vote was prompted by "a backlash from store owne rs, drink compan ies and bottlers ." The AP (10/11) reports the repeal follows a "a monthslo ng confl ict" involving "a court battle" and significant monetary investment by "both sides." Reuters (10/11, Prentice, Pierog) reports that the repeal is "significant " for being "the first'' overturned soda tax "since a string of U.S. cities last year voted in favor of such taxes. " Bruce Japsen writes for For bes (10/ 11, Japsen , 5.11M) that the overwhelming 15-2 vote "comes despite a recent multi-million-dollar advertising blitz in the Chicago media market by billiona ire businessman Michael Bloomberg" in an effort to save the tax. The Chicago Tribune (10/11 , Trotter , Yerak , 1.98M) quotes Rosie Regas , co-owner of the Fairplay independent chain's three Chicago stores , saying , "This was a nightmare. I get it county needs money. But find another way." Regas' three stores saw a 27 percent drop in sweetened drink sales. the Contributors Guy Bentley and Daniel Takash write in a Was hington Examiner (10/11, 465K) oped that the result "should serve as a warning to lawmakers across the country that these taxes" are damaging to "consumers and businesses whi le failing to ach ieve their stated obj ectives and that voters" won't to lerate them . Medicare: CMS RELEASES STAR RATINGS FOR MEDICARE ADVANTAGE AND PRESCRIPTION DRUG PLANS. Modern Healthcare (10/11 , Castellucci, Subscription Publication, 238K) reports that "CMS' release of its Medicare star ratings reveals that performance among insurers overall in Medicare Advantage remains largely unchanged year-over-year. " The latest data released Wednesday show that "the number of Medicare Advantage plans that performed well in the CMS' star ratings program dropped slightly from last year," while the number of insurers that receive certain ratings "hasn't changed significantly in recent years ." Healthcare Finance News (10/11 , Morse, 93K) reports "Kaiser Permanente , Tufts Health Plan, and Anthem in New Hampshire are among 26 plans receiving five stars" in CMS' rating for 633 Medicare Advantage and prescription drug plans . Medicaid & CHIP: OPINION: MEDICAID EXPANSION IS AN OPPORTUNITY TO ADDRESS HEALTHCARE INEQUALITY IN MAINE. Dr. Jeffrey Graham of C.A. Dean Hospita l in Greenville writes in a Bangor (ME) Daily News (10/11, 162K) op-ed that Maine voters should vote "yes" on Questio n 2, which would expand Maine's Medicaid program . Dr. Graham says expanded Medicaid in Maine would "provide health care coverage to 70,000 Mainers" and address the injustice of healthcare inequality . Dr. Graham adds that expanded Medicaid would help Maine's fight against the opioid epidemic. /\MERICAi\ pVERSIGHT EXT-18-248-C-000334 Health & Medical News: FDA TO CONSIDER EXPERIMENTAL GENE THERAPY FOR BLINDNESS. CNN (10/11, Scutti, 33.59M) reports that on Thursday, a Food and Drug Administration advisory committee will meet to review Luxturna (voretigene neparvovec) in a public meeting. If approved, Luxturna "would become the first gene therapy for the treatment of an inherited disease in the United States," Leber's congenital amaurosis (LCA), a rare disease that "causes severe visual impairment beginning in infancy." The piece profiles a young patient whose vision improved after the treatment. Luxturna is credited with improving the eyesight of 93 percent of participants in a Phase 3 clinical trial. CNN adds that the FDA is not required to follow the recommendation of the advisory committee. EXPERIMENTAL GLAUCOMA DRUG EFFECTIVELY LOWERS EYE PRESSURE, FDA PRELIMINARY REVIEW CONCLUDES. Reuters (10/11, Clarke) reports that a preliminary review by the Food and Drug Administration concludes that Aerie Pharmaceuticals ' Rhopressa (netarsudil ophthalmic solution) "is effective in loweri ng eye pressure" among patients with glaucoma. However , "the agency said the product was less effective when given twice a day in people with the highest pressure." Fierce Biotech ( 10/11, Taylor) reports that "a panel of experts convened by the FDA will take a deep dive into the data and opine on its merits on Friday." LEGISLATION TO ESTABLISH DIABETES COMMISSION HEADS TO WHITE HOUSE. The AP (10/12) reports a bipartisan bill authored by Sens. Jeanne Shaheen (D-NH) and Susan Collins (RME) to "establish a national commission of health care experts on diabetes care and prevention is headed to President Donald Trump's desk." The co-authors say that the law will bring private and public sector experts , clinical endocrinologists, diabetes researchers, and others to improve "education, care delivery and patient outcomes." The piece mentions that the CDC says nearly 26 million Americans have diabetes, plus another 79 million have pre-diabetes. SMALLPOX VACCINE MADE OF HORSEPOX, NOT COWPOX, RESEARCH INDICATES . Newsweek (10/11, Firger, 991 K) reports that a paper published Wednesday in the New England Journal of Medicine found "compelling new information that suggests the effective ingredient in the smallpox vaccine is" made of horsepox rather than cowpox, as was previously believed . The smallpox virus still resides at high containment repositories in the CDC headquarters, "and at the State Research Centre of Virology and Biotec hnology (VECTOR) in Novosibirsk, Russia." While "the World Health Assembly plans to destroy supplies of the virus in these labs," the virus "has proven useful for medical research to develop experimental treatments for other diseases such as cancer." SANOFI TO INVEST $202 MILLION TO EXPAND FRENCH VACCINE FACILITY. Reuters (10/12, Blamont) reports that Sanofi plans to invest $202 million to expand its vaccines manufacturing site at Val-de-Reuil in northwestern France. Sanofi said Thursday that the new facility will allow its Sanofi Pasteur vaccines division to increase supply of one of its influenza vaccines, VaxigripTetra, to up to 70 countries. David Loew, executive vice president at Sanofi, said, "Influenza continues be a major public health problem around the world, causing serious complications, hospitalizations and deaths , mostly for certain high-risk individuals." SAN DIEGO SCHOOL DISTRICT CONSIDERS LATER START TIMES. The San Diego UnionTribune (10/11, Warth, 668K) reports the San Diego Unified School District "board on Tuesday unanimously supported Trustee John Lee Evans' motion to provide each school cluster ...with information to help decide whether to move back the start of the school day." The Union-Tribune notes that "fifteen out of the district's 16 comprehensive high schools start around 7:30 a.m.," but "the American Academy of Pediatrics, American Medical Association , Centers for Disease Control and National Institutes of Health have endorsed 8:30 a.m. start times for secondary /\MERICAi\ pVERSIGHT EXT-18-248-C-000335 schools over the past three years ." The article highlights medical opinion that "it would be wrong to ignore the effects of sleep deprivation on the brain ." STUDY SUGGESTS PROSTATE CANCER PATIENTS ARE UNCLEAR ON DIFFERENCES AMONG TREATMENTS. Reuters (10/ 11, Harding) reports that a study published Sept. 28 in the journal BJU International suggested "many patie nts with localized prostate cancer don't understand the differences between their treatment options. " Researchers "analyzed questionnaires completed by 4 74 prostate cancer patients who had j ust received information about their treatment options from a urologist," and found that "just over one-third of the patients were aware that cancer recurrence was just as likely with surgery as with radiation , while 39 percent were aware that prostatectomy increased the risk of incont inence." In addition, "forty-five percent of the survey respondents thought that patients on active surveillance always wound up receiving radiation or therapy later on," and "only half of patients on active surveillance require definitive treatment." FRED HUTCHINSON, MD ANDERSON EXAMINE TOXIC SIDE EFFECTS OF CAR-T THERAPY. The Washington Post (10/12, McGinley, 10.38M) "To Your Health" blog reports that the Fred Hutch inson Cancer Research Center and MD Anderson Cancer Center are researching the negative side effects of CART-cell therapy. Fred Hutchinson 's research , based on a clinical trial of 133 patients , found cytokine release syndrome (CRS) and neurotoxicity to be common side effects of CAR-T therapy. Meanwhile, in an article published in Nature Reviews Clinical Oncology in September, MD Anderson Cancer Center researchers "proposed guidelines for systematically dealing with the tox icities caused by the drugs ," based on a study of 100 patients . EXPERT PANEL DISCUSSES FUTURE OF CANCER RESEARCH AND TREATMENT. STAT (10/11, Joseph, 43K) reports the "Warn on Cancer 3.0" panel, sponsored by STAT and the Jackson Laboratory, spoke about the future of cancer research and treatment at the HUBweek festival. Panel member Tyler Jacks , the director of the Massach usetts Institute of Technology 's Koch Institute for Integrative Cancer Research , said, "We have entered a new era." Another panel member Dr. Jeff Engelman, the vice president and global head of oncology research at Novartis , said that cancer researchers don't follow a single path to make discoveries anymore, because researchers have a variety of tools at their disposal. PUERTO RICO INVESTIGATING POSSIBLE CASES OF LEPTOSPIROSIS. The AP (10/11, Melia) reports that officials are investigat ing four deaths in the wake of Hurricane Maria as potential cases of leptospiros is, "a disease spread by animals' urine." Puerto Rico's governor referenced the investigations on Wednesday , as worries over "exposure to contaminated water" continue to fester, the article says. The article adds that the CDC is helping investigate, as symptoms of the disease are similar to "those of other illnesses , including dengue. " SYRACUSE UNIVERSITY MUMPS OUTBREAK MAY SURPASS 18 CASES. The Syracuse (NY) Post-Standard (10/11, 690K) reports that a Syracuse University mumps outbreak has "13 confirmed cases and five probable cases," and over "10 other students are considered suspect cases ...requir[ing] further test ing," according to information obta ined from local health officials on Wednesday . WASHOE COUNTY OFFICIALS CONFIRM FIRST HANTAVIRUS FATALITY SINCE 1995. The AP (10/11) reports that health officials in Washoe County "confirmed their first fatal case of hantavirus" in over two decades . The article said the county 's last death associated wit h the rodent-transmitted illness occurred in 1995. STATES ACTING ON DRUG PRICES AFTER FEDERAL INACTION. The Hill (10/ 11, Roubein , 1.68M) reports that as there has been "little action in Wash ington to rein in the costs of prescript ion drugs," some state governments "are taking matters into their own hands" and passing prescription drug pricing transparency laws. This year, "dozens of bills on drug pricing were filed in state legislatures " and "advocates are hoping to rack up wins in more states next /\MERICAi\ pVERSIGHT EXT-18-248-C-000336 year." OPINION : FEDERAL POLICIES OBSTRUCT VALUE-BASED PRICING FOR PRESCRIPTION DRUGS. In an opinion piece fo r The Hill (10/11, 1.68M), former Rep . Jim Greenwood (R-PA) writes that value-based pricing is "showing great promise in other areas of health care" but faces obstacles fo r prescription drugs due to "outdated federa l rules." Greenwood highlights Medicaid's "Best Price" rule and "restrictio ns on communications between drugmakers and payers" as "policies may have been appropriate for the old payment model based on volume or consumption " but also "act as barriers to a value-based approach ." SHORTAGE OF PHYSICIANS SPECIALIZING IN GENETICS , DESPITE BOOM IN RESEARCH. STAT (10/11, Thielking, 43K) reports that although "research grounded in genetics is booming ," there is a "shortage of doctors trained to diagnose and treat such illnesses ." The article expla ins the shortage likely has seve ral causes, including a lack of exposu re to genet ics for medical students and compa rative ly low pay. PROBLEMS REMAIN AT JOHNSON & JOHNSON PHARMACEUTICAL FACILITIES IN PUERTO RICO. STAT (10/11 , Silverman, 43K) reports that an interna l document shows that at Johnson & Johnson's seven prescription drug manufactur ing facilities in Puerto Rico, "connectivity remains an issue and so product ion will vary considerably from location to location" after Hurricane Maria. A spokesperson said the "potentia l for intermittent shortages " exists for certain products , but pointed out that many are produced in other locations that can help meet demand . PENNSYLVANIA GOVERNOR SIGNS "RIGHT TO TRY" LAW. The AP (10/11) reports Pennsylvan ia Gov. Tom Wolf (D) on Wednesday ratified a "right to try" bill, making the state the 38th in the US to enact such a law giving terminally ill patients access to experimental treatments that do not have full federa l regulatory approval. Under the law, manufact urers of medical drugs , products , and devices may provide them to patients who have recommendations from physicians and who have been unable to participate in clinical trials. The Doylestown (PA) Intelligencer (10/11, Callahan , 20K) reports one term inally ill patient reacted to the law by saying it is "another arrow in our quiver to fight for our lives," adding that with regard to FDA regulatory approva l, "I don't need the FDA to protect me from death." MERCK TO DISCONTINUE MARKETING FOR CHOLESTEROL TREATMENT . The AP (10/11, Johnson) reports Merck on Wednesday said it will abandon marketing efforts for its CETP inhibitor called anacetrapib , an experimental cholesterol treatment , follow ing years of testing . Accord ing to the art icle, it is "the fourth time th is type of once-promising drug has been scrapped ." Reuters (10/11 , Banerjee) reports Merck "said ...the clinical profile of the treatment does not support regulatory filings ." A large study on anacetrapib found it "cut the risk of heart attack and death by a modest 9 percent, wh ile causing a build up of the drug in fat tissue , leaving its commercia l future uncerta in." ARDEL YX ANNOUNCES IBS TREATMENT SUCCEEDS IN LATE-STAGE TRIAL. Reuters (10/11, Mathias) reports Ardelyx Inc on Wednesday said a second late-stage trial of its experimental irritable bowel syndrome with constipat ion (IBS-C) treatment tenapanor met the primary study goal of reducing abdominal pain by at least 30 percent and increas ing bowel movement compared to a placebo group . Ardelyx said it plans to file fo r approval with the FDA late in 2018. PHARMACEUTICAL INDUSTRY APPEALS SOUT H DAKOTA DECISION ON PRESCRIPTION PAYMENT BALLOT MEASURE. The AP (10/11, Nord) reports South Dakota Biotech and Pharmaceutical Research and Manufacturers of Amer ica "have appealed to the South Dakota Supreme Court after a state judge rejected their challe nge to Attorney Genera l Marty Jackley's /\MERICAi\ pVERSIGHT EXT-18-248-C-000337 explanation" of a ballot measure seeking to limit the price state agencies pay for prescription medications. While Jackley said his explanation was "fair, clear and simple," industry members "argued that the explanation falls short because it doesn 't mention language giving supporters legal standing if the initiative is challenged in court ." DISTRICT JUDGE TO DETERMINE WHETHER ALLERGAN PATENT TRANSFER CONSTITUTES "SHAM" DEAL Reuters (10/11, Frankel) reports US District Judge William Bryson is prepar ing to decide whether Allergan 's agreement to transfer patents for its dry eye treatment Restasis to the Saint Regis Mohawk Tribe "was merely a sham to allow the drug company to evade a challenge to its patents in a completely different forum. " Allergan notified Bryson of the transfer and requested the tribe be counted as plaintiffs in a challenge to Restasis' patents , filed by Mylan , that Bryson already was consider ing. According to Reuters, the "seeming ly routine procedura l issue" of adding the tribe as plaintiffs is now "a test of the legitimacy of a patent litigation tactic that is as creative as it is controversial." CONSUMERS MAY NOT RECOGNIZE DRUG SIDE EFFECTS WHEN ADS CONTAIN LONG LISTS OF RISKS, STUDY SUGGESTS. The New York Daily News (10/11 , Gibbs, 3.61M) reports a study (PDF) published in the journal Nature Human Behav iour found "that when a drug advertisement throws too many risks at you ...the less risky a drug is perceived to be by a potential consumer " based on "a psychological phenomenon called 'the dilution effect."' The article says advertisements for medications "are required by the Food and Drug Administration to list their risks along with the drug's benefits ," although "sawy marketers" may have found "that the more risks the commercial or print ad lists, the better for their brand because the smaller side effects dilute the larger risks." CICLOMED GAINS FDA APPROVAL TO BEGIN CLINICAL TRIALS FOR BLADDER CANCER TREATMENT. The Kansas City (MO) Business Journal (10/ 11, Reuter, Subscript ion Publication , 876K) reports CicloMed LLC of Kansas City, Missouri, recently received FDA approval to begin human clinical trials for use of its Ciclopriox Prod rug among bladder cancer patients , the company said Wednesday. CicloMed is a subsidiary of BioNovus Innovations LLC and will begin clinical trials at a number of cancer centers. AMAZON ENTERING PHARMACY SPACE COULD LOWER DRUG PRICES, MORGAN STANLEY SAYS. CNBC (10/11 , Farr, 3.48M) reports on its website that Morgan Stanley issued a new analysis for investors outlining how Amazon 's possible entry into pharmacy could benefit consumers , positing that the company could open "virtual retail pharmacies ...to drive pricing down," forge relationships with generic drug makers to further lower treatment prices , and establish partnerships with branded drug makers. Morgan Stanley predicts such actions would generate rebates and similar discounts that companies and pharmacy benefits managers could "pass back to consumers. " HYPERTENSIVE WOMEN IN THEIR 40S MAY BE AT INCREASED RISK FOR DEMENTIA IN LATER YEARS, STUDY INDICATES. In "Well, " the New York Times (10/11 , Bakalar, Subscription Publication , 13.56M) reports that women with hypertension "in their 40s are at increased risk for dement ia in later years , researchers" concluded in a study published online Oct. 4 in Neurology . The study , which included "5,646 men and women " who were followed for yea rs starting in 1964, revealed that "women who were hypertensive at an average age of 44 had a 68 percent higher risk for dementia than those who had normal blood pressure at that age, even after" adjusting for confounding factors . The finding appears not to apply to hypertensive men "in their 30s or 40s," however. TAI CHI MAY BE USEFUL WAY TO INTRODUCE RELUCTANT PEOPLE TO EXERCISE AFTER A HEART ATTACK, STUDY INDICATES. TI ME (10/11, Park, 5.85M) reports , "In a small new study published" online in the Journal of the American Heart Associat ion, investigators "found that ta i chi might be a useful way to introduce reluctant people to exercise " after having had a heart attack. The study included 29 heart attack patients who refused to participate in /\MERICAi\ pVERSIGHT EXT-18-248-C-000338 traditiona l card iac rehabilitation . MedPage Today (10/11, Lou, 60K) reports the authors of an accompany ing editorial observed , "Ultimately, it may become possible to attribute the benefits of cardiac rehabil itation to its different components, and it may be prudent to prescribe the particular component (or equiva lent alternative) most needed and/or preferred by each patient, espec ially for those unable or unwilling to participate in a comprehensive cardiac rehab ilitation program." One of the editoria lists disclosed "a postdoctora l train ing grant from the National Heart, Lung , and Blood Institute ." PREVALENCE OF HOSPITA L ADMISSIONS FOR STROKE THAT HAD CONCOMITANT HYPERTENSION , DIABETES , AND DYSLIPIDEMIA INCREASED MORE THAN 200% BETWEEN 2004 AND 2014 , STUDY FINDS. According to the NPR (10/11, Fulton, 2.4M) "Shots" blog, "for years ," physicians have been warn ing patients that "high cholesterol, cigarette smoking , illegal drug use and diabetes increase" the "chances of having a potentially fatal stroke ." Nevertheless, the majority "of the stroke patients showing up at hospitals from 2004 to 2014 had one or more of these risk factors ." What's more, "the numbers of peop le at risk in this way tended to grow among all age groups and ethnicities in that time period," researchers found. MedPaqe Today (10/11, Jenkins , 60K) reports researchers "noted that the prevalence of hospital admissions for stroke that had concomitant hypertension , diabetes, and dyslipidemia increased by more than 200%, from 9.4% to 23.7% , during the study period." The findings of the 922 ,000participant study were published online in Neurology. The author of an accompanying editorial , however, "warned against rushing to judgment about healthcare performance in the US without a more careful inspection of the data ." CON FERENCE FOCUSES ON PREVENTING YOUTH SUICIDE AMONG NATIVE AME RICANS . The Helena (MT) Independe nt Record (10/11, Loranger, 36K) reports on two-day conference in Helena on mental health focused on ways to prevent suicide among Native Amer ican youth. The conference is "the first step in The Native Youth Suicide Reduction Plan" and included more than 75 peop le from tribal governments, Urban Indian Health Centers , the Indian Health Service , and the Department of Health and Human Services . RESEARCHER S IDENTIFY FACTORS TO HELP PREDICT SEVE RE TOXICITIES AMONG PATIENTS RECEIVING CAR-T INFUSIONS. STAT (10/12, Keshavan , 43K) reports that a study published in Cancer Discovery finds that patients "with severe lymphomas and leukemias who received CAR-T infusions " who "displayed early side effects like fevers, low blood pressure , and spikes in an inflammatory cytokine protein called IL6 were more prone to having severe toxicit ies later on ." They also found that fata l toxicities happen more often with younger patients and patients receiving CAR-T infusions with higher potency . SAN ANTONIO JOINS INITIATIVE TO REVERSE INCREASE IN HIV. The San Anton io Express-News (10/12, Ravani, 1.18M) reports on San Antonio 's launch of launch the Fast Track Cities initiative which aims to lower the number of new HIV diagnoses in Bexar County. HIV diagnoses have "steadily increased over the last decade, reaching 360 a year in 2016 , said Colleen Bridger, the director of Metro Health" who organized the meet ing to launch the initiative. 'The initiative is a part of an international effort to reach a 90-90-90 target where 90 percent of people with HIV know their status, 90 percent of people with HIV are being treated and 90 percent of them have suppressed viral loads or are 'undetectable ."' Global Health: MADAGASCAR SAYS PLAGUE OUTBREAK HAS SPREAD TO SEYCHELLES. The New Yo rk Times (10/11, McNeil, Subscription Publication, 13.56M) reports that Madagascar's health ministry said Wednesday that the country 's plague outbreak "has spread to the Seychelles, a nearby chain of islands in the Indian Ocean ." The ministry said, in the Times' words , "a 34-yearold man who fell ill after return ing from Madagascar on Friday has tested positive for pneumonic /\MERICAi\ pVERSIGHT EXT-18-248-C-000339 plague," and he "is now in isolation at Seychelles Hospital and is receiving antibiotics ." The Times notes that Madagascar 's "outbreak has killed at least 50 people so far, and 500 confirmed cases have been reported, accord ing to the World Health Organization and Madagascar 's health ministry ." STUDY MAPS RISK OF FATAL FEVER EPIDEMICS ACROSS AFRICA. Reuters (10/11 , Guilbert) reports that research published in "The Lancet medical journal assessed the likelihood of four viruses - Ebola , Lassa, Marburg and Crimean-Congo - spread ing on" Africa, "charting progress from a first human case through to a potential pandemic." Researchers said "West Africa is most at risk of fatal haemorrhag ic fever epidemics, including Ebola." University of Washington professor Simon Hay said , 'This study's framework provides an important tool for pinpointing where local surve illance and pre-emptive countermeasures are most needed ." EXPERTS DISAGREE ABOUT GLOBAL DANGER OF DRUG-RESISTANT MALARIA SPREADING IN SOUTHEAST ASIA. Science Magazine (10/11, Roberts, 399K) reports that a drug-resistant form of malaria is spreading throughout Southeast Asia. However, scientists disagree about its wor ldwide threat level. The article says a "team from the Mahidol Oxford Tropical Medicine Research Unit in Bangkok writes in the October issue of The Lancet Infectious Diseases" that the strain could have devastating consequences, and the group's head is pushing for the declaration of a Public Health Emergency of International Concern. The article, however , also quotes multiple experts who believe the risk is being overblown. BOTSWANA OFFICIALS DETECT ANTHRAX IN DEAD HIPPOS FOLLOWING SIMILAR OUTBREAK IN NAMIBIA. Reuters (10/11) reports that authorities in Botswana on Wednesday said that anthrax has been identified in deceased hippos in the Okavango River. Neighboring Namibia similarly announced Monday that over 100 hippos died of anthrax in its northeastern region. ALBERTA TO BAN MINORS FROM USING UV TANNING BEDS. The Canadian Press (10/11, Cotter) reports that Alberta Health Minister Sarah Hoffman said Wednesday that "youths under 18 will not be allowed to use ultraviolet tann ing machines starting on Jan . 1." Hoffman said, "Research has shown that using artificial tanning when you are under 35 dramat ically increases your risk for melanoma. The changes we're making will help protect our youth from a disease that affects hundreds of Albertans every year." The article notes that the "Canadian Cancer Society had been urging the ...government to take action, warning the delay has been putting young people at risk of develop ing skin cancer, including potentially deadly melanoma. " ITALY TO CULL BIRDS IN RESPONSE TO FIVE OCTOBER H5N8 AVIAN FLU OUTBREAKS. Reuters (10/11, Pullella) reports that Italy will cull nearly 900,000 birds as a result of five outbreaks of H5N8 avian flu in October , according to officials who spoke Wednesday. The outbreaks have occurred "in farms the central and northern parts of the country ," the story says. PROMINENT UK RESEARCHER WARNS LACK OF POST-BREXIT CLARITY COULD JEOPARDIZE PHARMACEUTICAL R&D. BBC News (UK) (10/11 , 1.61M) reports that professor Jeremy Farrar, head of the Wellcome Trust and "one of the UK's most influent ial research leaders ," warns that the UK could lose its position in pharmaceutical R&D if its post-Brex it plans are not made clear soon. "If that clar ity is not forthcom ing and people can't be sure of their longterm stability and the clarity of those future relationships , then inevitab ly that will be factored into their investment decisions, " Farrar said. National News: MEDIA ANALYSES: TRUMP THREATENS FREE PRESS WITH REACTION TO NBC REPORT. All three broadcast networks covered President Trump 's criticism of an NBC report ( 10/11, Kube, 3.46M) stating that he called for a tenfold increase in the size of the US nuclear arsena l during a July meeting , and the President's seem ing suggestion that media outlets should /\MERICAi\ pVERSIGHT EXT-18-248-C-000340 face the loss of broadcast licenses for such reporting . The latter thread of the story gets the most attention and it is universally negative , with multiple outlets comparing Trump 's words to President Nixon's abuse of power against the media, questioning Trump 's commitment to the First Amendment , and not ing that federa l broadcast licenses do not exist. NBC Nightly News (10/11 , story 3, 2:40, Holt , 16.61 M) reported that Trump made comments "about the size of the US nuclear arsenal ...that stunned a top secret meeting shortly before the Secretary of State called him a 'moron .' The President dism issed our reporting , saying it's not true and that our sources are made up. Those sources , however , do exist. In fact, three of them were in the room when the President talked about dramatically increasing the number of US nukes." Trump: "No, I never discussed increasing it. We won't need an increase . But I want modernization, and I want total rehab ilitation. It's got to be in tip-top shape ." NBC's Kristen Welker: "But three officials present in the room say the [July 20] meet ing was at times tense , including when the President was shown a chart of the history of the nuclear arsenal peaking in the late 1960s at more than 32,000 weapons. The President told his team he wanted the US to have that many. The current number stands at 4,000 .... In disputing the NBC News report, the President took the extraordinary step of appearing to attack the First Amendment, tweeting about NBC and the networks, 'At what point is it appropr iate to challenge their license?"' Ten hours after that initial tweet, Trump tweeted, "Network news has become so partisan, distorted and fake that licenses must be challenged and , if appropriate, revoked. Not fair to public!" On ABC World News Tonight (10/11, story 6, 2:10, Muir, 14.63M), Jonathan Karl reported that the President's Wednesday comment was "actually a change from December , when he tweeted, 'The United States must greatly stre ngthen and expand its nuclear capability until such time as the world comes to its senses regarding nukes .' Today, the President did n't just dispute the NBC report , but went so far as to question their right to report it." Trump : "And it's frankly disgust ing the way the press is able to write whatever they want to write. And people should look into it." Karl: "And on Twitter , he seemed to make a threat: 'With all of the fake new coming out of NBC and the networks , at what point is it appropr iate to challenge their license? Bad for country! "' In a 30second item, the CBS Evening News (10/11 , story 4, 0:30, Mason, 11.17M) called those comments "a page out of the Nixon playbook, wh ich included license challenges and threats of antitrust suits against the networks. " USA Today (10/11 , Estepa, 8.62M) reports, "Angry over a story that said he wanted to increase the country 's nuclear arsena l, President Trump charged on Wednesday that NBC and other news networks should have their licenses challenged. " The Washington Post (10/11, Nakamura, 10.38M) reports that the President "threatened NBC over a news report he called ' pure fiction ."' The President "has previously challenged NBC's reporting on the meet ing, including a revelation" that Tillerson "referred to the president as a 'moron ' after the meeting and considered resigning from the Cabinet." The New York Times (10/11 , Baker , Kang, Subscription Publication, 13.56M) reports that the President "threatened " NBC, draw ing "criticism that the president was using his office to undermine First Amendment guarantees of free speech and free press. And , in fact, the networks themselves - and their news departments - do not hold federa l licenses, though individua l affiliates do.'' Like CBS, the Times also compared Trump to Nixon , who "told advisers to make it difficult for The Wash ington Post to renew the F.C.C. license for a Florida telev ision station it owned .'' The Los Angeles Times (10/11, Bierman, Bennett , 4.49M) similarly writes that Trump "has threatened press freedoms before , but on Wednesday, he went a step further: suggesting that television networks lose their federal broadcast licenses for what he considers 'fake news."' The Times also says the threat "recall[ed] for many the threats of President Richard M. Nixon." Politico (10/11, Nelson, McGill, 3.6M) reports , 'Trump lashed out at NBC , appearing to make a threat that is not even possible, given that the Federal Communications Comm ission doesn't directly license networks." The Daily Caller (10/11 , Ross, 521K) says that "any attempt to take NBC News or other networks off the air would be nearly imposs ible ," and Bloomberg News /\MERICAi\ pVERSIGHT EXT-18-248-C-000341 (10/11, Shields , 4 .52M) says that Trump can "probably not" do that, "in part because the NBC network he attacked has no licenses (which are issued to TV stat ions) and in part because the federal government cannot legally police political speech ." The Wall Street Journal (10/11, Bender , Subscr iption Publication , 6.45M) also reports that Trump den ied calling for the massive increase in the nuclear arsenal. Reuters ( 10/ 11), the Wash ington Times (10/11, Boyer, Persons, 541 K), and The Hill (10/11, Easley, 1.68M) have straighforward accounts of the President's remarks. Mattis Calls NBC Report "False" And "Erroneous." The Washington Examine r (10/ 11, Brown, 465K) reports that Defense Secretary Mattis also challenged the report , saying, "Recent reports that the President called for an increase in the US nuclear arsenal are absolutely false . This kind of erroneous reporting is irresponsible." The Daily Caller (10/11 , Pickrell, 521 K) and Townhall (10/11, Brown, 523K) also cover Mattis' statement. Sasse Asks If Trump Is "Recanting" Oath To Defend First Amendment. The Washington Examiner (10/11, Correll, 465K) reports that Sen . Ben Sasse "is quest ioning whether President Trump is still committed to preserving the First Amendment after he repeatedly floated retribution aga inst the media for publishing stor ies he doesn't like." In a statement, Sasse said, "Mr. President: Words spoken by the President of the United States matter. Are you tonight recanting of the oath you took on January 20th to preserve , protect, and defend the First Amendment?" White House Says Trump's Relations With Tillerson Are Fine. Sara Murray reported on CNN's Situation Room (10/11 , 1.12M) that Trump on Wednesday "downplayed any talk of te nsion between himself and his Secretary of State as old news, someth ing that happened last week ." Murray continued : "In fact, the Wh ite House does say the President had lunch with Secretary Tillerson yesterday ." Kellyanne Conway said on Fox News' America's Newsroom (10/11 , 1.71 M) that the President "has confidence in his secretary of state and his entire Cabinet. They met yesterday for lunch and they are in touch very closely as you can imagine as any president and secretary of state are." NYTimes Says Congress Should Limit Trump's Ability To Launch Nuclear Attack. The New York Times (10/11 , Subscription Publication , 13.56M) editorial izes, "The broad debate over President Trump 's fitness for the difficult and demanding office he holds has recently been reframed in a more pointed and urgent way: Does he understand, and can he responsibly manage , the most destructive nuclear arsenal on earth? " The Times writes that "Congress has been sufficiently alarmed to consider legislat ion that would bar the president from launchi ng a first nuclear strike without a declaration of war by Congress ," which is "a sound idea [that] could be made stronger with a requirement that the secretar ies of defense and state also approve any such decision. " TRUMP PITCHES TAX PLAN TO TRUCKERS IN PENNSYLVANIA. Coverage of President Trump's stop outside Harrisburg, PA to promote his tax reform plan is heaviest in print and local media, with only one broadcast network airing a brief report. Reports stress the President's pitch to truck drivers as he tries to portray the plan as beneficial to the middle class - and not a boon for the wealthiest. Some reports also say that Trump chose Pennsylvan ia hoping to put pressure on Democratic Sen . Bob Casey, who is up for re-election next year in a state Trump carr ied in 2016 . ABC World News Ton ight ( 10/11, story 8, 0:50, Muir, 14.63M) reported that the President was in Pennsylvan ia "talking about his proposed tax plan, and making some new promises about how much middle class fam ilies wou ld save under the plan." ABC 's Cecilia Vega : "President Trump says the typical American fam ily will save $4,000 - a 'pay raise,' he is calling this. He is claiming this will come from cuts to the corporate tax rate. But this is a tax reform plan ...with few details right now. Some experts say it's act ually the top one percent of income earners who will earn and win the most out of this plan, and it will add trillions to the federal deficit." /\MERICAi\ pVERSIGHT EXT-18-248-C-000342 The Harrisburg (PA) Patriot-News (10/11, 553K) reports that after the "tax reform plan initially was skewered by critics as a boon for the wealthy," the President "took a deliberate blue-collar approach to present his proposed tax cuts in the Harrisburg area ." At an airport stop near Harrisburg, "he invited groups of truckers, staged rigs as a backdrop and presented his framework for an overhaul of the country's tax code in terms of how it would affect truckers." Trump said, "Our framework ensures that the benefits of tax reform go to the middle class, not to the highest earners. It's a middle-class bill." The Allentown (PA) Morning Call (10/11, Olson , 312K) reports that the President promoted the plan "as a proposal that will benefit Pennsylvania truckers and trucking company officials seeking to pass on their businesses to their children." He told a crowd of about 1,000, "When your trucks are moving, America is growing." Transport Topics (10/11, Lamb) reports that "representat ives from trucking companies, many of which are family-owned , expressed enthusiasm at the prospect of ending the estate tax," saying that would make it easier to keep businesses in their families. WPMT-TV Harrisburg , PA (10/11, 10:05 p.m. EDT, 14K) reported that Trump "focused on the trucking industry, which he called a critical partner in keeping the American economy running and competing with other countries." WHTM-TV Harrisburg, PA (10/11, 11:02 p.m . EDT, 13K) reported, "You could say the President was preaching to the choir. a thousand invited guests , mostly pro-business. He was warmly received as he talked taxes , trucks and truckers." WGAL-TV Lancaster, PA (10/11, 11:01 p.m. EDT, 49K) reported that Trump "rebuffed critics who claim his plan is a big win for the wealthy." The AP (10/11, Lucey, Boak) reports , "Trump has left it up to Congress to fill in many specifics of his plan, which omits details such as the income levels for his new tax brackets . The outreach to truckers in Pennsylvania is an attempt to give a blue-collar appeal to a framework that outside tax analysts say would largely favor the wealthy." The President told the truckers, "You're going to make more money. You're going to do better than ever before. And we truly admire you. You are our heroes, believe me. You are our heroes." Charles Hurt of the Washington Times said on Fox News Special Report (10/11, 2.11 M), 'This is by far the most populist presidency we 've had in modern times. I don't ever remember a president campaigning or hosting an event with long-haul truck drivers." Philly (PA) (10/11, Whelan, 1.19M) reports that Trump stuck "mostly to the words on a TelePrompter ," and "stayed away from the distractions that have muddled his message in recent days: the fight over NFL players kneeling in protest during the national anthem, for instance; the dispute with Secretary of State Rex Tillerson, who had called the president a "moron," over the two men's respective IQs; and his Twitter -sniping with ESPN." The Washington Post (10/11, Paletta, Wagner , 10.38M) reports that the speech "came just one week before Senate Republicans must decide whether to pave the way for his tax plan." With Sen . Rand Paul "expected to oppose the budget resolution, as he has traditionally voted against any budget that doesn't eliminate the deficit," the Administration will need near-unanimity among other Senate Republica ns, or some Democratic support . The Hill (10/11, Fabian, Jagoda, 1.68M) reports that Sen. Bob Corker has also "pledged not to vote for a tax bill if it adds to the deficit." The Washington Times (10/11, Miller, 541 K) reports that the Pennsylvania venue was chosen "in part to put pressure" on Casey. Politico (10/11, Nussbaum , 3.6M) says the speech "did not include any sustained appeal to Democrats," but the New York Times (10/11, Baker, Subscription Publication, 13.56M) headlines its report "In Pennsylvania, Trump Hunts For Democratic Support For Tax Plan," writing that the President "took his campaign for tax cuts to another key battleground state on Wednesday in search of elusive Democratic votes" as he argued that the plan "would benefit middle-class Americans, like truck drivers, more than it would help his fellow business tycoons." Casey, however, posted dozens of tweets Wednesday that were critical of the plan. The Washington Examiner (10/11, Weaver, 465K) reports that Trump touted Rep. Lou /\MERICAi\ pVERSIGHT EXT-18-248-C-000343 Barletta (R-PA) , who is challengi ng Casey , saying, "He's going to w in. You're going to win big." The Los Angeles Times (10/11, Mascaro , Puzzanghera, 4.49M) reports that as the President "hit the road Wednesday to promote the plan, Republica ns in Congress were quietly discussing scaling back key provisions in an effort to deliver the top White House priority. There 's already talk that the cornerstone of the GOP proposal - a dramatically reduced 20% corporate tax rate that Trump has called a 'red line' - may slip to 22% or 23%," w ith Republicans reporting "resistance from lawmakers and lobbyists who want to preserve deductions and loopholes that were targeted for elimination " to offset "the massive corporate cut from the current 35% rate." House Republicans from Pennsylvania were on hand for the speech. Rep. Patrick Meehan (RPA) tweeted, "Pleased to be on hand for @POTUS speech on #TaxReform in PA - strong focus on what tax reform means for middle class & small business jobs". Rep. Lloyd Smucker (R-PA) tweeted , "Great to be in Harrisburg for #taxreform today . @realDonaldTrump is right: make tax code simple , honest, and fa ir for all Amer icans." USA Today (10/11 , Shannon , Lee, Machcinsk i, Long , Heisey, 8.62M) reports, "Before the event , a group of about 20 protesters had been parked in a private parking lot j ust outside the fencing of Harrisburg Internatio nal Airport." They "were asked by airport police to move their vehicles to a location about a half-mile from the staging area" and "moved their veh icles peacefully , but only two returned for when President Trump landed at the airport." Bloomberg News (10/11 , Olorunnipa , Epstein, 4 .52M) also reports on the speech . Trump: "It's A Massive Tax Cut." Trump said on Fox News' Hannity (10/ 11, 2.32M), "First of all, it's a massive tax cut. ... When we first introduced it, for yea rs they talked about tax reform. The problem with the word 'reform ,' nobody understands what it means. It could mean you raise taxes . This is the largest tax cut in the history of our country ." CEA Chairman: Trump Tax Cut Could Lift Wages By $4,000 Per Year. The Washington Free Beacon (10/ 11, Meyer, 158K) reports that Council of Economic Adv isers Chairman Kevin Hassett, speak ing at a Washington event on tax reform , said "a tax cut like the one President Trump is proposing cou ld potentially lift wages by about $4,000." Hassett said, "Over the last eight years the average real income growth was only about 0.6% per year. That's j ust not fast enough . ... What President Trump wants the team to do is come up with a plan that fixes that." Politico Analysis: Tax Cuts That Do Not Benefit Wealthiest Hard To Craft. Politico (10/11, Faler, 3.6M) reports that wh ile Trump "has promised that wealthy Americans won't get a massive tax cut as part of Republicans' plans to rewrite the tax code," that is hard to achieve, since "higher earners already shou lder most of the tax burden while average Americans pay a relatively small share of income taxes." That makes it "increasingly diff icult to cut taxes , particularly tax rates, without favoring the rich." Reuters ( 10/11, Becker , Morgan) reports that "about three-quarters of Amer icans say they believe the wealthiest people shou ld pay more in taxes , Reuters/lpsos polling shows ." The survey found that 53% of adults '"stro ngly agree' that the wealthiest America ns should pay higher tax rates," while another 23% "somewhat agree ." Cruz, Sanders To Debate Trump Tax Plan On CNN Next Week. CNN (10/11 , 33.59M) reports that Sens. Ted Cruz and Bernie Sanders will debate Trump 's efforts to overhaul the nation's tax code on CNN on October 18 at 9 pm ET. The debate will be moderated by Dana Bash and Jake Tapper . ADMINISTRATION OFFICIAL: LONG-TERM PUERTO RICO RECOVERY PLAN IS IN THE WORKS. Reuters (10/11, Rampton) reports that "an adm inistration official" said Wednesday that the federa l government is preparing a long-term plan to help Puerto Rico rebuild following Hurricane Maria. While the House "is set to consider on Thursday a $4.9 billion loan for Puerto /\MERICAi\ pVERSIGHT EXT-18-248-C-000344 Rico," the loan "is meant to be a short-term measure to help the island pay urgent bills." The Administration officia l said, "The Community Disaster Loan cannot and does not address the recovery , rebuilding, and future of Puerto Rico, which the administration intends to address with a more long-term solution in concert w ith the Puerto Rican government, oversight board, court and Congress." Eighty-Fo ur Percent Of Puerto Rico Still Without Power. The Wash ington Post (10/11 , RoigFranzia, Hernandez , 10.38M) reports that while life in San Juan "inches toward something that remotely resembles a new, uncomfortable form of normalcy," much of "the rest of the island lies in the chokehold of a turgid , frustrating and perilous slog toward recovery." According to the Governor's office, "eighty-four percent of the island is still without power," and "local officials in many areas are steeling themselves - with a sense of anger and dread - for six months or more without electricity ." Moreover , "half of Puerto Ricans have no work ing cellphone service, creating islands of isolation within the island and cutting off hundreds of thousands of people in regions outside the largest metropolitan areas from regular contact with their families , aid groups , medical care and the central government." Maria Devastates Puerto Rico's Rain Forest. The New York Times (10/11, Ferre-sadurnf , Subscr iption Publication , 13.56M) reports that Maria "obliterated " El Yunque Nationa l Forest, "the only tropical rain forest in the United States forest system." The forest "has been an enormous source of pride in Puerto Rico and one of the main dr ivers of the island's tourism industry." NBC Connects Family In US With Mother In Puerto Rico. NBC Nightly News (10/1 1, story 13, 1:35, Holt, 16.61 M) reported on a Connecticut could who have been unable to reach the husband 's mother in Puerto Rico. Correspondent Gutierrez said NBC let the mother use a satellite phone , add ing, "Tonight, this family is finally reconnected ." DHS: ONE SHIP TRAVELING TO PUERTO RICO UNDER JONES ACT WAIVER DELIVERING FEMA AID . McClatc hy (10/11 , Daugherty , 67K) reports that whi le DHS said that 14 ships notified the government under President Trump's Sept. 28 waiver of the Jones Act and "three have completed their journeys to Puerto Rico," only one "is delivering FEMA aid to the island." DHS spokesman David Lapan said , "Most humanitarian relief supplies are being delivered by US government (OHS, FEMA and DoD [Department of Defense]) assets, or Jones Act-qualified vessels ." HOUSE TO VOTE ON DISASTER AID BILL THURSDA Y. Reuters (10/11, Rampton) reports that the House Appropr iations Committee "has approved $36.5 billion in emergency funding for relief and recovery from the recent devastat ing hurricanes and wildfires." The measure "includes $7 billion more than the Wh ite House had sought last week and nearly $6 billion more for the Federal Emergency Management Agency than the admin istration's request." In addit ion, it "includes $576.6 million for wildfire efforts , $16 billion for the Nationa l Flood Insurance program and a provision enabling low-income Puerto Ricans to receive emergency nutrit ion assistance." The Washington Post (10/11 , Debonis , 10.38M) says the House is set to vote on the measure Thursday. Republican Study Comm ittee Chair: Congress Must Plan And Budget For Future Natural Crises. In a Wall Street Journal (10/ 11, Subscription Publication, 6.45M) op-ed , Republican Study Committee Chairman Mark Walker (R-NC) writes that as the United States endures natural emerge ncies, Congress should plan and budget for future crises instead of simply creating lastminute disaster relief bills. Walker argues that although Congress should provide relief for current victims, without establishing a rainy day fund for the future , Congress is worsening the country's debt problem. SAN JUAN MAYOR COMMENTS ON FEUD WITH TRUMP . USA Today (10/11, 8.62M) picked up a PRI story reporting that San Juan Mayor Carmen Yulin Cruz said of her public disagreement with President Trump, "I don 't give a sh*t." Cruz added , "This isn't about me or politics. I'm not /\MERICAi\ pVERSIGHT EXT-18-248-C-000345 going to be the face you see out there just giving you a box of food for the photo op. I'm the face of the person who is going to make sure somebody gets that to you .... So like the last scene of Gone With the Wind - 'Frankly my dear , I don't give a damn ."' While Cruz "says she doesn 't care about being called a nasty woman ," she "has a warn ing, too." She said, "If I were a Republican president ...and I never would be one ... l would be very worr ied. There is going to be an exodus of Puerto Ricans to the main land . And Puerto Ricans vote Democrat. Anywhere they go, they will change the politica l landscape ." TENTH CONSECUTIVE ATLANTIC HURRICANE FORMS FOR FIRST TIME SINCE 1893. The CBS Evening News (10/11, story 9, 0:15, Mason, 11.17M) reported that the hurricane season "broke a record today when Ophelia became the 10th consecutive hurricane to form in the Atlantic ," something that "hasn't happened since 1893." TRUMP: IF NFL HAD SUSPENDED KAEPERNICK, LEAGUE "WOULD NEVER HAVE HAD A PROBLEM." President Trump said on Fox News' Hannity (10/11, 2.32M), "I watched Colin Kaepernick [kneel during the national anthem] and I thought it was terrible. Then it got bigger and bigger and started mushrooming . And frankly, the NFL should have suspended him for one game and he would have never done it again. They could have then suspended him for two games. And they could have suspended him if he did it a third time for the season and you would have never had a problem. I will tell you, you cannot disrespect our country , our flag , our anthem. You cannot do that." The Wash ington Times (10/ 11, Boyer, 541 K) also reports on Trump's remarks. Politico (10/11, Nelson, Tamborr ino, 3.6M) reported that Trump tweeted earlier Wednesday "that 'it is about time ' the NFL insist that its players stand during the national anthem , lauding NFL Commissioner Roger Goodell for 'dema nding' such a rule be forthcoming - a characterizatio n the NFL promptly shut down ." Trump tweeted , "It is about time that Roger Goodell of the NFL is finally demanding that all players STAND for our great National Anthem-RESPECT OUR COUNTRY ." However, NFL spokesman Brian McCarthy said in a Wednesday statement, "Commentary this morning about the Commissioner 's position on the Anthem is not accurate. As we said yesterday, there w ill be a discussion of these issues at the owners meeting next week ." Politico added that in a Tuesday memo to NFL executives, Goodell wrote, "Like many of our fans, we believe that everyone should stand for the national anthem." The AP (10/11) reports that Trump's tweet was referring "to Goodell 's meetings next week with NFL owners , where they will consider changes to a game manual that says players 'should ' stand during the national anthem. That's a guidel ine that the league has left to the discretion of players who have kneeled in larger numbers after Trump's criticism." In add ition, Goodell "told club executives Tuesday in a memo ...that the anthem issue is dividing the league from its fans. He said the NFL needs to move past the controversy ." Player Says San Francisco 49ers Won't Be Forced To Stand For Anthem. The AP (10/11) reports that the San Francisco 49ers "won't be forc ing their players to stand during the national anthem, safety Eric Reid said Wednesday. Reid , the first player to jo in Colin Kaepern ick in protest last season, said he had a conversation recently with 49ers CEO Jed York , who indicated he will continue to support his players if they decide to kneel during the national anthem to protest social injustice . 'He's expressed very clearly that he wants to support us, that he's not going to force us to do anything ,' Reid said. 'Speaking for our team , that's what he's told me exp licitly."' CNN Analysis: NFL, ESPN Have Struggled In Responding To Trump Criticism. In an online analysis headlined "The NFL And ESPN Badly Misjudged Trump . Now They 're Paying The Price," Gregory Krieg wrote for CNN (10/ 11, Krieg, 33.59M) that it's becoming "clearer that the NFL and ESPN's attempts to appease Trump have failed. ESPN retreated on Monday , suspend ing SportsCenter host Jemele Hill, who has been crit ical of Trump on Twitter , following 'a second violation of our social media guidelines. "' Krieg said that "Trump may be badly hobb led in Washington , DC, but he is no less an astute manipulator of public opinion. The NFL and ESPN, like so many presidential candidates last year , reacted to Trump 's attacks with tactics draw n from /\MERICAi\ pVERSIGHT EXT-18-248-C-000346 a bygone era." NYTimes' The Upshot: NFL "Now Among The Nation's Most Divisive Brands." Writing in 'The Upshot" on the website of the New York Times (10/11, Quealy, Subscription Publication, 13.56M), Kevin Quea ly said, "About three weeks ago" - prior to Trump saying "that NFL owners should fire players who kneel during the national anthem - Democrats and Republicans held relatively similar views about the league ," with approximately 60% saying "they viewed it favorably" and approximately 20% saying "they viewed it unfavorably, according to daily online surveys conducted by Morning Consult." Now, however, "Trump voters are now much more likely to say that they view the NFL negatively , reflecting a sharp change around Sept. 23, when " he "criticized the players at a speech in Alabama. " Quea ly added, "The NFL is now among the nation's most divisive brands , behind Trump Hotels and a handfu l of media companies, including The New York Times. " Sharpton: In Suspending Hill, ESPN "Caved In To Pressure" From Trump. In a USA Today (10/11, Sharpton , 8.62M) op-ed, the Rev. Al Sharpton says, "On Monday , ESPN took the extreme measure of suspending host Jemele Hill for two weeks" because she exercised "her freedom of speech to make an analysis . While employers may have the right to dictate how their emp loyees behave in the workplace and on social media, it is clear that ESPN caved in to pressure pressure that came from the top." Sharpton says that Trump "has repeated ly put direct pressure on both ESPN and the NFL to force their players to stand for the anthem . ... It's maddening that the president can call for a boycott, or call players a 'son of a b----,' or call for private citizens to be fired , or tweet numerous th ings about the NFL, ESPN, Hill and athletes, and there are no consequences . But the moment a black woman speaks on the issue she is silenced ." TRUMP ANNOUNCES $1 MILLION IN FEDERAL FUNDS FOR LAS VEGAS LAW ENFORCEMENT. USA Today (10/11, Jackson, 8.62M) reports that the President and his aides said Wednesday that the federal government is giving $1 million to the Las Vegas "to help offset overtime costs related to the investigation of the mass shooting earlier this month." Trump wrote in a tweet, "Happy to announce we are awarding $1M to Las Vegas - in order to help local law enforcement working OT to respond to last Sunday 's tragedy. " A written statement from the Justice Department "said the money would come from emergency response funds with in the Bureau of Justice Assistance. " The statement said the funds "recognize the hard work and ded ication of law enforcement officers across Las Vegas and the State of Nevada, who worked tirelessly in the wake of the tragic shooting last week." Trump Postpones Las Vegas Fundraiser. Politico (10/11, lsenstadt , 3.6M) reports that the President has postponed a Las Vegas fundraiser that had been planned for Oct. 21. Organizers have not determined a new date for the event wh ich "was intended to benefit Trump's reelection campaign and the Republican National Committee. " Police Revise Timeline Of Las Vegas Shooting, Have Not Identified A Motive. NBC Nightly News (10/11, story 6, 1:35, Holt, 16.61 M) reported that the Las Vegas gunman fired the first shots "at two employees" inside the hotel. NBC (Williams) added that six minutes before Stephen Paddock fired on the concert "a hotel security guard responding to an alarm on the 32nd floor was wounded when Paddock" through his door . A "hotel engineer had j ust arrived when he heard gunfire. " Stephen Schuck , Hotel Engineer: "I was about a third of the way down the hallway, and I started to hear shots go off." Williams added that Schuck made a radio call saying someone was shooting and police "are looking at when that word was received from the hotel , and whether it could have been relayed faster to the SAT team , making its way to the 32nd floor." Brian Ross reported on ABC World News Tonight (10/ 11, story 5, 2:05, Muir, 14.63M) that the revised police timeline says "it was about six minutes" after Paddock shot through the door that he "began to fire on the concert crowd. " A "person who has reviewed the records tells ABC News hotel secur ity did not call the police until after the rampage was already under way ." However, MGM , the owner of the hotel, "says the recent time line from police may not be accurate. " /\MERICAi\ pVERSIGHT EXT-18-248-C-000347 The CBS Evening News (10/11, story 3, 2:00, Mason, 11.17M) reported that Clark County Sheriff Joseph Lombardo "said police have yet to find a motive for the attack." TRUMP TOUTS $5.2 TRILLION STOCK MARKET GAIN. President Trump said on Fox News' Hannity (10/11, 2.32M), "I'm so proud of the $5.2 trillion of increase in the stock market. If you look at the stock market, that's one element but then we have many other elements. The country, we took it over in the last eight years they borrowed more than it did in the whole history of our country. So they borrowed more than $10 trillion. Right? We picked up $5.2 trillion just in the stock market. Possibly picked up the whole thing in terms of the first nine months, in terms of value. You can say in one sense, we are really increasing values and maybe in one sense, we are reducing debt." TRUMP TO MEET WITH ECONOMIST, FED HOPEFUL JOHN TAYLOR THIS WEEK. Bloomberg News (10/11, Jacobs , Torres, 4.52M) reports President Trump is set to meet this week with Stanford economist John Taylor, according to "three people familiar with the matter." Taylor "is on the shortlist of people under consideration to be the next chairman of the Federal Reserve." The sources "were unsure when the meeting was to take place." Economists Say Kevin Warsh Most Likely Nominee . The Wall Street Journal ( 10/11, Torry, Subscription Publication , 6.45M) reports that a Journal survey of business and academic economists found that former Fed governor Kevin Warsh is viewed as the most likely to be nominated by President Trump as the next Fed Chairman. Economists placed a 28 percent probability that Warsh would be tapped - beating out current Fed Chair Janet Yellen at 22 percent and Fed governor Jerome Powell at 21 percent. Fed Expects December Rate High Despite Concerns About Low Inflation. CNBC (10/11, Cox , 3.48M) reports Federal Reserve officials plan a the benchmark interest rate increase in December and anticipate an expanding economy, "despite some divisions over where inflation is headed," according to minutes from September's Federal Open Market Committee meeting. Despite low inflation readings, confidence "remained fairly high that the 2% target is likely to be hit not too far into the future." The New York Times (10/11, Appelbaum, Subscription Publication, 13.56M) reports that although concerns about low inflation "was the dominant topic" at September 's FOMC meeting, "most officials" were inclined to raise the rate later in the year, so long as medium-term economic outlook remains unchanged. Minutes also indicate the Fed expects slower economic growth for a few months, but "does not expect a long-term effect." DEMOCRAT GREEN PULLS BACK FROM FORCING HOUSE VOTE ON TRUMP IMPEACHMENT. The Washington Post (10/11, Debonis, 10.38M) reports that Rep. Al Green (DTX) "stopped just short of forcing a House vote on President Trump's impeachment Wednesday , pulling back under apparent pressure from his own party." The Democrat "read his impeachment resolution on the House floor Wednesday afternoon , bringing it up under rules that would force a rapid vote. But when, less than an hour later, the House's presiding officer called the resolution up for action, Green did not appear on the floor to offer it." The Post adds, "According to multiple House Democratic aides, party leaders had prevailed upon Green not to offer the resolution and thus force his colleagues to cast a potentially troublesome vote." The Hill (10/11, Marcos, 1.68M) reported, "The four articles of impeachment unveiled by Green say Trump has 'has undermined the integrity of his office with impunity' and 'brought disrepute on the presidency,' but do not argue that the president has committed a crime. Instead, the articles state that Trump is 'fueling an alt-right hate machine' that is 'causing immediate injury to Amer ican society;' brought 'shame and dishonor to the office of the presidency by associating the majesty and dignity of the presidency with causes rooted in white supremacy;' engaged in dece it by making the false claim that three to five million people voted illegally in the 2016 presidential election; and encouraged police brutality during a July speech to law enforcement." /\MERICAi\ pVERSIGHT EXT-18-248-C-000348 LONGTIME TRUMP FRIEND "SHOCKED" AND "STUNNED" BY PRESIDENT'S RHETORIC AND TWEETS. The Washington Post (10/11 , Kranish , 10.38M) has a 4,000-word front-page feature on Thomas Barrack Jr ., "a billionaire who is one of President Trump's oldest friends ." The Post says that "few people are closer to Trump than Barrack, his friend for three decades." He "helped rescue Trump 's real estate empire years ago," raised money for Trump's campa ign, and "turned down a Cabinet offer , preferring to be an outside adviser, although his name is still mentioned as a potential White House chief of staff should Trump dec ide to choose a new one." But he told the Post that he "has been 'shocked' and 'stunned' by some of the president's rhetoric and inflammatory tweets," and "wonders why his longt ime friend spends so much of his time appealing to the fringes of American politics" by promoting immigrat ion restrict ions from Muslim nations and a US-Mexico border wall. TRUMP: DEMOCRATS USED RUSSIA AS "AN EXCUSE" AFTER LOSING ELECTION. President Trump said Wednesday on Fox News' Hannity (10/11, 2.32M), "Russia was an excuse used by the Democrats when they lost the election. They lost the election and they sat in a room and they said, 'Wow, we look bad.' The morning after, in fact it's been written about I guess in various books or a book, but they said , 'Why did you lose the election?' And they said , 'Oh , it was Russia.' It wasn't Russia. It was a bad candidate ... . Now, with all of that being said, they said Russia. And then they say, 'Oh, it was Trump that colluded with Russia.' I'm saying , 'I did?' ... This was an excuse by the Democrats . ... It was an excuse for losing an election that frankly they should have won because w inning the electoral college is so easy for Democrats ." House Intel Panel Asks Trump Campaign Data Firm For Information In Russia Probe. In an "exclusive," the Daily Beast (10/11, Woodruff , Ackerman, 988K) reported , "A data firm backed by some of Donald Trump's closest allies is now facing scrutiny as part of an investigation into possible collusion between the president's team and Russian operat ives ." Citing "sources fam iliar with the probe," the Daily Beast said that the House Permanent Select Committee on Intelligence (HPSCI) "is looking at Cambridge Analytica's work for ...Trump's campaign as part of its investigation into Russian efforts to meddle in the 2016 race." The firm "is in the process of turning over documents to HPSCI , according to a source famil iar with the committee's work. Another source close to the invest igation said that the probe's focus on Cambridge Ana lytica is 'fru itfu I."' The Hill (10/11, Chalfant, 1.68M) reported, "A spokesman for the data mining firm confirmed " on Wednesday "that Cambr idge Analyt ica 'has been asked by the House Intelligence Comm ittee to provide it with information that might help its investigation. "' However , said The Hill, a spokesperson for the firm "refuted the notion that the company itself is under investigat ion, describing the [Daily Beast] report as having 'significant inaccuracies."' The spokesperson is quoted as saying, "[Cambridge Analytica] is not under invest igation , and there is no suggestion of any wrongdoing by the company ." In Court Filing, Fusion GPS Says It Didn't Give Trump Dossier To BuzzFeed. The Daily Caller (10/11, Ross, 521 K) reported, "In a surprise twist, oppos ition research firm Fusion GPS says that it did not give its dossier of infamous anti-Trump research to BuzzFeed News prior to the outlet's Jan . 10 publication of the salacious document. That revelat ion, made in court papers filed by Fusion GPS' lawyers in a Washington , D.C., federal court Tuesday, re-opens the issue of who provided the dossier to BuzzFeed .'' The Daily Caller added, "Fusion GPS made the disclosure in a motion to quash a request for discovery made by Aleksej Gubarev , a Russia n tech executive who is suing BuzzFeed for defamation " after having been "identified in a Dec. 13 memo contained in the dossier , which was written by former British spy Christopher Steele .. .. 'Fusion did not create or author the December Memo, and did not give it to Buzzfeed ,' reads its latest court filing ." Trio Of Congressional Committees "Scuffling" Over Dossier. Reuters (10/ 10, Hosenball, Landay) reported, "Three congressional committees are scuffling over" the dossier , "people /\MERICAi\ pVERSIGHT EXT-18-248-C-000349 involved in the inquiries said." Reuters added, "The Senate Intelligence Committee and special counsel Robert Mueller are looking into possible collusion between Russia and Trump 's campaign and Mueller's investigators have met with Stee le," who assembled the doss ier. At the same time , "the Repub lican chairmen of the House Intelligence and Senate Judiciary committees are challenging the doss ier's credibil ity and one has implied that Russians may have played a role in its preparat ion, sources famil iar with the inquiries said." Assange Disputes Rohrabacher's Remarks On Possible Deal. The Daily Caller (10/ 11, Pfeiffer , 521 K) reported that Wikileaks founder Jul ian Assange is disputing Rep. Dana Rohrabacher's (R-CA) remarks "that Assange would give up the source behind a release of Democratic National Comm ittee emails in 2016. Assange 's tweeted his dispute Tuesday and Wednesday following a story from The Daily Caller about a potential deal between him and the Amer ican government." Assange is quoted as tweeting, "Disgraceful report ing. Wikileaks never has and never w ill reveal a source . Offers have been made to me - not the other way around. I do not speak to the public through third parties." The Daily Caller article Assange was responding to was "about Rohrabacher meeting with Sen. Rand Paul to discuss letting President Donald Trump know about a potentia l deal with Assange. " The Wash ington Times (10/11 , Blake, 541 K) reports on the Daily Caller article that drew Assange's response. House Intelligence Panel Planning To Release Russian-Backed Facebook Ads. The Washi ngton Post (10/11 , Demirjian , 10.38M) reports that the House Intelligence Committee "plans to release a trove of Russian-backed Facebook ads from the 2016 election season after officials from Facebook and two other tech giants testify publicly in November . The leaders of the committee 's Russia probe, Rep. K. Michae l Conaway (R-Tex .) and committee ranking member Adam B. Schiff (D-Calif .), to ld reporters Wednesday that they would move 'as quick as we can' to release the advert isements to the public ." The Post adds , "Facebook identified more than 3,000 advertisements purchased in a Russian-orchestrated campa ign to exploit divisions around issues such as race, as well as mislead the American public in the run-up to the 2016 elections." WSJournal A 1: Russia Converted Kaspersky Software Into Espionage Tool. On its front page , the Wall Street Journal (10/11, A 1, Harris, Lu bold, Subscription Publication, 6.45M) reports that Russia's government used Kaspersky antivirus software to surrept itiously scan computers around the globe for classified US government records and top-secret informat ion, adjust ing the program to turn it into a tool for spying, according to current and ex-US officials familiar with the matter. The Journal says that software is produced by Kaspersky Lab , which is based in Moscow. Politico Analysis: Senate Democrats Fret Russia Could Damage Their Reelection Bids. Politico (10/11, Cheney, Schor , Bennett, 3.6M) reported that Senate Democrats facing reelection in 2018 "are increasi ngly worried about a troubling reality: Russia appears set to mess with US elections - again. The bipart isan leaders of the Senate Intelligence Committee warned last week that Russia's second stra ight attempt to upend a major election appears certain." Politico added that lawmakers such as Sens. Bob Casey (D-PA), Heidi Heitkamp (D-ND), and Jon Tester (DMT) , "who hail from states President Donald Trump won in 2016", worry that "the Trump administration is dragging its feet on thwarting sophisticated Russian cyber operat ions that could have significant impact on their races - and could even sway which party wins control of the Senate ." DEMOCRATIC SENATORS TELL SESSIONS THEY WANT ANSWERS ON TRUMP CONVERSATIONS . Politico (10/11 , Gerstein , 3.6M) reports that Democrat ic senators are warning Atto rney General Sessions "that when he appears before the Senate Judiciary Committee next week he should deta il his conversations with Donald Trump or else announce that the president is invoking executive privilege to protect those communicat ions." Accordi ng to Politico , all nine committee Democrats sent Sessions a letter on Wednesday "noting that during his June appeara nce at the Senate Intelligence Committee he repeated ly declined to answer such questions , saying the president had the right to decide whether to assert execut ive privilege over the discussions, " and saying "that kind of deferral won't fly this time. 'We expect that when /\MERICAi\ pVERSIGHT EXT-18-248-C-000350 you appear before the Senate Judiciary Committee on October 18th, you will have determ ined whether the president will invoke executive privilege as to specific topics and will be prepared to answer completely all questions in those areas on which he has not,"' the lawmakers wrote . AFTER WHITE HOUSE BEMOANS CONGRESSIONAL BREAKS, HOUSE VOTES TO LEAVE EARLY FOR VACATION. The Washington Examiner (10/11, Wegmann , 465K) reported , "On Tuesday , the White House complained that Congress was tak ing too many vacations," with press secretary Sarah Sanders saying "from the podium that the nation would be 'a lot better off if the Senate would stop taking vacations and start staying here until we actually get some real th ings accomplished.' But either lawmakers weren't listening or they just don't care what the Trump White House has to say. On Wednesday , the House voted to cancel Friday votes and skip town Thursday afternoon to get a head start on their next weeklong vacation ." MCCONNELL SAYS HE'LL MOVE FORWARD ON JUDGES WITHOUT DEMOCRATIC "BLUE SLIPS." Roll Call (10/11, Lesniewski , 134K) reports that Senate Majority Leader McConnell has "confirmed he plans to move forward on j udicial nominees even if home-state Democratic senators don't return the so-called 'blue slips' to the Judiciary Committee .'' The tradition has been "for the Judiciary Committee not to consider lifetime appo intments to the federal bench without the acquiescence of the delegation , regardless of party.'' The Washington Times (10/11, Swoyer, 541 K) says Senate Minority Leader Schumer on Wednesday "put pressure" on Senate Judiciary Committee Chairman Grassley to retain the "blue slip" process. A Wall Street Journal (10/11, Subscription Publication, 6.45M) editor ial praises McConnell 's move , argui ng Schumer is using the process , which is a courtesy, for political purposes . LEADERS OF CONSERVATIVE GROUPS CALL FOR MCCONNELL, HIS DEPUTIES TO RESIGN. The Washing ton Post (10/11, Sullivan , 10.38M) reports that a collection "of conservative activists who have long clashed" with congress ional Republican leaders called Wednesday for Senate Maj ority Leader McConnell "and his top deputies to step down ." In a letter to McConnell and at a jo int news conference , "the activists vented frustration with the Senate's lack of major legislat ive accompl ishments this year, including their failure to undo the Affordable Care Act. ' It is time for you and your leadership team to step aside , for new leadership that is committed to the promises made to the American people ,' says the letter, which is signed by six activists ." The Post lists the activists as Media Research Center President Brent Bozell; Senate Conservatives Fund President Ken Cuccinelli; Tea Party Patriots co-founder Jenny Beth Martin; FreedomWorks President Adam Brandon ; For America President David Bozell ; and ConservativeHQ.com chief Richard Viguerie. Politico (10/11, Kim, 3.6M) reported that at Wednesday's news conference, Cuccinelli said , "This pattern of fai lure from McConnell's gang of five leadership team whi le loathing and attack ing their own base , the most loyal bloc of voters that has elected them and all of their caucus members , can no longer be tolerated ." Politico quoted the activists as writ ing in their letter to McConnell, "You have done nothing. You have promised tax reform. You have done nothing. You don 't even show up for work.'' Breitbart (10/11, Moran, 2.42M) reported, "The grassroots conservative leaders chastised the members of Senate leadership ," arguing they "should resign to make way for more effective lawmakers who will enact the president's populist agenda .'' The New York Times (10/11 , Peters, Subscription Publication , 13.56M) reports that McConnell "was an ever-present boogeyman in" last month's GOP Senate primary runoff in Alabama, where Roy Moore unseated appointed Sen . Luther Strange , "a McConnell ally ." The Times says that a "faction conservative activ ists," among them Steve Bannon , "now hopes to replicate that kind of grassroots-fueled victory across the country" in primaries aga inst GOP Senate incumbents. KUSHNER REPORTEDLY SENT APPROVING TEXT AFTER BANNON "DECLARE[D] WAR" ON GOP SENATORS. Politico (10/ 11, Karni, 3.6M) reported that after Steve Bannon's Monday appearance on Fox News, where he "declare[d] war on" GOP senators "and call[ed] for'' the /\MERICAi\ pVERSIGHT EXT-18-248-C-000351 resignation of Sen. Bob Corker (R-TN), the former White House strategist "received a text from an unlikely fan: Jared Kushner ," who messaged "to say he thought the TV hit was a success, according to multiple people who were eating with Bannon at" the time . Politico said the message "was surprising on multiple fronts. For one, Bannon associates and White House officials said Kushner hasn't reached out to Bannon since he was ousted from his White House post in August. But even stranger was that" those dining with Bannon, including "conservative media personalities , thought Kushner was belatedly endorsing an anti-establishment strategy that has many Republicans concerned about losing control of the Senate all together." Gingrich: Bannon's Targeting Of GOP Senators In 2018 "Stunningly Stupid." The Hill (10/11, Concha, 1.68M) reported that during a Tuesday appearance on Sean Hannity's radio program, Newt Gingrich said that Bannon 's "strategy for creating a civil war inside the Republican party is 'stunningly stupid."' Of Bannon's declaration to back primary challengers to nearly every GOP senator, Gingrich said that there are "10 Democrats up next year in states Trump carried. You have six Democrats up next year in states Trump carried by a huge margin. Now you take the amount of money Bannon is going to raise. If he spent that money in North Dakota, Montana , Indiana , Missouri, West Virginia [where Democrats face reelection in 2018] - the fact is you would have such a big Republican majority, you'd pass the stuff you guys want to pass." Gingrich added , "Creating a civil war inside the Republican Party may feel good, but I think as a strategy, it is stunningly stupid." McClatchy Analysis: GOP Candidates Aggressively Seeking Bannon's Endorsement. McClatchy (10/10, Glueck, 67K) reports, "The Steve Bannon primary is on - and it's playing out at every level of government, " with leading GOP "Senate recruits ...wooing him by phone , and candidates for state legislature ...cornering him at political rallies. Primary rivals are openly jockeying for the support of his network , and insurgent Republican hopefuls text him, dine with him and traipse to his Washington townhouse in the hopes of securing his blessing ." McClatchy adds that in the wake of Bannon-backed Roy Moore's (R-AL) win last month in Alabama's Republican Senate runoff, Bannon "is suddenly at the center of GOP races across the board, heavily involved in boosting a slate of Senate challengers as candidates up and down the ballot try to land his support." McClatchy adds that Bannon is also endorsing gubernatorial and House candidates. Bannon-Aligned Group Endorses Three GOP Senate Hopefuls. The Hill (10/11, Easley, 1.68M) reported, "A pro-Trump outside group aligned with ...Bannon endorsed three Republicans running for Senate on Wednesday, firing the starting pistol on what's shaping up to be a nasty primary season for the GOP. The Great America Alliance - an antiestablishment group which counts Bannon 's political adviser Andy Surabian as a strategist " - endorsed Rep. Marsha Blackburn (R), who is bidding to succeed retiring Sen. Bob Corker (R-TN); state Attorney General Patrick Morrisey (R-WV), who is seeking to take on Sen. Joe Manchin (D-WV); and state Auditor Matt Rosendale (R-MT), who is challenging Sen. Jon Tester (D-MT) . All three Republicans face primary battles. Robert Kagan writes in the Washington Post (10/11, 10.38M) that the GOP deserves the "destruction" it "may be about to suffer at the hands" of Bannon. Kagan argues that whether or not a "thorough ly Trumpist Republican Party won't be able to defeat a Democratic Party apparently bent on nominating unelectable candidates on the left," Bannon and Trump "undoubtedly believe it is more important to turn the party into Trump's personal vehicle, to drive out the resisters, the finger-waggers, the losers, the proud scions of the responsib le establishment who could not stop Trump and apparently cannot legislate their way out of a paper bag." TRUMP TO SPEAK AT VALUES VOTER SUMMIT ON FRIDAY. The Washington Times (10/11, Harper, 541 K) reports, "President Trump remains faithful to the faith-minded , values-attuned voters who showed up by the millions to elect him in 2016 ... Multiple surveys from the Pew Research Center and other pollsters reveal that up to 81 percent of values voters staunchly stand /\MERICAi\ pVERSIGHT EXT-18-248-C-000352 by the president." Trump, "in turn, has cleared his crowded schedule to spend some time with them," planning to address the Values Voters Summit on Friday. FEDERAL COURT UPHOLDS CONGRESSIONAL PRAYER. The Washington Times (10/11, Swoyer, 541 K) reports that the US District Court for the District of Columbia ruled Wednesday that Congress can continue to open its sessions with prayer and that the House can continue to select who leads the prayer. House Speaker Ryan praised the ruling, saying, "Since the first session of the Continental Congress, our nation's legislature has opened with a prayer to God. Today , that tradition was upheld and the freedom to exercise religion was vindicated." GROUP OF EX-OBAMA LAWYERS FILES INJUNCTION AGAINST TRUMP VOTER COMMISSION. McClatchy (10/11 , Roarty , 67K) reports, "A group of former Obama Administration lawyers on Wednesday moved for a temporary injunction against President Donald Trump's voting fraud commission, saying the committee caused an 'immediate blow to the proper functioning of our democracy' when it requested voter data from all 50 states without following legally mandated procedures. The motion, filed in US District Court in Washington, DC, by Protect Democracy Project and United to Protect Democracy , cited reports of people withdrawing their voter registration in response to the Trump commission's request for information - proof, the motion argues, that the court should stop the Trump group from collecting the data now before it does more harm. The motion also argues that the requests 'may increase the vulnerability of voter registration systems to hackers' and, contrary to federal law, gives Protect Democracy insufficient time to respond and mobilize the public to its actions ." FBI OPENS INVESTIGATION INTO WEINSTEIN. The Daily Mail (10/11, Parry, 5.15M) reports that the FBI "has opened an investigation into Harvey Weinstein ." The probe comes at the behest of the Department of Justice ...which instructed the bureau to investigate the mounting allegations leveled at the movie mogul." The DC adds that it is unknown whether the DOJ order came directly from [Attorney General] Sessions," but "the move is likely to be seen in a political light given Weinstein's friendship with Trump foe Hillary Clinton." The DC also reports that the move "came amid rumors that Weinstein plans to head to Europe for sex rehab - leading to fears of a Roman Polanski-style situation where he dodges prosecution in the U.S." In an op-ed for the Daily Caller (10/11, Ingersoll, 521 K) posted before the DOJ probe was announced, editor in chief Geoffrey Ingersol l wrote that Trump and Sessions "will be derelict in their duties if they do not launch a full investigation." Trump Ingersoll wrote, "can give voice to the voiceless. He can give victims the opportunity to shake the shackles of Hollywood exploitation." Anne Thompson reported on NBC Nightly News (10/11, story 5, 2:05, Holt, 16.61 M) that more than 20 women are now accusing Weinstein "of some kind of sexual misconduct." NBC highlights the story of one woman, actress Dawn Dunning, and says the allegations are "making Weinstein a pariah in the business he loves." Linsey Davis reported on ABC World News Tonight (10/11, story 4, 2:55, Muir, 14.63M) that authorities are facing questions "about why Weinstein was not prosecuted after" a "secretly recorded audio during a 2015 NYPD sting operation." The Manhattan DA "defended its decision not to prosecute ." Manhattan DA Cyrus Vance, Jr.: "Obviously, he has some serious issues, and the tape is terrible. But I as DA have to be guided by the evidence and the elements of the crime ." The New York Times (10/11, McKinley, Subscription Publication, 13.56M) reports that Vance "defended his decision" not to prosecute Weinstein, saying his office lacked sufficient evidence to prosecute. Vance said, "Our best lawyers looked at the case .... I, like they , was very disturbed by the contents of the tape . It's obviously sickening. But at the end of the day we operate in a courtroom of law, not the court of public opinion, and our sex crime prosecutors made a determination that this was not going to be a provable case." Jericka Dunce reported on The CBS Evening News (10/11, story 5, 2:30, Mason, 11.17M) that while "alleged assaults happened" in the Los Angeles Area, the Los Angeles County district attorney's office and the LAPD "say they have no record of any reports filed against Weinstein." /\MERICAi\ pVERSIGHT EXT-18-248-C-000353 In an editorial, the Washington Post (10/11, 10.38M) says that while "the details of Mr. Weinstein's actions are grotesque enough ," the "fact that his systematic abuse of power seems to have been an open secret" is "just as shocking." The Post laments the "complicity" that "protects many Harvey Weinsteins in many industries," and says the stories from Weinstein's alleged victims "make clear the crucial role that those in positions of responsibility must play by denouncing misconduct when they see it and demanding accountability, rather than remaining quietly complicit." Republicans Seek To Exploit Weinstein's Donations To Democrats . Politico (10/11, Debenedetti, 3.6M) reports that while "leading Democrats hope they've done enough to wash their hands of politically uncomfortable ties to Harvey Weinstein," Republicans "aren't letting go just yet." Each "high-profile Democrat to receive money from Weinstein" has "made plans to direct it elsewhere, aside from recent retirees like former President Barack Obama and former Secretary of State Hillary Clinton - who still denounced him." However , the DNC stopped short of promising a full giveaway." While the DNC "pledged 'over $30,000' of Weinstein donations to political groups that work to elect women, the committee "had raised over $300,000 from Weinstein, a fact Republicans have been quick to exploit." POLITICO New York (10/11, Vielkind) reports that New York Gov, Andrew Cuomo is keeping some of the campaign cash he received from Weinstein, "renewing criticism from Republicans and setting himself apart from other politicians who benefited from the film producer's largesse ." Cuomo "raised $110,400 from Weinstein or his company since 1999," but his campaign "said it would donate $50,000 to an unspecified women's charity." The decision drew fire from the Republican State Committee whose spokeswoman Jessica Proud said, "In the dictionary next to the word 'hypocrisy' is a picture of Andrew Cuomo . ... Democrats across the country have had the sense to give the money back, but not Governor Cuomo. What kind of message does it send to women and victims that despite everything we know about the abuse Harvey Weinstein inflicted on them, he still won't let go of his $60,000? His actions speak volumes." Conway : Clinton A "Hypocrite About Women's Empowerment ." Presidential counselor Kellyanne Conway was asked on Fox News' America 's Newsroom (10/11, 1.71M) about her criticism of Hillary Clinton for taking so long to make a statement about the allegations facing Weinstein. Conway said, "I felt like a woman who ran to be commander-in-chief and President of the United States who talks about women's empowerment took an awfully long time to give support to those women who were coming forward and has still as far as we know kept the money, kept the dirty money that dirty Harvey has given her in her campaign." Asked if Clinton returning the money would "make it better for you ," Conway said, "No. First of all she doesn't need to mollify me. She need to not be a hypocrite about women's empowerment." Bannon Was Once In Business With Weinstein. The AP (10/11, Werner) reports that former White House chief strategist Steve Bannon "profited off a relationship with the movie mogul, in an ill-fated joint venture more than a decade ago." In 2005 , Bannon "served as chairman of a small company that distributed DVDs and home videos, and went into business ...with The Weinstein Co., led by Harvey Weinstein and his brother Bob," who "became 70 percent owners of the now defunct venture, Genius Products ." The AP adds that the link opens Bannon "to charges of hypocrisy given Breitbart's intense focus on the scandal and its political fallout." Farrow Says He Took Weinstein Story To New Yorker When NBC Dragged Its Feet. The New York Times (10/11, Koblin, Subscription Publication , 13.56M) reports that on Wednesday "the media and entertainment industries were still discussing how and why [Ronan] Farrow 's story on allegations of sexual abuse levied against the film mogul Harvey Weinstein by numerous women had ended up being published by The New Yorker- after it began as an investigative report for NBC News." Farrow, a former NBC News contributor to ld MSNBC's Rache Maddow "he had taken his investigation to The New Yorker only after the network dragged its feet," but NBC News president Noah Oppenheim "disputed the suggestion that the network 's news division had /\MERICAi\ pVERSIGHT EXT-18-248-C-000354 lacked the courage to air Mr. Farrow's expose ." WPOST A1: PRIVATE DEAL GUARANTEED MOORE $180K ANNUALLY FOR PART-TIME WORK AT CHARITY. The Wash ington Post (10/11 , A1, Boburg, O'Harrow Jr ., 10.38M) reports on its front page that Roy Moore (R-AL), who is battling ex-US Attorney Doug Jones (D) in the Dec . 12 Alabama specia l Senate election, previously stated "that he did not take a 'regular salary ' from the small charity he founded to promote Chr istian values because he did not want to be a financial burden . But privately , Moore had arranged to receive a salary of $180,000 a year for part-time work at the Foundation for Moral Law, internal charity documents show ," collecting over "$1 million as president from 2007 to 2012 , compensation that far surpassed what the group disclosed in its public tax filings most of those years. When the charity couldn 't afford the full amount, Moore in 2012 was given a promissory note for back pay eventually worth $540,000 or an equal stake of the charity's most valuable asset, a historic building in Montgomery, Ala. , mortgage records show." OBAMA TO STUMP FOR NORTHAM IN RICHMOND ON OCT. 19. The AP (10/11, Suderman) reports that former President Barack Obama "is set to return to the campaign trail for the first time since he left office with a rally" in support of Lt. Gov. Ralph Northam (D-VA) , who is battling exRNC chief Ed Gillesp ie (R) in this fall's "closely watched race" to succeed term-l imited Gov. Terry McAuliffe (D-VA) . According to the Northam camp, "the lieutenant governor and Obama will appear together at an event in Richmond on Oct. 19. The focus of the rally will be 'the need for the next governor to create economic opportunity for all Virginians,' according to Northam's campaign ." The Washington Post (10/11 , Nirappil , 10 .38M) reports that Obama 's "foray into the" contest "could inject energy into what has been a relatively sleepy race . A recent Washington Post-Schar School poll found fewer peop le were closely watching the contest than at the same point in 2013 , despite the fact that the major parties view the contest as test of politics in the era of President Trump. " Politico (10/ 11, Robillard, 3.6M) reported that Obama's "long-planned entrance into the contest comes as the race is drawing more national attention ,'' with Trump having "recently" backed "Gillespie, and Vice President Mike Pence" prepared "to campaign for Gillesp ie on Saturday in the state 's southwest, while former Vice Pres ident Joe Biden will campaign in the state 's Democratic-leaning D.C. suburbs on the same day." Under the headline "Virginia Governor Race Gets Hot As Obama, Bush Face Off ," Breitbart (10/11 , Moran, 2.42M) reported on Obama's slated appearance in support of Northam , and added that former President George W . Bush "will head line fundraisers for Gillesp ie in Richmond and Alexandr ia on October 16." The Wall Street Journal (10/11, Hook, Subscription Publ ication , 6.45M) also reports on Obama's planned rally for Northam. Gillespie Says He Would Bar Sanctuary Cities From Being Established In Virginia, If Elected. The Washington Times (10/11, Persons, 541 K) reports that during a Wednesday appearance on Fox News, Gillespie said "that he will not allow sanctuary cities to be established in Virginia if he's elected governor." Referring to Northam, Gillespie said, "The point I made to my opponent, the lieutenant governor, who voted aga inst a ban on sa nctuary cities , and in [Monday 's] debate , would not say that he wou ld ban them even if they were established here in the commonwea lth - I want to prevent them from ever being established ." THE HILL: RETIREMENTS COMPLICATING DEMOCRATS' EFFORT TO RECLAIM HOUSE . The Hill (10/11, Kam isar, 1.68M) reported , "Retirements from House Democrats are complicat ing the Democratic push to retake the majority next year." The Hill sa id that NH1 Rep. Carol SheaPorter 's (D) recent announcement that she won 't seek "ree lection means Democrats w ill soon face three vacancies in Democratic-held districts that President Trump carried last year. " The others are the distr icts of NV3 Rep. Jack Rosen (D), who is challenging Sen. Dean Heller (R), and MN1 Rep. Tim Wa lz (D), who is runn ing for governor. The Hill added, "Democrats are still confident that Pres ident Trump 's low approval ratings and voter discontent with a Repub lican /\MERICAi\ pVERSIGHT EXT-18-248-C-000355 Congress will lead to more Republican retirements and help them expand the map." However, "with Democrats hoping for the net gain of 24 seats that would hand them the majority, retirements on their own side are complicating the midterm picture." CRUZ EDGES DEMOCRAT O'ROURKE IN Q3 FUNDRAISING, HOLDS LARGE CASH ADVANTAGE. The Dallas Morning News (10/11, Kelly, 984K) reports that Rep. Beto O'Rourke (D-TX), who is mounting a 2018 bid to unseat Sen. Ted Cruz (R-TX), "raised $1.7 million in the" third quarter of th is year. However, Cruz "kept a step ahead, raising $2 million" during the same period. The figure "marks a slight drop from O'Rourke's tally for the previous quarter, when he out-raised Cruz, $2.1 million to $1.6 million." Cruz "still has more than $6.3 million in the bank, up from $5.7 million, his campaign said. O'Rourke aides say he has about $2.8 million." The Texas Tribune (10/11, Svitek, 13K) also reports on the candidates' fundra ising numbers. Ingraham Says "Good-Old-Boy Type" Asked Her To Primary Cruz. The Washington Examiner (10/11, Lim, 465K) reports that in her new book, Fox News commentator Laura Ingraham writes that "she was asked at the 2016 Republican National Convention to challenge [Cruz] in his next primary." Ingraham is quoted as writing in her book, "People were so torched by Cruz's failure to endorse [President] Trump that talk of primarying him ignited almost the moment he walked off the stage. In fact, a tanned, good-old-boy type in his late 40s approached me and asked me if I'd consider moving to Texas to run against him." FLAKE PRIMARY FOE WARD RAISES $690K IN Q3. In an "exclusive," The Hill (10/11, Easley, 1.68M) reported that ex-state Sen. Kelli Ward (R-AZ), who is mounting a 2018 primary challenge to Sen. Jeff Flake (R-AZ), "raised $690,000 in the third quarter of 2017, nearly doubling the amount she had raised in the first six months of the year." Ward "has raised $1.047 million so far in 2017. Her cash reserves bounced from $83,000 at the end of the second quarter to over $250,000 presently ." GOP MONTANA SENATE HOPEFUL ROSENDALE RAISES OVER $400K IN TWO MONTHS. The Hill (10/11, Kamisar, 1.68M) reported that state auditor Matt Rosendale (R-MT), who is seeking to take on Sen. Jon Tester (D-MT) in 2018, "raised about $410,000 in the third fundraising quarter" of this year. Because Rosendale "announced his bid at the end of July, he only had two of [the] three months" in 03 to raise cash. The Hill added, "Most Montana Republica ns consider Rosendale the slight favorite in the GOP primary thanks to his experience running statewide and his conservative reputation as a member of the state legislature. He also is expected to win the" endorsement of Stave Bannon. Three other candidates are running in the GOP primary. DEMOCRAT BROWN RAISED $2.6M IN Q3, HAS $8.3M BANKED FOR REELECTION RACE. The Toledo (OH) Blade (10/10, Troy, 187K) reported that Sen. Sherrod Brown's (D-OH) campaign on Tuesday said "it raised more than $2.6 million during the third quarter ," ending the period with "$8.3 million cash on hand." Brown's 2018 challengers, businessman Mike Gibbons (R) and state Treasurer Josh Mandel (R-OH) , have yet to release their latest fund raising numbers . MANCHIN EASILY BESTS GOP CHALLENGERS JENKINS, MORRISEY IN Q3 MONEY RACE. The AP (10/11) says that Sen. Joe Manchin (D-WV) "reports raising about $900,000 in the past three months for his 2018 re-election campaign with about $4.1 million on hand ." State Attorney General Patrick Morrisey (R-WV), who is battling Rep. Evan Jenkins (R-WV) in the GOP Senate primary , "reports raising about $670,000 in his first reporting quarter since officially announcing his run, with $548,000 on hand at the end of September." Jenkins , meanwhile , "reported about $220,000 raised in the period with almost $1.26 million on hand." BLACKBURN HAILS TWITTER REVERSAL ON AD AS "OUR FIRST SENATE CONSERVATIVE VICTORY." Politico (10/11, Nelson, 3.6M) reported that during a Wednesday appearance on Fox News, Rep. Diane Black (R-TN) - who is mounting a 2018 bid to succeed /\MERICAi\ pVERSIGHT EXT-18-248-C-000356 retir ing Sen . Bob Corker (R-TN}- said that "Twitter 's decision to reverse course and allow [her] to promote a video featuring anti-abortion language is 'ou r first Senate conservative victory ."' Blackburn had kicked off her Senate run "with a video posted to Twitter in which she boasted that she had 'fought Planned Parenthood and we stopped the sale of baby body parts , thank God .' Twitter initially deemed the 'baby body parts' language too 'inflammatory ' for Blackburn to promote but later reversed that decision ." Said Blackburn, "The Amer ican people have just risen up , and I sa id this is our first Senate conservative victory ." Blackburn said on Fox News ' Fox & Friends (10/11 , 1.15M), "Soc ial media and Twitter are important platforms. But the liberal left cannot continue to think they have the right to censor free speech and especially with campaign messages with which they disagree. " PROSECUTION RESTS IN MENENDEZ TRIAL; DEFENSE ASKS JUDGE TO DISMISS CASE. On Wednesday, the prosecut ion in the federal corruption tr ial of Sen. Bob Menendez (D-NJ) and his longtime fr iend and donor, eye doctor Salomon Melgen, rested its case. The Washington Post (10/11 , Barrett , Maiman, 10.38M) reports, "After a stream of witnesses that included jet pilots , former congressional staffers, federal offic ials , and one ex-senator , the government's case ended with testimony from FBI agent Alan Mohl ," who "has been read ing ema ils between Menendez and the senator's staff that prosecutors say shows the lawmaker was determ ined to use his position to help" Melgen. The Philadelphia Inquirer (10/ 11, Seidman , Tamari, 1.71 M) reports that after the prosecution rested its case , lawyers for Menendez and Melgen "asked the judge to dismiss the case immediately on grounds the government had not proven a qu id pro quo . The j udge excused the jury and said he would hear oral arguments on the mot ion Wednesday afte rnoon . Prosecutors accuse Menendez of advocating for Melgen 's personal and financial interests over the course of several years in exchange for free trips on Melgen 's j et, vacations at his Dom inican villa , and some $750 ,000 in political donat ions ." Bloomberg News (10/11, Voreacos , Weinberg, 4 .52M) reports that "defense attorneys pressed to have the case dismissed based on a 2016 U.S. Supreme Court ruling that narrowed the definition of public corruption ." Menendez attorney Abbe Lowell "said the senator didn't engage in 'offic ia l acts' on Melgen 's behalf, espec ially given the narrower defin ition laid out by the Supreme Court." And Melgen attorney Kirk Ogrosky "said prosecutors failed to show that the two men entered into a corrupt agreement. 'There's not a scintilla of evidence of an agreement ,' he told US District Judge William Wa lls." The judge, though, "repeatedly signaled that he is unlikely to dismiss the case before it goes to the j ury." However , Politico (10/11, Friedman , 3.6M) reported, "Hours after the prosecution rested ," the judge "cast doubt Wednesday on a theory that's central to its case. At the same time , Walls said he will allow the jury to decide whether Menendez filed fa lse reports with the US Senate , a charge seen by many as the toughest to beat. At issue is the 'stream of benefits ' theory of bribery, wh ich defense attorneys argue was invalidated by the US Supreme Court's 2016 dec ision overturn ing the corruptio n conviction of former Virg inia Gov. Bob McDonnell ," which "narrowed the type of conduct that can be used to prosecute for corruption . 'I'm particularly concerned about stream of benefits . And we 'll see ,' Walls told prosecutor Peter Kosk i." The New Yo rk Times (10/11 , Corasan iti, Subscription Pub licat ion, 13.56M) reports that Walls "said that he interpreted Chief Justice Roberts 's ruling as invalidating the 'stream of benefits ' theory of bribery, wh ich says that a bribe can occur if one party offers a thing of value to keep the other party on retai ner, essentially, rather than a more straightforward trade. 'The po int is th is: Does 'stream of benefits' still live?' Judge Walls said to Peter Koski , the lead prosecutor in the case . ' If 'stream of benefits ' still lives, then you still have a chance. You still have a chance even if 'stream of benefits' doesn 't live, particularly with regards to fa lse reports ."' The Wall Street Journa l (10/11 , Macmillan, Subscription Publication, 6.45M) also reports on Wednesday's development at the Menendez-Melgen trial. /\MERICAi\ pVERSIGHT EXT-18-248-C-000357 JUDGE ORDERS RELEASE OF GIANFORTE'S MUGSHOT. The AP (10/11) reports that Gallatin County District Judge Holly Brown on Wednesday "ordered the release of a mugshot taken of ' Rep. Greg Gianforte (R-MT}, who "was convicted of assaulting a reporter on the eve of the special election that put him in office." The AP adds that County Attorney Marty Lambert "would not release the image without a court order, arguing it is confidential criminal justice information .. .. Neither Gianforte nor Lambert opposed the release of the photo. Gianforte pleaded guilty to assaulting Guardian reporter Ben Jacobs on May 24 as Jacobs sought to question him about health care legislation."USA Today (10/11, Cummings, 8.62M) reports, "Despite the incident, the millionaire businessman easily won the election. Gianforte was ordered to pay a $385 fine, complete 40 hours of community service and 20 hours of anger management." GOP HOPEFUL ROSSI RAISES $575K IN NINE DAYS. The Hill (10/11, Kamisar, 1.68M) reported that state Sen. Dino Rossi (R), who is mounting a 2018 bid to succeed retiring Rep. Dave Reichert (R-WA), "raised more than a half-millio n dollars in the first nine days of his House campaign, he said Wednesday, an eye-popping sum." Rossi "announced his campaign's haul of $575,000 in a Facebook post." The Hill added that Rossi "ran a tight race for governor in 2004 and was the GOP's nominee for Senate in 2010 , but lost both races. When Reichert announced his retirement in September, Rossi was instantly floated as a top choice of Republicans looking to hold on to the Democratic-leaning seat. He announced his bid a few weeks later." KERRY ENDORSES, STUMPS WITH NEW JERSEY GUBERNATORIAL CANDIDATE MURPHY. NJ News (10/11, Brodesser-Akner, 1.21 M) reports that ex-Goldman Sachs executive Phil Murphy (D), who is battling Lt. Gov. Kim Guadagno (R-NJ) in this fall's race to succeed termlimited Gov. Chris Christie (R-NJ), on Wednesday was endorsed by ex-US Secretary of State John Kerry (D). During a joint appearance "at a VFW post in Clifton," Kerry - "a decorated Vietnam combat veteran" - lauded Murphy "as someone who would bring 'a business mindset' to the state's handling of veterans affairs." MARYLAND'S ROCKEYMOORE CUMMINGS JOINING CROWDED DEMOCRATIC PRIMARY. The Washington Post (10/11, Wiggins, 10.38M) reports that "policy consultant" Maya Rockeymoore Cummings (D-MD), wife of veteran Rep. Elijah Cummings (D-MD), will mount a 2018 bid to oust Gov. Larry Hogan (R-MD), "becoming the second woman and the third African American to join the crowded Democratic primary field." Rockeymoore Cummings "has more than two decades of experience working in the public and private sectors , including as chief of staff to" now-former Rep. Charlie Rangel (D-NY), "senior resident scholar for health and income security at the Nationa l Urban League and vice president of research and programs at the Congressional Black Caucus Foundation. She started Global Policy Solutions, a social change strategy firm , in 2005." The Baltimore Sun (10/11, Dresser, 706K) reports that Rockeymoore Cummings "plans to announce her candidacy Thursday via a web video." SE/U Backing Ex-NAACP Chief Jealous In Democratic Race. The Baltimore Sun (10/11, Cox, 706K) reports that Service Employees International United, "a labor union with 45,000 members in Maryland, will support" ex-NAACP chief Ben Jealous (D) in the Democratic gubernatorial primary. The Sun says, "SEIU leaders plan to formally endorse Jealous during an event on Thursday, according to his campaign. " The Washington Post (10/11, Wiggins, 10.38M) reports, "The much sought-after nod from the" SEIU "will be the latest endorsement for" Jealous , who previously has won the backing of "Sen. Bernie Sanders (I-Vt.), Our Revolution, and Maryland Working Families." POLITICO MAG EXAMINES DIFFERENCES BETWEEN MACOMB COUNTY NATIVES EMINEM, KID ROCK. In a piece for Politico Magazine (10/11, 3.55M), Zack Stanton, digital editor of Politico Magazine and a native of Macomb County, Ml, said that rapper Eminem, a fierce critic of President Trump , and Kid Rock, a strong supporter of the President, are both "product[s] of Michigan's Macomb County," which "went for Trump overwhelmingly" in 2016, "delivering more votes for him than for any other presidential candidate in the history of the county." Stanton said /\MERICAi\ pVERSIGHT EXT-18-248-C-000358 that Eminem "grew up in southern Macomb in the work ing-class Democratic suburbs of Warre n and East Detroit." Kid Rock, meanwhile was "the third of four children in a well-to-do fam ily in the placid northern Macomb small town of Romeo, a Republican redoubt." Stanton added , "There are, in a sense, two Macombs ." Meanwh ile, under the headline "After Eminem's Trump-Trash ing Freestyle, Hip-Hop Becomes Leading Source Of Protest Music," the Milwaukee Jou rnal Sentinel (10/11, Levy, 628K) reports, "Ten months after Donald Trump's inaugurat ion, the most celebrated music scolding the president has been from rappers . A scathing freestyle from Eminem, dubbed 'The Storm' and dropped during the BET Hip Hop Awards Tuesday , is the ta lk of the news cycle right now, topp ing YouTube's trending chart Wednesday, and with 20 million views as of Wednesday afternoon between YouTube and Facebook ." JUDGE ALLOWS DAKOTA ACCESS PIPELINE TO CONTINUE OPERATIONS. The AP (10/11, Nicholson) reports that US District Judge James Boasberg in Bismarck, ND ruled on Wednesday that the Dakota Access oil pipeline "can continue operating while a study is completed to assess its environmental impact on an Amer ican Indian tribe." Judge Boasberg 's decision "will come as a blow to the Standing Rock Sioux, who have argued that an oil spill from the pipeline under Lake Oahe - from which the tribe draws its water - could have a detrimental effect on the tribal community ." Judge Boasberg "found that it is likely the Army Corps of Engineers w ill be able to justify previous dec isions made while permitting the pipeline. 'The Corps must simply connect the dots,' he said. 'This, then, is not a case in wh ich the agency must redo its analysis from the ground up."' The judge "also acknow ledged that shutting down the pipeline would disrupt the energy industry, but said it wasn't a major factor in his decision ." CALIFORNIA WILDFIRES CONTINUE TO RAGE AS DEATH TOLL RISES TO 21. NBC Nightly News (10/11, lead story, 2:30, Holt, 16.61 M) reported that three days have passed wit h "still no control" of the 22 wildfires burning across California, wh ich have resulted in at least 21 dead and 3,500 businesses and homes destroyed , especia lly in the wine country north of San Francisco. Winds were "picking up once aga in" Wednesday night, as new evacuations were underway and 8,000 firefighters battled the fires. Authorities "are dealing with hundreds of missing persons reports, complicated by destroyed cell towers," and officials "are seeing the worst air quality ever recorded in parts of the Bay Area." ABC World News Ton ight (10/11, lead story , 3:40, Muir, 14.63M) reported that whole neighborhoods have "turned to ashes " as firefighters race to contain the damage. Cal Fire Director Ken Pimlott described the fires as "literally burning faster than firefighters can run." As of Wednesday night, fires have burned through 170,000 acres, and new evacuat ion orders in Sonoma and Napa Counties were declared. At least 73 cell towers have been destroyed , and winds around Santa Rosa were forecast to gust up to 40 miles per hour. The CBS Evening News (10/11 , lead story , 2:40 , Mason, 11.17M) reported Pimlott called the fires "a serious, critical , catastrophic event." Cal Fire Battalion Chief Jonathan Cox praised firefighters ' efforts and their "real sense of purpose and mission," but expressed concern that the fires could be "pushed in other directions ." Nearly 400 people have been reported missing. The Los Angeles Times (10/11, Willen , 4.49M) reports that officia ls "fear that strong winds forecast for Wednesday evening and Thursday morning will spread embers from the dead ly Tubbs fire to populated areas of Santa Rosa and Calistoga that have so far been spared the flames ." The New York Times (10/11, A1, Fuller, Perez-Peria, Bromwich, Subscription Publication , 13.56M) reports that survivors have "told of narrow escapes from walls of flame that seemed to erupt from nowhere on Sunday night and Monday morning, forcing them to run even before text messages and other alerts were sent out by emergency warning systems ." /\MERICAi\ pVERSIGHT EXT-18-248-C-000359 The Wall Street Journal (10/11, Lazo, Ailworth, Lovett, Subscription Publication, 6.45M) reports that California Gov. Jerry Brown said Wednesday that the cost of the fires will reach "tens of billions" of dollars , and that the wildfires were "one of the biggest" in the state's history. More than 60,000 people have fled their homes . CHARLOTTESVILLE SCHOOLS ON "MODIFIED LOCKDOWN" FOLLOWING THREATENING MESSAGE BOARD POST. The Washington Post (10/11, Larimer, 10.38M) reports that schools in Charlottesville, Virginia were placed on a "modified lockdown" on Wednesday following a threatening message board post. According to a police statement on the city's website, the post on the unidentified message board had expressed "discontent with recent events in Charlottesville" and admiration for Las Vegas shooter Stephen Paddock. The police statement indicated the identity of the individual behind the post was unknown and that officers had been stationed at city schools and some private schools. SUPREME COURT WEIGHS IMMUNITY FOR CORPORATIONS IN OVERSEAS HUMAN RIGHTS SUITS. The Washington Post (10/11, Barnes, 10.38M) reports that a majority of Supreme Court justices "seemed skeptical Wednesday that an 18th-century law allows foreign citizens to sue foreign corporations in U.S. courts over allegations of human rights atrocities committed abroad." The Post adds that the court "has wrestled before with the kind of lawsuits authorized by the Alien Tort Statute, which was enacted by the first Congress in 1789 ," and "the justices have limited the kind of actions that can be brought but in 2013 declined to decide whether corporations were immune from suits under the statute." According to the Post, "the new case involves 6,000 foreign citizens who allege that the Arab Bank provided financial services to terror ists who engaged in attacks against Israelis in 2000." The plaintiffs "said the suit was authorized by the Alien Tort Statute (ATS), which was largely ignored for 200 years before human rights organizations began filing suits seeking relief for abuses overseas." The New York Times (10/11, Liptak, Subscription Publication, 13.56M) reports that the court, "which has already placed strict limits on lawsuits brought in federal court based on human rights abuses abroad, seemed open on Wednesday to barring such suits entirely when the defendants are corporations." Jeffrey L. Fisher, an attorney for the plaintiffs, "said his clients had made grave accusations against the bank. 'What we allege is knowing and purposeful financing of terrorism with the expectation that it will make those terrorism attacks more successful and more lucrative for the perpetrators , and that is a violation of the law of nations,' he said." Paul D. Clement, representing the bank, "said American courts have no business sorting out the truth of accusations involving foreign parties and conduct. 'This case arises out of a suit by Israeli nationals against a corporation chartered in Jordan for injuries suffered in Israel and the adjoining territories,' he said." BOY SCOUTS TO ALLOW GIRLS TO JOIN. NBC Nightly News (10/11, story 9, 1:45, Holt, 16.61M) reported the Boy Scouts of America announced Wednesday it had reached a unanimous decision that, starting in 2018, girls can join the Cub Scouts, and that starting in 2019, older girls can become Eagle Scouts . BSA Chief Scout Executive Michael Surbaugh said of girls joining, "They' ll have the opportunities for an advancement track that is identical to boy scouting but maintains the opportunities for them to have leadership with their own girl gender." The decision intensified a "growing feud with the Girl Scouts of America," which is now exploring what types of legal actions can be pursued against BSA - including the retraction of the Boy Scouts' congressional charter . In an editorial, the Wall Street Journal (10/11, Subscription Publication, 6.45M) writes that the Boy Scouts of America's decision to allow girls to join the organization in the fut ure represented a compromise that prevents total gender integration in the group while addressing growing pressure to allow girls to join and the SSA's flagging membership. The Journal says the question remains as to whether the decision will satisfy the progressive movement's concerns about gender differences, but concludes by expressing hope that BSA will succeed in its new policy. /\MERICAi\ pVERSIGHT EXT-18-248-C-000360 EXPERTS SEE 2017 AS BEGINNING OF END OF INTERNAL COMBUSTION ENGINE . The Washington Post (10/1 1, Holley, 10.38M) reports that 2017 likely will be viewed one day as the beginning of the end of vehicles with internal combustion engines, according to experts, who say the "tipping point" for electric cars entering the mainstream has followed three major developments. First, China announced plans to eliminate internal combustion engines entirely by 2030. Second, the Tesla Model 3 debuted, with a starting price of about $35,000. Third, major automakers - including GM, Volvo, Volkswagen, Mercedes, Audi, BMW, and Ford - all have announced electric vehicles plans in recent months. ALEC BALDWIN HAS "ANOTHER EPIC MELTDOWN" ON NEW YORK CITY STREETS. Page Six ( 10/11, Siegler, 455K) reports , "Explosive actor Alec Baldwin had another epic meltdown on the streets of New York this week. " Baldwin "was seen in a verbal exchange with a presumably reckless motorist" near Greenwich Village "that included insults and soft-drink throwing." ROVE: TRUMP HURTING HIMSELF BY ATTACKING CORKER. In a Wall Street Journal (10/11, Subscription Publication, 6.45M) column , Karl Rove writes that President Trump 's attacks on Sen . Bob Corker make Trump appear weak and ineffective, may allow Democrats to seize the House and Senate in 2018, and seek to undermine a senator whose help Trump needs in order to pass tax reform legislation . WPOST: PRUITT DESTROYS CLEAN POWER PLAN. In an editorial , the Washington Post (10/11, 10.38M) criticizes EPA Administrator Pruitt's decision to repeal the Clean Power Plan and argues that the rule's elimination not only bypasses the fact that many, including the Supreme Court , had viewed the policy as legal , but also likely will lead to much fewer limits on carbon emissions . The Post describes Pruitt's approach as "anti-scientific," "ideological," and "a betrayal of his office ." WPOST CRITICIZES TRUMP CABINET FOR USING PRIVATE PLANES. In an editorial, the Washington Post (10/11 , 10.38M) criticizes Trump Cabinet members for what the Post describes as private travel at "exorbitant expense to taxpayers. " The Post particularly criticizes Interior Secretary Zinke for "spending $12,375 on a charter flight from Las Vegas, where he spoke at the behest of a politica l patron, to his home state of Montana in June. " The Post adds that Energy Secretary Perry, Veterans Affairs Secretary Shulkin, and Treasury Secretary Mnuchin "are among at least seven Cabinet-level officials who have shunned the plebeian confines of readily available commercial planes in favor of private jets and military flights at public expense , sometimes to smart destinations in Europe and sometimes accompanied by their spouses - all at a total cost of millions of dollars." NYTIMES: NEW YORK MAYORAL DEBATE OFFERED LITTLE. In an editorial, the New York Times (10/11, Subscription Publication, 13.56M) writes that Tuesday night's debate among the three candidates for New York mayor offered few policy specifics, was by "loud and obnoxious" spectators and "endless audience shouting ," and resulted in no indisputable winner. The Times concludes that the biggest loser from the debate was the voters of New York . WSJOURNAL: GOP'S AIR-TRAFFIC CONTROL PLAN WOULD HELP BOTH ECONOMY AND TRAVELING PUBLIC. In an editorial, the Wall Street Journal (10/11, Subscription Publication, 6.45M) writes that House Repub licans' current plan to convert Federal Aviation Administration airtraffic control into an operation run by airlines, pilots, controllers, and other industry experts would help improve both the economy and travelers ' experience. The Journal argues that Republicans should seize the opportunity to pass the legislation while they have a President who wants reform as part of his infrastructure improvement plan. Editorial Wrap-Up: NEW YORK TIMES. "Mr. Trump Alone Can Order A Nuclear Strike . Congress Can Change That." The New York Times (10/11, Subscription Publication, 13.56M) editorializes , "The broad /\MERICAi\ pVERSIGHT EXT-18-248-C-000361 debate over President Trump 's fitness for the difficult and demanding office he holds has recently been reframed in a more pointed and urgent way: Does he understand, and can he responsibly manage, the most destructive nuclear arsenal on earth? " The Times writes that "Congress has been sufficiently alarmed to consider legislat ion that would bar the president from launching a first nuclear strike without a declaration of war by Congress ," which is "a sound idea [that] could be made stronger with a requirement that the secretaries of defense and state also approve any such decision. " "Biggest Loser At New York Mayoral Debate? The Voters. 11 In an editorial, the New York Times (10/11, Subscription Publicat ion, 13.56M) writes that Tuesday night's debate among the three candidates for New York mayor offered few policy specifics, was by "loud and obnoxious " spectators and "endless audience shouting ," and resulted in no indisputable winner. The Times concludes that the biggest loser from the debate was the voters of New York. WASHINGTON POST. "The Culture Of Complicity Protecting Harvey Weinsteins Everywhere. 11 In an editorial , the Wash ington Post (10/11, 10.38M) says that while "the details of Mr. Weinstein's actions are grotesque enough," the "fact that his systematic abuse of power seems to have been an open secret" is "just as shocking ." The Post laments the "complic ity" that "protects many Harvey Weinsteins in many industries," and says the stories from Weinstein's alleged victims "make clear the crucial role that those in positions of respons ibility must play by denouncing misconduct when they see it and demanding accountabil ity, rather than remaining quietly complicit." "The EPA Rips Up The Clean Power Plan. 11 In an editorial , Washington Post (10/11, 10.38M) criticizes EPA Administrator Pruitt's decis ion to repea l the Clean Power Plan and argues that the rule's elimination not only bypasses the fact that many, including the Supreme Court , had viewed the policy as legal, but also likely will lead to much fewer limits on carbon emissions . The Post describes Pruitt's approach as "anti-scientific ," "ideolog ical," and "a betrayal of his office." "Trump's Cabinet Can't Seem To Stop Taking Private Planes. 11 In an editorial, the Washington Post ( 10/ 11, 10.38M) criticizes Trump Cabinet members for what the Post describes as private travel at "exorbitant expense to taxpayers. " The Post particularly criticizes Interior Secretary Zinke for "spending $12,375 on a charter flight from Las Vegas, where he spoke at the behest of a politica l patron , to his home state of Montana in June. " The Post adds that Energy Secretary Perry, Veterans Affairs Secretary Shulkin, and Treasury Secretary Mnuchin "are among at least seven Cabinet-level officials who have shunned the plebeian confines of readily available commercial planes in favor of private jets and military flights at public expense , sometimes to smart destinations in Europe and sometimes accompanied by their spouses - all at a total cost of millions of dollars." WALL STREET JOURNAL. "An Air Traffic Winner. 11 In an editorial , the Wall Street Journal (10/11, Subscription Publication , 6.45M) writes that House Republicans ' current plan to convert Federal Aviation Administration air-traffic control into an operation run by airl ines, pilots, controllers , and other industry experts would help improve both the economy and trave lers' experience . The Journa l argues that Republicans should seize the opportunity to pass the legislation while they have a President who wants reform as part of his infrastructure improvement plan. "Senate Blue Slip Bluster." A Wall Street Journal (10/11, Subscription Publication, 6.45M) editorial praises Senate Majority Leader McConne ll's dec ision to move forward on judicial nominees even if home-state Democratic senators don 't return the so-called 'blue slips' to the Judic iary Committee, arguing that Minority Leader Schumer is using the "blue slip" process, which is a courtesy , for political purposes. "The Boy-Girl Scouts Of America. 11 In an editor ial, the Wall Street Journal (10/11, Subscription Publication, 6.45M) writes that the Boy Scouts of Amer ica's dec ision to allow girls to join the /\MERICAi\ pVERSIGHT EXT-18-248-C-000362 organization in the future represented a comprom ise that prevents tota l gender integrat ion in the grou p wh ile addressing grow ing press ure to allow girls to join and the BSA's flagging membership. The Journal says the question remains as to if the decision will satisfy the progressive movement's concerns about gender differences, but conc ludes by expressing hope that BSA will succeed in its new policy. The Big Picture: HEADLINES FROM TODAY 'S FRONT PAGES . Wall Street Journal: President To Ease Health Insurance Rules Beijing Pushes For A Direct Hand In China's Big Tech Firms Russia Has Turned Kaspersky Software Into Tool For Spying Junk Bond Boom Reaches Far Corners Of The World New York Times: Trump's Tough Talk On NAFTA Suggests Pact's Demise Is Imminent Foiled In Congress , Trump Moves On His Own To Undermine Obamacare Rohingya Recount Atroc ities: "They Threw My Baby Into A Fire" Weinstein Company Was Aware Of Payoffs In 2015 Boy Scouts Will Accept Girls, In Bid To "Shape The Next Generation Of Leaders" The Girl In The No. 8 Jersey Raining Ash And No Rest: Firefighters Struggle To Conta in California Wildfires Washington Post: Boy Scouts. In Historic Move. Will Accept Girls Puerto Rico's Misery Drags On Trump Amps Up Threats On Press President Trump 's Loyal Whisperer Fears Grow Of Wildfires Merging In California Charity Privately Paid Roy Moore Financial Times: Kobe Steel Shares Plunge As Scandal Widens Spanish Prime Minister Demands Clarity On Catalan Independence Peltz's P&G Loss Unlikely To Stop Activist Investing Tide Trump Adm inistration Hits Out At IMF Over Tax Reforms Washington Times : Military Heats Up Battle In Libya As Islamic State Militants Seek Refuge D.C. Officials Defend Gun Laws, Look To Further Tighten Concealed-Carry Rules Trump Sells Tax Plan In Pennsylvan ia: "Rocket Fuel For Our Economy" As Boy Scouts Welcome Girls, Rival Group Sees Expansion Of "War On Boys" California Wildfires Expected To Worsen In Coming Days: State's "Biggest, Most Serious" Event "Disgusted" Obamas Were Star-Struck By Hollywood Mogul Weinstein's Access , Cash Story Lineup From Last Night's Network News : ABC: West Coast Wildfi res; West Coast Wildfires- Firefighting; West Coast Wildfires-Tracking; Weinstein Sexual Harassment Scandal; Las Vegas Shooting Investigation; Tru mp-US Nuclear Arsenal; Trump-Homeland Security Secretary Pick; Trump-Tax Reform; Louisiana State University-Hazing; Seattle-Gun Fire Exchange; Utah-Nurse Arrest Outcome; Boy Scout-Gi rl Members; West Coast Wildfires-Aftermath. CBS : West Coast Wildfi res; West Coast Wildfires-Affected Families; Las Vegas Shooting Investigation ; Trump-US Nuclear Arsenal; Weinstein Sexual Harassment Scandal; Louisiana State University- Hazing; Syria-Raqqa Assau lt; Boy Scout-Girl Members; Hurricane Season Record; Chicago-Soda Tax Rollback ; Utah Foster Family; Retired K-9 Dog. /\MERICAi\ pVERSIGHT EXT-18-248-C-000363 NBC: West Coast Wildfires ; West Coast Wildfires-Affected Families; Trump-US Nuclear Arsenal; Louisiana State University-Haz ing; Weinstein Sexual Harassment Scandal ; Las Vegas Shooting Investigation ; Niger-US Casualty Investigation; Trump-Iran Nuclear Deal; Boy Scout-Gi rl Members; Utah-Nurse Arrest Outcome; Chicago-Soda Tax Rollback ; Lost Dog Found; Puerto Rico Hurricane Recovery. Network TV At A Glance: West Coast Wildfires - 15 minutes , 35 seconds Weinstein Sexual Harassment Scandal - 7 minutes, 30 seconds Las Vegas Shoot ing Investigation - 5 minutes, 40 seconds Trump-US Nuclear Arsenal - 5 minutes, 20 seconds Boy Scout-Girl Members - 3 minutes , 40 seconds Story Lineup From This Morning's Radio News Broadcasts: ABC: Las Vegas Shooting Investigation; West Coast Wildfires; NAFTA Renegotiation ; Boy ScoutGirl Members ; Wall Street News. CBS: West Coast Wildfires ; Trump-NFL Kneeling ; Niger-US Casualty Investigation; Louisiana State University-Hazing; Falcon 9 Launch. FOX: West Coast Wildfires; Emergency Aid Budget; Trump-Tax Reform. NPR: West Coast Wildfires ; Puerto Rico Hurricane Recovery ; Trump-US Nuclear Arsenal ; Trump-Tax Reform. Last Laughs: LATE NIGHT POLITICAL HUMOR. Jimmy Kimmel: "The big story out of the BET show was Eminem launch ing a five-minute freestyle attack on Donald Trump. It was very well done. He found a way to rhyme the word 'orange ,' which previously had been thought impossible." Jimmy Kimmel: "According to the story in Vanity Fair, Joh n Kelly is miserable in his job , only staying in it out of a sense of duty to keep Trump from making a disastrous decision . But publicly , they say he's very happy. Sure he is, you can see how happy he is right there . He always looks like he's in one of those 'Wanna Get Away' Southwest Airlines commercials ." Stephen Colbert: "Over the summer , Trump met with top military officials and said he wanted a nearly ten-fo ld increase in the US nuclear arsenal. A ten-fo ld increase? Excuse me while I onefold into the fetal position. He knows we can already end all life on Earth, right? The cockroaches will survive, which is good news for Steve Bannon." Stephen Colbert: "Speaking of staffing issues , last night , around 9:00, Trump tweeted, The fake news is at it again , this time try ing to hurt one of the finest people I know, General John Kelly , by saying he will soon be..... fired . This story is totally made up by the dishonest media. The chief is doing a fantastic job for me and, more importantly , for the USA!' Yes, very important you clear up that John Kelly works for the USA, because so much of Trump's staff works for Russia." James Corden: "An article today revealed that during a national secur ity meeting last summer, Donald Trump said that he wanted to increase the number of America 's nuclear weapons by ten fold. Trump would have gone higher than ten fold, but he ran out of fingers to count them on." James Corden: "Eminem's lyrics were politically charged. He defended the NFL players who have been kneeling during the national anthem , and later Donald Trump responded with his own rap that went, 'Will the NFL players please stand up, please stand up, please stand up."' Jimmy Fallon: 'Trump said it's disgusting that the press is able to write w hatever it wants to write . When asked about the First Amendment, he said , 'Is that the one that says not to ta lk about /\MERICAi\ pVERSIGHT EXT-18-248-C-000364 fight club?"' Jimmy Fallon: "Last night at the BET awards, Eminem did a four-minute freestyle rap criticizing Trump .. .. Trump was mad, but he was also a little confused . Today, he told people to boycott the M&Mstore." Seth Meyers: "President Trump this morning tweeted, quote, 'With all the fake news coming out of NBC and the networks, at what point is it appropriate to challenge their license?' You 're coming after NBC? They didn't take our license after that monkey hospital show, they're not going to take it for you." Seth Meyers: "President Trump said today, quote, 'It's frankly disgusting the way the press is able to write whatever they want to write, and people should look into it.' Hey man, are you having trouble reading the First Amendment?" This copy of the HHS News Briefing was sent to you because you are registered for email notification on our website. If you would like to cancel email delivery click here. Copyright 2017 by Bulletin Intelligence LLC Reproduction or redistribution without permission prohibited. Content is drawn from thousands of newspapers, national magazines , national and local television programs, radio broadcasts, social-media platforms and additional forms of opensource data. Sources for Bulletin Intelligence audience-size estimates include Scarborough, GfK MRI, comScore, Nielsen, and the Audit Bureau of Circulation. 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Sender: Bulletin Intelligence Recipient: "HHS@bulletinintelligence.com" Sent Date: 2017/10/12 07:32:07 Delivered Date: 2017/10/12 07:34:42 /\MERICAi\ pVERSIGHT EXT-18-248-C-000365 Holt, Lydia (ACF) "Lloyd, Scott (ACF) "; "Tota, Kenneth (ACF) "; To: "White, Jonathan (ACF) "; "Moreno, Mr. Pedro (ACF) " CC: "White, Laura (ACF) " Subject: RE: UPDATE:Media Inquiries--San FranciscoACLU vs. HHS Litigation Date: 2017/10/12 09:55:14 Priority: Normal Type: Note Good Morning, This is the official statement being provided for all current UAC inquiries regarding the ACLUcase: The following may be attributed to the Administration for Children and Families at the U.S. Department of Health and Human Services: "In most cases when a child enters the United States illegally without a parent or guardian, by law the minor is placed into the care and custody of the Office of Refugee Resettlement at HHS' Administration for Children and Families. At that point, our paramount concern is the child's safety and well-being. While the child is in our custody, our goal is to provide food, shelter and care to her under federal statute. In this specific case, we are providing excellent care to the adolescent girl and her unborn child, who remain under our care until the mother's release." From: Holt, Lydia (ACF) Sent: Wednesday, October 11, 2017 7: 14 PM To: Lloyd, Scott (ACF); Tota, Kenneth (ACF); White, Jonathan (ACF); Moreno, Mr. Pedro (ACF) Cc: White, Laura (ACF) Subject: RE: UPDATE: Media Inquiries--San Francisco ACLU vs. HHS Litigation You ' re welcome Scott. From: Lloyd, Scott (ACF) Sent: Wednesday, October 11, 2017 7: 10 PM To: Holt, Lydia (ACF); Tota, Kenneth (ACF); White, Jonathan (ACF); Moreno, Mr. Pedro (ACF) /\MERICAi\ pVERSIGHT EXT-18-248-C-000366 Cc: White, Laura (ACF) Subject: RE: UPDATE:Media Inquiries--San FranciscoACLUvs. HHS Litigation Thank you, Lydia. Scott From: Holt, Lydia (ACF) Sent: Wednesday, October 11, 2017 7:07 PM To: Lloyd, Scott (ACF); Tota, Kenneth (ACF); White, Jonathan (ACF); Moreno, Mr. Pedro (ACF) Cc: White, Laura (ACF) Subject: UPDATE:Media Inquiries--San FranciscoACLUvs. HHS Litigation Good evening all, Just wanted to provide an update on the media queries received regarding the ACLUvs. HHS litigation today. Vice News Courthouse News Service BuzzFeed Washington Times Telemundo Los Angeles and San Francisco Journal OC is working with ASPAand is prepar ing a statement to provide to the press at this time. I will update you as more information becomes available. Thanks, Lydia Lydia A. Holt Public Affairs Specialist Office of Refugee Resettlement Administration for Children and Families (ACF) U.S. Department of Health and Human Services 330 C Street SW Washington , D.C. 2020 1 Lydia.Ho lt@acf.hhs. gov 202.401.9217 (W) l(b)(6) KC) Teleworking on Mondays Holt, Lydia (ACF) /\MERICAi\ pVERSIGHT EXT-18-248-C-000367 "Lloyd, Scott (ACF) "; "Tota, Kenneth (ACF) "; "White, Jonathan (ACF) "; "Moreno, Mr. Pedro (ACF) "; "White, Laura (ACF) " Sent Date: 2017/10/12 09:55:13 Delivered Date: 2017/10/12 09:55:14 /\MERICAi\ pVERSIGHT EXT-18-248-C-000368 ACFMedia Clips (ACF) To: "ACF- All ACFStaff " Subject : ACFMedia Clips for Oct. 12, 2017 Date: 2017/10/12 14:32:12 Priority : Normal Type: Note ACF Media Clips for Oct. 12, 2017 - Child Care Murray stumps for child care: Senator visits Hadlock center to hear about cost U.S. Sen. Patty Murray visited the Cedarbrook Early Leaming Center in Port Hadlock to talk with parents and child care providers to publicize a bill she has introduced , the Child Care for Working Fami lies Act. Peninsula Daily News , WA Oct. 12, 2017 -If we don't speak up for our youngest children their development will be compromised Three weeks ago, Sen. Patty Murray (D-Wash.) shared her bold vision for what a nation committed to all young children could look like by introducing The Child Care for Working Fam ilies Act. Supported by 27 senators and endo rsed by over 100 organizations serving children and fami lies, The Child Care for Working Families Act addresses the massive child care crisis in our nation head on. Opinion The Hill, DC Oct. 11, 2017 - Children, Youth & Families After growing up in 20 foster homes, St. Louis woman brings music to kids who've had a rough start Barr ier now offers the same exper ience to kids in foster care or who've been adopted after living tumultuous environments. Her 1-year-old organization has taken dozens of St. Louis children and their families to musicals at the Fox Theatre and The Murry. KBIA , MO Oct. 12, 2017 Universities need to help foster kids get a degree The neglect foster kids face - whether with their foster or biological families - makes it difficult for them to "develop the brain connections that facilitate language and vocabulary /\MERICAi\ pVERSIGHT EXT-18-248-C-000369 development, and therefore may impair communication skills," according to a journal article in the American Academy of Pediatrics. Opinion University of Ma,yland Diamondback, MD Oct. 12, 2017 Councilor challenges state contract with religious organization to recruit foster parents A $100,000 contract for a faith-based initiative by Bethany Christian Services of Candia to recruit foster and adoptive families was approved by the Executive Council on Wednesday, despite opposition from Democratic Councilor Andru Volinsky of Concord, who questioned if the group would serve gay foster or adoptive parents. Manchester Union Leader, NH Oct. 11, 2017 For Kansas foster care task force, report of missing children latest concern The number of children in foster care nationwide increased every year from 2012 to 2015, the last year for which national data is available. Thirty-five states, including Kansas, saw an increase in the number of children in their foster care systems during that period. KCUR , MO Oct.12, 2017 Wide receiver stands out during his sophomore campaign (featuring ACF) Starting at the age of seven, Gladney began living in group homes in the Binghamton, New York, area. He bounced around quite a bit, which can be common in foster care, unable to land somewhere permanent. According to data from the Administration of Children and Families, at the federal Department of Health and Human Services, children have, on average, three different foster care placements. Ithacan, NY Oct.11, 2017 Help! Government kidnapped my child! (featuring ACF) According to statistical data published by the federal Department of Health and Human Services in 2012, Child Protective Services (CPS) checked up on 3.2 million children, though only 686,000 were reported as abused or neglected - meaning that 2.5 million children have been declared non-victims. Since the early years of its creation , the scope of CPS' powers has grown, and it has usurped an immense amount of the natural and God-given right of parents to rear their children. Opinion New American , WI Oct. 11, 2017 Child Support Halbert Sullivan is 2017 nonprofit executive of the year While in his master ' s program , two women approached him with the idea for starting the Fathers' Support Center, which promotes the father's involvement in their children's lives through intensive job training, group therapy, community service and parenting workshops. /\MERICAi\ pVERSIGHT EXT-18-248-C-000370 Since its inception in 1997, the center has served more than 14,000 fathers and their families, transitioning nonparticipating fathers to a position of involvement in the lives of over 40,000 children. St. Louis American, MO Oct. 12, 2017 Child support guidelines may change to factor in wage hike Arizona court officials may tweak state guidelines for determining child support obligations to take into account a voter-approved increase in the minimum wage. Officials say not making a change to reflect the higher minimum wage could require low-income workers to pay a higher percentage of their earnings in child support. Associated Press, AZ Oct. 11, 2017 - Head Start JCPS leaders said they won't tolerate alleged abuse of students in Head Start program (featuring A CF) Seven teachers and assistants within JCPS have been fired since a report was released from the Administration for Children and Families in August alleging children were slapped , threatened and thrown in a closet. On Tuesday night, board members discussed that report, which details 23 incidents that happened in the Head Start and Early Head Start programs in several JCPS schools last year. WDRB, KY Oct. 10, 2017 Report alleges abuse inside JCPS Head Start program (featuring ACF) A recent investigation found incidents of Jefferson County Public Schools Head Start teachers and assistants hitting, biting, force-feeding and throwing children. The Director of the National Head Start program has threatened to suspend JCPS. WLKY, KY Oct. 11, 2017 -Federal official threatens to suspend JCPS Head Start program over abuse allegations (featuring A CF) A top federal official said Washington is ready to suspend the Jefferson County Public Schools Head Start program, if necessary, because of ongoing allegations of abuse. Ann Lineham, Acting Director of the national Head Start program, met personally with JCPS administrators and Board members Tuesday, and accused them of not doing enough to protect its youngest and most vulnerable students. WAVE,KY Oct. 11, 2017 - JCPS fires seven after federal report details neglect, abuse of students (featuring ACF) /\MERICAi\ pVERSIGHT EXT-18-248-C-000371 Jefferson County Public Schools has fired seven employees after a report from a federal agency listed 13 incident s in which staff abused or neglected children. The incident s were reported by parents or JCPS staffers between Dec. 1, 2016 and May 18 at 10 JPCS sites. Insider Louisville, KY Oct. 11, 2017 Refugee Resettlement U.S. resettles fewer refugees, even as global number of displaced people grows (featuring ACF) Compared with those seeking refuge on Europe's shores, the U.S. Refugee Resettlement Program is a different pathway for those fleeing conflict. For example, the more than 1.3 million refugees entering Europe in 2015 were asylum seekers, not resettled refugees. They sought refuge in Europe on their own after arriving in Europe and were not formally resettled by European countries. They will wait for decisions on their asylum applications while living in Europe. Opinion Pew Research Center, DC Oct. 12, 2017 Number of refugees coming to the U.S. falling fast under Trump, study shows (featuring ACF) The Christie administration last year told the federal government that New Jersey would no longer will participate in refugee resettlement programs, leaving it up to nonprofit groups and churches. Newark Star-Ledger, NJ Oct. 12, 2017 Trafficking US closes trucking firm tied to smuggling case Federal safety regulators have shut down a troubled Iowa trucking company that owned the semitrailer involved in a human trafficking case in which 10 immigrants died in Texas. Associated Press, IA Oct. 12, 2017 Human trafficking is still a problem in D.C. area The International Labour Organization estimates that there are more than 20.9 million victims of human trafficking worldwide. More than half of all vict ims are women and girls, with 26 percent of all cases being children. Locally, 2,563 people have been reported missing in the District in 2017 alone, according to statistics released by the Metropolitan Police Department on Sept. 29. Of these , 1,637 were children, some who may be victims of human trafficking rings. Opinion Afro, MD Oct. 12, 2017 /\MERICAi\ pVERSIGHT EXT-18-248-C-000372 - Unaccompanied Alien Children Judge won't order officials to allow abortion for immigrant (featuring ACF) A federal judge in San Francisco said Wednesday that the government cannot prevent a pregnant 17-yea r-old at a Texas facility for unaccompanied immigrant children from getting an abortion, but declined to issue an order that would bar federal officials from interfering in the girl's access to the procedure. U.S. Magistrate Judge Laurel Beeler said the legal challenge on behalf of the girl by the American Civil Libertie s Union of Northern California was not filed in the right court. Associated Press, TX Oct. 12, 2017 Judge refuses to step in to immigrant's abortion controversy (featuring ACF) A federal judge Wednesday declined to make the federal government stop blocking a detained 17-year-old immigrant from getting an abortion, despite finding "no justification" for restricting her rights. U.S. Magistrate Judge Laurel Beeler rejected the ACLU's request for a restraining order as moot, finding the claims of an unaccomp anied immigrant minor at a shelter in Texas were too unrelated to the lawsuit already filed in Beeler' s court. Courthouse News Service, SF Oct. 12, 2017 Judge refuses to hear case on teenage illegal immigrant who wants an abortion(feat uring ACF) A federal judge in California refused to hear a case slated for Wednesday deciding whether the state of Texas must help a teenag e illegal immigrant obtain an abortion. U.S. Magistrate Judge Laurel Beeler said she couldn't hear the case because the girl - who remains anonymous for privacy reasons - is in Texas rather than the state of California. A judg e in another state does not have jurisdiction to rule on the case she said. Daily Caller, DC Oct. 12, 2017 Texas backs Trump agency in holding undocumented abortion-seeking minor 'hostage' (featuring A CF) Attorney General Ken Paxton declared in a court brief this week in support of the Trump administration's decision to prevent an undocumented minor from obtaining abortion in the state that Texas "must not become a sanctuary state for abortions." Paxton led six other states, including Loui siana and Oklahoma, in defending ORR in a court brief. However , the feds are legally required to provide unaccompanied minor s with basic necessities, such as housing and medical care, including family planning services and abortion. Austin Chronicle, TX Oct. 12, 2017 Judge says feds have no right to block undocumented minor's abortion - but won't stop them (featuring A CF) A federal judge has declined to stop the govern ment from blocking a teenage girl living in Texas from getting a legal abortion. The 17-year-old girl is an undocumented immigrant currently in the care of the federal government , since she travelled to the U.S. as an unaccompanied minor, /\MERICAi\ pVERSIGHT EXT-18-248-C-000373 meaning she is entitled to U.S. health care. But, while U.S. Magistrate Judge Laurel Beeler said she found "no justification" for the government restricting Doe's right to an abortion, she said the issue is out of her hands. San Antonio Current, TX Oct. 12, 2017 Undocumented teen's abortion delayed by CA ruling (featuring ACF) A U.S. magistrate judge in San Francisco refused Wednesday to order federal officials to allow an abortion for an undocumented pregnant 17-year-old who is being held in a governmentfunded shelter in Texas and who wants the procedure. U.S. Magistrate Judge Laurel Beeler said the case was too remote from the Northern California federal court district for her to take action. Beeler also said in a written ruling that the federal officials were not entitled to obstruct Jane Doe from obtaining an abortion. "The government may not want to facilitate abortion, but it cannot block it. It is doing that here," Beeler wrote. Cal[fornia Patch, CA Oct. 12, 2017 An immigrant minor in Texas is being denied an abortion because of this cruel Trump policy (featuring A CF) While living in a government-funded immigration center in Texas, an immigrant minor was denied an abortion , according to the American Civil Liberties Union. The young woman entered the United States undocumented at the age of 17 and is now under the legal custody of the Office of Refugee Resettlement (ORR). Despite obtaining a judicial waiver required by the state to obtain an abortion, she has been unable to obtain access to a clinic. Bustle, NY Oct. 12, 2017 Judge won't reverse Trump admin block on abortions for undocumented teen girls (featuring A CF) A federal judge refused Wednesday to step into a Texas abortion case involving a shelter that is encouraging a 17-year-old immigrant to choose life for her unborn baby , instead of abortion. On Wednesday, U.S. Magistrate Judge Laurel Beeler refused to grant the pro-abortion legal group ' s request , saying the restraining order should be filed in a different court and as a separate case to one that the ACLU filed earlier this year, according to the AP. While Beeler said the matter was not for her to decide , she also said she thinks there is "no justification" for preventing the girl from getting an abortion. Lif e News, DC Oct. 12, 2017 Judge denies ACLU effort to release immigrant girl from custody to get abortion (featuring ACF) A federal judge on Wednesday declined to force the federal government to release a pregnant girl from a refugee shelter so that she can get an abortion, saying the decision didn't belong in her court. But in her ruling , U.S. District Judge Laurel Beeler expressed concern that the Trump administration is blocking access to abortion for migrant girls in federal custody. Reveal/ The Center for Investigative Reporting, CA /\MERICAi\ pVERSIGHT EXT-18-248-C-000374 Oct. 11, 2017 Judge throws out suit filed by unaccompanied minor seeking abortion (featuring ACF) A federal judge threw out a suit Wednesday from an unaccompanied minor from Central America who sued the Trump administration for denying her access to an abortion during her detention in a federally funded immigration facility in Texas. In the ruling, the judge noted that the Trump administration can't legally prevent unaccompanied minors from getting abortions. But because the plaintiff was in Texas, the judge held, her case shouldn't have been heard in California, where it had been joined with another federal case challenging religious-affiliated detention centers denying abortions, according to the ACLU. Vice News, NY Oct. 11, 2017 Undocumented teen's request to have an abortion in Texas dismissed by federal judge (featuring A CF) A federal judge dismissed a request Wednesday for an undocumented teen to have an abortion in Texas, but her advocates say the fight is not over. The organization requested a temporary restraining order to force the U.S. Department of Health and Human Services to either transport Doe or allow her to be taken to an abortion clinic for her procedure. U.S. Magistrate Judge Laurel Beeler denied the request, saying that because Doe is not from the Northern California district, it's not the correct venue for the decision. Dallas Morning News, TX Oct. 11, 2017 Court won't hear case of undocumented teenager seeking abortion access (featuring ACF) A federal court has refused to hear the case of a pregnant 17-year-old undocumented immigrant at the center of a legal dispute over whether unaccompanied immigrant minors have the right to an abortion in the United States. The California judge denied the request, arguing that she couldn't hear Doe's case because Doe is in Texas. However, the judge did say that "the government has no business blocking Jane Doe's abortion." Texas Tribune, TX October 11, 2017 The latest: Judge won't order officials to allow abortion (featuring ACF) A federal judge won't order federal officials to allow a pregnant 17-year-old being held in a Texas facility for unaccompanied immigrant children to get an abortion. U.S. Magistrate Judge Laurel Beeler ruled Wednesday that the legal challenge on behalf of the girl by the American Civil Liberties Union of Northern California was not filed in the right court. Associated Press, DC Oct. 11, 2017 -Judge won't order officials to allow abortion (featuring ACF) A federal judge in California says she doesn't understand why federal officials don't step aside and allow a pregnant 17-year-old being held in a Texas facility for unaccompanied immigrant children to get an abortion. U.S. Magistrate Judge Laurel Beeler also said Wednesday during a /\MERICAi\ pVERSIGHT EXT-18-248-C-000375 hearing in San Francisco that she didn't think the legal challenge on behalf of the girl by the American Civil Liberties Union of Northern California belonged in her courtroom. Daily Journal, CA Oct. 11, 2017 Court denies reguest to release undocumented teen from Texas facility for an abortion (featuring A CF) A federal court denied a request Wednesday from attorneys advocating on behalf of a pregnant minor in the custody of the Office of Refugee Resettlement in Brownsville. The teenager is being prevented from getting an abortion because of a Trump administration policy that bars unaccompanied immigrant minors from accessing them. The court, which is in Northern California, said it couldn't grant the request because the teen is in Texas. In its ruling, however, it said "the government may not want to facilitate an abortion, but it cannot block it." KERA, TX Oct. 11, 2017 ACLU sues Trump administration to force government to provide abortions for illegal immigrant minors (featuring ACF) The American Civil Liberties Union (ACLU) added the case of an unaccompanied minor, who came into the U.S. illegally and is not being given abortion access by the government, to their June lawsuit against the federal government for awarding grant money to religious organizations , such as the United States Conference of Catholic Bishops (USCCB) that help unaccompanied minors but won't refer them for abortions. Townhall, CA Oct. 11, 2017 Immigrant minor held 'hostage' by Texas because she wants abortion care (featuring ACF) An unaccompanied immigrant minor at a Texas shelter is being prevented from accessing abortion care by the Office of Refugee Resettlement (ORR) , the federal agency overseeing migrant youth crossing the U.S.-Mexico border without a guardian. Officials are both refusing her transportation to the medical facility and refusing to allow her to leave the shelter with her guardian for the purpose of obtaining an abortion. ORR is supposed to provide transportation to minors when they need to go to court or see a doctor. Rewire, MD Oct. 11, 2017 -Texas can't become 'sanctuary state for abortions,' Paxton tells court (featuring ACF) Texas Attorney General Ken Paxton on Tuesday urged a federal court in San Francisco to say that women in the United States illegally do not have a right to abortion services. Paxton filed a brief in an existing case, which includes an undocumented minor in Texas seeking an abortion, arguing that the "Constitution does not confer on Jane Doe the right to an abortion. " El Paso Times, TX October JO, 2017 /\MERICAi\ pVERSIGHT EXT-18-248-C-000376 This information is provided for internal research purposes and should not be circulated outside of ACF. Each article is copyrighted by the source listed, and the prior written permission of the source is needed for further copying. Sender: Recipient: ACF Media Clips (ACF) "ACF- All ACFStaff " Sent Date: 2017/10/12 14:29:25 Delivered Date: 2017/10/12 14:32:12 /\MERICAi\ pVERSIGHT EXT-18-248-C-000377 Marriott, Brian (ACF) "Wolfe, Kenneth (ACF) "; "Wynne, Maggie (HHS/IOS) "; "Wagner, Steven (ACF) " ; "Yoest, Charmaine (OS/ASPA)"; "Lloyd, Scott (ACF) " CC: "Powers, Mary (ACF) " Subject: RE: UAC Dat e : 2017/10/ 12 15:16:29 Priority: Normal Type : Note Thanks Ken. Beat me to it. From: Wolfe, Kenneth (ACF) Sent: Thursday, October 12, 2017 3: 13 PM To: Wynne, Maggie (HHS/IOS); Wagner, St even (ACF); Yoest, Charmaine (OS/ASPA); Marriott, Brian (ACF); Lloyd, Scott (ACF) Cc: Powers, Mary (ACF) Subject: RE: UAC Here is the reconciled/final statement from last evening , attributable to the Administration for Children and Families at the U.S. Department of Health and Human Services - "In most cases when a child enters the United States illegally without a parent or guard ian, by law the minor is placed into the care and custody of the Office of Refugee Resett lement at HHS' Administrat ion for Children and Families. At that po int, our paramount concern is the child' s safety and well-being. While the child is in our custody , our goal is to provide food, shelter and care to her under federal statute. In this specific case, we are prov iding exce llent care to the adolesce nt girl and her unborn child, who remain under our care until the mother' s release." From: Wynne, Maggie (HHS/l05) Sent: Thursday, October 12, 2017 3:11 PM To: Wagner, Steven (ACF); Yoest, Charmaine (OS/ASPA); Marriott, Brian (ACF); Wolfe, Kenneth /\MERICAi\ pVERSIGHT EXT-18-248-C-000378 (ACF); Lloyd, Scott (ACF) Cc: Powers, Mary (ACF) Subject: UAC Please ensure that I am included on emai ls related to the UAC case currently at issue in TX. E .g., I don't think I have received the final ACF-prepa red statement. Thank you , Maggie Marriott, Brian (ACF) "Wolfe, Kenneth (ACF) "; "Wynne, Maggie (HHS/IOS) "; "Wagner, Steven (ACF) "; "Yoest, Charmaine (OS/ASPA)"; "Lloyd, Scott (ACF) "; "Powers, Mary (ACF) " Sent Date: 2017/10/12 15:16:28 Delivered Date: 2017/10/12 15:16:29 /\MERICAi\ pVERSIGHT EXT-18-248-C-000379 From: Bena, Anna Marie (HHS/OGC)(ACF) To: "ORRSenior Leadership "; "Wynne, Maggie (HHS/IOS) " Subject: ORRLitigation Update Date : 2017/10/12 15:49:05 Priority : Normal Type: Note I have attached the litigation update. UAClitigation. In ACLU v Price, on 10/5 the ACLU filed a Motion to Amend/Correct their complaint and a First Motion for Temporary Restraining Order related to ORRfamily planning practices arising out of Texas. On 10/11, the court denied both motions, but denied the TRO without prejudice to Jane Doe's asserting her claims in a different lawsuit. In Gomez, on 10/6, the defendants filed several documents in support of their Motions to Dismiss. Refugeelitigation. In Indiana, on 10/10 the court granted Indiana's motion for extension of time to file a reply (reply due by 10/18). In Oregon, on 10/6 the court granted Federal defendants' motion for extension of time to file response/reply regarding their motion to dismiss. UACbond hearings. • There are currently 21 outstanding bond hearing requests. Of these: o 7 hearings are currently scheduled: • 1 hearing in the Arlington, VA • 6 hearings in the New York, NY court o 3 motions have been fi led in San Antonio, TX (awaiting scheduling notices) o 1 motion filed by ORRwas rejected by the San Francisco court; ORRwill re-file • Since last week: o There have been no bond hearings. o 1 UAC withdrew his bond hearing request. • To date there have been: o 8 IJ decisions. In all cases the judges agreed with ORR. o 18 UACs who requested bond hearings but subsequently withdrew their requests o 10 UACs who requested bond hearings but no longer require them because they are no longer in ORRcustody (e.g., because they were subsequently reunified with a sponsor, were ordered removed, aged out, etc.). Sender: Recipient: Bena, Anna Marie (HHS/OGC)(ACF) "ORRSenior Leadership"; "Wynne, Maggie (HHS/IOS) " Sent Date: 2017/10/12 15:49:01 /\MERICAi\ pVERSIGHT EXT-18-248-C-000380 Delivered 15:49:05 Holt, Lydia (ACF) To: "Lloyd, Scott (ACF) " "White, Jonathan (ACF) "; CC: "White, Laura (ACF) " Subject: RE: Follow-upfrom AssociatedPress/ UACLitigation Date: 2017/10/12 15:52:46 Priority: Normal Type: Note Will do. Thank.you, Lydia From: Lloyd, Scott (ACF) Sent: Thursday, October 12, 2017 3:51 PM To: Holt , Lydia (ACF) Cc: White, Jonathan (ACF); White, Laura (ACF) Subject: RE: Follow-up fro m Associated Press/ UAC Litigation Plea se respond that we're not able to answer that question , as to # 1 From: Holt, Lydia (ACF) Sent: Thursday, October 12, 2017 3:49 PM To: Lloyd, Scott (ACF) Cc: White, Jonathan (ACF); White, Laura (ACF) Subject: Follow-up from Associated Press/ UAC Litigation Hi Scott, I am providing the follow-up query below for your awareness. Both Jonathan and AnnaMarie have advised that the only question we would be able to answer is question #1. However, providing this data, which is a very tedious process, will take a number of days to complete. Please let me know if you have any concerns. Thanks. QUERY /\MERICAi\ pVERSIGHT EXT-18-248-C-000382 I'm working on a follow-up to the Jane Doe story and had a few specific questions for ACF related to emails the ACLUof Northern California included in one of its federal court filings. A Lot of these emails were excerpted by the Center for Investigative Reporting and written here: https://www.revealnews.org/blog/court-filing-trump-appointee-blockspregnant-teen-migrant-from-getting-abortion/ The questions I had were: 1. How many children in HHS' custody are pregnant? 2. Is it ORR policy to forbid (or discourage) unaccompanied children in its custody from seeking a judicial bypass of abortion restrictions? (Noting email from Scott Lloyd: "She should not be meeting with an attorney regarding her termination or otherwise pursuing judicial bypass at this point ." 3. Is it ORR policy to require unaccompanied children in its custody to obtain parental consent and specifically a notarized declaration of consent from the parents, even if the parents might be in a foreign country? (Noting email at top of Document 84-8 : "After the options counseling, if the UC still desires the abortion, and it is still within the window for a legal abortion, a. the UC must obtain parental consent, which will necessitate options counseling with them, plus signed, notarized declaration of consent.") 4. Related to those from Scott Lloyd abortion services affirming options questions, has ORR codified guidance in a March 30 email (Document 84-4 : "Grantees should not be supporting pre or post-release; only pregnancy services and lifecounseling.") 5. In a March 22 email, a writer whose name is blacked out questions whether ORR's directive not to allow unaccompanied children to get a judicial bypass is legally sound. The response to that email is entirely blacked out. What did ORR instruct that writer and others who may have questioned the policy? (March 22 email in Document 84-3 : "Isn't that contrary to state law? My understanding is that the judicial bypass was created specifically so that the young lady does not need approval from her guardian (in our case the Director of ORR) to move forward with a term of pregnancy.") 6. Has Director Lloyd spoken directly to any individual children seeking an abortion? (Noting email in Document 84-6 from Jonathan White: "Were you able to speak with the pregnant girl at the SWK site (KAMM)?"And /\MERICAi\ pVERSIGHT EXT-18-248-C-000383 Scott Lloyd response "Yes-they were going to a CPCsite today and we 're going to discharge according to my understanding ."} Lydia A. Holt Publi c Affairs Specialist Office of Refugee Resettlement Administration for C hildr en and Fami lies (ACF) U.S. Department of Health and Human Services 330 C Street SW Washington, D.C. 2020 1 Lydia.Holt @acf.hhs. gov 202.40 I .9217 (W) rC) i(b)(6) Teleworking on Mondays Holt, Lydia (ACF) "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; "White, Laura (ACF) " Sent Date: 2017/10/12 15:52:45 Delivered Date: 2017/10/12 15:52:46 /\MERICAi\ pVERSIGHT EXT-18-248-C-000384 White, Jonathan (ACF) To: "Lloyd, Scott (ACF) " CC: "White, Laura (ACF) " Subject : Re: Follow-up from AssociatedPress/ UACLitigation Date: 2017/10/12 16:44:32 Priority : Normal Type: Note Scott, (b)(5) Jonathan Jonathan White Commander , US Public Hea lth Service Deputy Director for Children's Programs Office of Refugee Resettlement Administration for Children and Fam ilies Jonathan. White acf.hhs.gov (b)(6) On: 12 October 2017 15:50, "Lloyd, Scott (ACF)" wrote : Please respond that we' re not able to answer that question, as to #1 From: Holt, Lydia (ACF) Sent : Thursday, October 12, 2017 3:49 PM To: Lloyd, Scott (ACF) Cc: White, Jonathan (ACF); White, Laura (ACF) Subject: Follow-up from Associated Press/ UACLitigation Hi Scott, I am providing the follow -up query below for your awareness . Both Jonat han and AnnaMarie have advised that the only question we would be able to answer is question #1. However, providing this data, which is a very tedious process, will take a number of days to complete . Please let me know if you have any concerns. Thanks . /\MERICAi\ pVERSIGHT EXT-18-248-C-000385 QUERY I'm working on a follow-up to the Jane Doe story and had a few specific questions for ACF related to ema ils the ACLUof Northern California included in one of its federal court filings. A lot of these emails were excerpted by the Center for Investigative Reporting and written here: https://www.revealnews.org/blog/courtfiling-trump-appointee-blocks-pregnant-teen-miqrant-from-getting-abortion/ The questions I had were: 1. How many children in HHS' custody are pregnant? 2. Is it ORR policy to forbid (or discourage) unaccompanied children in its custody from seeking a judicial bypass of abortion restrictions? (Noting email from Scott Lloyd: "She should not be meeting with an attorney regarding her termination or otherwise pursuing judicial bypass at this point." 3. Is it ORR policy to require unaccompanied children in its custody to obtain parental consent and specifically a notarized declaration of consent from the parents, even if the parents might be in a foreign country? (Noting email at top of Document 84-8: "After the options counseling, if the UC still desires the abortion, and it is still within the window for a legal abortion, a. the UC must obtain parental consent, which will necessitate options counseling with them, plus signed, notarized declaration of consent .") 4. Related to those questions, has ORR codified guidance in a March 30 email from Scott Lloyd (Document 84-4: "Grantees should not be supporting abortion services pre or post-release; only pregnancy services and lifeaffirming options counseling.") 5. In a March 22 email, a writer whose name is blacked out questions whether ORR's directive not to allow unaccompanied children to get a judicial bypass is legally sound . The response to that email is entirely blacked out. What did ORR instruct that writer and others who may have questioned the policy? (March 22 email in Document 84-3 : "Isn't that contrary to state law? My understanding is that the judicial bypass was created specifically so that the young lady does not need approval from her guardian (in our case the Director of ORR) to move forward with a term of pregnancy.") 6. Has Director Lloyd spoken directly to any individual children seeking an abortion? (Noting email in Document 84-6 from Jonathan White: "Were you able to speak with the pregnant girl at the SWK site (KAMM)?"And Scott Lloyd response "Yes-they were going to a CPC site today and we're going to discharge according to my understanding.") /\MERICAi\ pVERSIGHT EXT-18-248-C-000386 Lydia A. Holt Public Affairs Specialist Office of Refugee Resettlement Administration for Children and Families (ACF) U.S. Department of Health and Human Services 330 C Street SW Washington, D.C. 2020 1 Lydia.Holt @acf.hhs.gov 2 2.4 1.9217 (W) (C) (b)(6) Teleworking on Mondays White, Jonathan (ACF) "Lloyd, Scott (ACF) "; Recipient : "White, Laura (ACF) " Sent Date : 2017/10/12 16:44:32 /\MERICAi\ pVERSIGHT EXT-18-248-C-000387 Wolfe, Kenneth (ACF) "Marriott, Brian (ACF) "; "Lloyd, Scott (ACF) "; To: "Wagner, Steven (ACF) "; "Pilato, Anna (ACF) " CC: "Powers, Mary (ACF) " Subject: RE: New lawsuit Date : 2017/10/13 16:43:02 Priority : Normal Type: Note The follow-up statement could incorporate language from Matt's talking points : (b)(S) /\MERICAi\ pVERSIGHT EXT-18-248-C-000388 From: Marriott, Brian (ACF) Sent: Friday, October 13, 2017 4:41 PM To : Lloyd, Scott (ACF); Wolfe, Kenneth (ACF); Wagner, Steven (ACF); Pilato, Anna (ACF) Cc: Powers, Mary (ACF) Subject: Re: New lawsuit I totally agree with that statement Scott. (bl(5l fb l(5 l IIam on the metro head!,-,-in-g-to_p_,,i,....ck,--u.........,.,.,.,....-----.-0-r_a.,....b-ou_t_a_n_a_n_o... .... or_e__. I get off. Steve, can you call Charmaine and Matt B t (b)(5) Brian On: 13 October 2017 16:24, "Llovd, Scott (ACF)" wrote: b)(5) From: Wolfe, Kenneth (ACF) Sent: Friday, October 13, 2017 4:18 PM To: Wagner, Steven (ACF); Marriott, Brian (ACF); Lloyd, Scott (ACF); Pilato, Anna (ACF) Subject: RE: New lawsuit Here is the new Associated Press article, following an interview with attorney Rochelle Garza: https://www.washingtonpost.com/national/immigrant-teen s-advocates-us-pushing-anti-abortionagenda/2017 / 10/ 13/b 1d l b9f4-b03e- l l e7-9b93-b97043e57a22 story.html Immigrant teen's advocates: US /\MERICAi\ pVERSIGHT EXT-18-248-C-000389 pushing antiabortion agenda By Nomaan Merchant IAssociated Press HOUSTON - Shortly after taking over the U.S. government office that oversees facilities for unaccompanied immigrant children, Scott Lloyd told a subordinate what to do with a teenager who wanted an abortion. Facilities under HHS "should not be supporting abortion services pre or post-release," but rather "life-affirming options counseling, " Lloyd wrote in an email. And the person seeking an abortion "should not be meeting with an attorney regarding her termination" or seeking a waiver exempting her from a state requirement that minors get a parent's consent, he wrote in another. The apparent new policy is being put to the test, as lawyers have gone to court to try to force the government to allow a 17-year-old Central American being held at a Texas facility to get an abortion. They accuse the Trump administration of trying to stop any immigrant teens in government custody from terminating a pregnancy. "She's being used as a pawn, " Rochelle Garza, a lawyer appointed to represent the interests of the teen , told The Associated Press on Thursday. She declined to give her client's name and native country due to privacy concerns. The teen is as much as 14 weeks pregnant in a state that bans most abortions after the 20th week and she's feeling hopeless, Garza said. On Wednesday, a federal judge in San Francisco said the government /\MERICAi\ pVERSIGHT EXT-18-248-C-000390 can 't prevent the teen from getting an abortion, but she said the case was filed in the wrong jurisdiction and declined to order the government not to interfere with the teen 's abortion access. Garza and the other lawyers, including some from the American Civil Liberties Union, filed a new complaint Friday in federal district court in Washington, D.C. The ACLU included Lloyd's emails in a filing in the case against the U.S. Department of Health and Human Services, which oversees facilities for children who arrive in the U.S. on their own. HHS didn 't respond to questions about whether it has a formal policy restricting immigrants in its care from seeking abortions. But last month, it issued a draft of its department-wide strategic plan for 2018 to 2022 that defines its mission as "serving and protecting Americans at every stage of life, beginning at conception." The agency also didn't reply to detailed questions about the emails, many of which had large portions blacked out. It has roughly 5,000 children currently in custody, though it did not say how many are pregnant. It did issue a statement Wednesday saying it is "providing excellent care to the adolescent girl and her unborn child, who remain under our care until the mother's release." Lloyd became director of HHS' Office of Refugee Resettlement in March after working for the Knights of Columbus, a Catholic group that opposes abortion. In an email dated March 14, Lloyd followed up on a visit with a pregnant teenager living at a facility for unaccompanied children. He asked for the shelter to meet her requests for bananas and soup, and to give her a more comfortable mattress. /\MERICAi\ pVERSIGHT EXT-18-248-C-000391 "Please have her clinician keep a close eye on her," Lloyd wrote. "As I've said, often these girls start to regret abortion, and if this comes up, we need to connect her with resources for psychological and/ or religious counseling." He also offered to connect the teen with "a few good families" who would "see her through her pregnancy." In a March 24 email, Lloyd said a girl who was pregnant should be offered "spiritual counseling" or taken for an ultrasound to a crisis pregnancy center. Such facilities seek to discourage women from having abortions. "She should not be meeting with an attorney regarding her termination or otherwise pursuing judicial bypass at this point," Lloyd said. Susan Hays, legal director of Jane's Due Process, which helps pregnant minors in Texas to get abortions, accused HHS of being "turned over to ideological extremists who want to use the power of the federal government to impose their religion on everyone else." Hays, whose group is working with the 17-year-old now seeking an abortion, said another teen earlier this year obtained the judicial bypass required by Texas law and began a medication abortion, which is administered by pills taken on two successive days. The first pill was administered on a Friday, but before the second pill could be given Saturday, HHS ordered the facility holding the teen not to let her have it, Hays said. Starting but not completing the abortion could have put the teenager's life at risk. /\MERICAi\ pVERSIGHT EXT-18-248-C-000392 After Hays and others intervened and threatened to go to court, the teen was allowed to complete the abortion that Sunday, she said. "That is a dystopian future for teenage girls who are forced to do that, and that's what ORR is doing today," Hays said. Garza said she is wrongly being denied access to her client, even though she has been appointed a guardian under the law and obtained a judicial bypass order. The teen will turn 18 before her pregnancy would reach full term, which could lead to her being transferred to an adult detention facility run by U.S. Immigration and Customs Enforcement. Garza said she fears the teen will be forced to have the child in adult detention or deported back to Central America, where she witnessed her parents beat a sister who was pregnant. "It's going to get to the point where there aren't more options, and then what's going to happen?" Garza said. From: Wagner, Steven (ACF) Sent: Friday, October 13, 2017 3:59 PM To : Wolfe, Kenneth (ACF); Marriott, Brian (ACF); Lloyd, Scott (ACF); Pilato, Anna (ACF) Subject: RE: New lawsuit I concur. Thanks From: Wolfe, Kenneth (ACF) Sent: Friday, October 13, 2017 2:21 PM To: Wagner, Steven (ACF); Marriott, Brian (ACF); Lloyd, Scott (ACF); Pilato, Anna (ACF) Subject: New lawsuit r~ FYI, we have received requests for comment from the Associated Press and NPR so far on this. I Wolfe, Kenneth (ACF) /\MERICAi\ pVERSIGHT EXT-18-248-C-000393 "Marriott, Brian (ACF) "; "Lloyd, Scott (ACF) "; "Wagner, Steven (ACF) "; "Pilato, Anna (ACF) "; "Powers, Mary (ACF) " Sent Date: 2017/10/13 16:43:02 /\MERICAi\ pVERSIGHT EXT-18-248-C-000394 Powers, Mary (ACF) "Wolfe, Kenneth (ACF) "; "Marriott, Brian (ACF) "; "Lloyd, Scott (ACF) "; "Wagner, Steven (ACF) "; "Pilato, Anna (ACF) " Subject : RE: New lawsuit Date : 2017/10/13 16:53:00 Importan ce: High Priority : Urgent Type: Note How far are we in getting these approved? I can call Charmaine tonight and get them approved. Edited the third bullet as suggestion. (b)(5) *Confidentialand pre-decisionalcommunication. From: Wolfe, Kenneth (ACF) Sent: Friday, October 13, 2017 4:43 PM To: Marriott, Brian (ACF); Lloyd, Scott (ACF); Wagner, Steven (ACF); Pilato, Anna (ACF) Cc: Powers, Mary (ACF) Subject: RE: New lawsuit The follow-up statement could incorporate language from Matt ' s talking points: (b)(S) /\MERICAi\ pVERSIGHT EXT-18-248-C-000395 (b)(5) From: Marriott, Brian (ACF) Sent: Friday, October 13, 2017 4:41 PM To : Lloyd, Scott (ACF); Wolfe, Kenneth (ACF); Wagner, Steven (ACF); Pilato, Anna (ACF) Cc: Powers, Mary (ACF) Subject: Re: New lawsuit . ~ KS) I totally agree with that statement Scott. i wrote: (b)(5) From: Wolfe, Kenneth (ACF) Sent: Friday, October 13, 2017 4: 18 PM To : Wagner, Steven (ACF); Marriott, Brian (ACF); Lloyd, Scott (ACF); Pilato, Anna (ACF) Subject: RE: New lawsuit Here is the new Associated Press article, following an interview with attorney Rochelle Garza: /\MERICAi\ pVERSIGHT EXT-18-248-C-000396 https ://www .washing tonpost.com/national/immigrant -teens -advocates-us-pushing -anti-abortionagenda/2017 / 10/ 13/bld l b9f4-b03e- l le 7-9b93-b97043e5 7a22 story.html Immigrant teen's advocates: US pushing antiabortion agenda By Nomaan Merchant IAssociated Press HOUSTON - Shortly after taking over the U.S. government office that oversees facilities for unaccompanied immigrant children, Scott Lloyd told a subordinate what to do with a teenager who wanted an abortion. Facilities under HHS "should not be supporting abortion services pre or post-release, " but rather "life-affirming options counseling, " Lloyd wrote in an email. And the person seeking an abortion "should not be meeting with an attorney regarding her termination" or seeking a waiver exempting her from a state requirement that minors get a parent 's consent, he wrote in another. The apparent new policy is being put to the test , as lawyers have gone to court to try to force the government to allow a 17-year-old Central American being held at a Texas facility to get an abortion. They accuse the Trump administration of trying to stop any immigrant teens in governm ent custody from terminating a pr egnancy. /\MERICAi\ pVERSIGHT EXT-18-248-C-000397 "She's being used as a pawn," Rochelle Garza, a lawyer appointed to represent the interests of the teen, told The Associated Press on Thursday. She declined to give her client's name and native country due to privacy concerns. The teen is as much as 14 weeks pregnant in a state that bans most abortions after the 20th week and she's feeling hopeless, Garza said. On Wednesday, a federal judge in San Francisco said the government can't prevent the teen from getting an abortion, but she said the case was filed in the wrong jurisdiction and declined to order the government not to interfere with the teen 's abortion access. Garza and the other lawyers, including some from the American Civil Liberties Union, filed a new complaint Friday in federal district court in Washington, D.C. The ACLU included Lloyd's emails in a filing in the case against the U.S. Department of Health and Human Services, which oversees facilities for children who arrive in the U.S. on their own. HHS didn't respond to questions about whether it has a formal policy restricting immigrants in its care from seeking abortions. But last month, it issued a draft of its department-wide strategic plan for 2018 to 2022 that defines its mission as "serving and protecting Americans at every stage of life, beginning at conception." The agency also didn't reply to detailed questions about the emails, many of which had large portions blacked out. It has roughly 5,000 children currently in custody, though it did not say how many are pregnant. It did issue a statement Wednesday saying it is "providing excellent care to the adolescent girl and her unborn child, who remain under our care until the mother's release." /\MERICAi\ pVERSIGHT EXT-18-248-C-000398 Lloyd became director of HHS' Office of Refugee Resettlement in March after working for the Knights of Columbus, a Catholic group that opposes abortion. In an email dated March 14, Lloyd followed up on a visit with a pregnant teenager living at a facility for unaccompanied children. He asked for the shelter to meet her requests for bananas and soup, and to give her a more comfortable mattress. "Please have her clinician keep a close eye on her," Lloyd wrote. "As I've said, often these girls start to regret abortion, and if this comes up, we need to connect her with resources for psychological and/ or religious counseling." He also offered to connect the teen with "a few good families" who would "see her through her pregnancy." In a March 24 email, Lloyd said a girl who was pregnant should be offered "spiritual counseling" or taken for an ultrasound to a crisis pregnancy center. Such facilities seek to discourage women from having abortions. "She should not be meeting with an attorney regarding her termination or otherwise pursuing judicial bypass at this point," Lloyd said. Susan Hays, legal director of Jane's Due Process, which helps pregnant minors in Texas to get abortions, accused HHS of being "turned over to ideological extremists who want to use the power of the federal government to impose their religion on everyone else." Hays, whose group is working with the 17-year-old now seeking an abortion, said another teen earlier this year obtained the judicial /\MERICAi\ pVERSIGHT EXT-18-248-C-000399 bypass required by Texas law and began a medication abortion, which is administered by pills taken on two successive days. The first pill was administered on a Friday, but before the second pill could be given Saturday, HHS ordered the facility holding the teen not to let her have it, Hays said. Starting but not completing the abortion could have put the teenager's life at risk. After Hays and others intervened and threatened to go to court, the teen was allowed to complete the abortion that Sunday, she said. "That is a dystopian future for teenage girls who are forced to do that, and that's what ORR is doing today," Hays said. Garza said she is wrongly being denied access to her client, even though she has been appointed a guardian under the law and obtained a judicial bypass order. The teen will turn 18 before her pregnancy would reach full term, which could lead to her being transferred to an adult detention facility run by U.S. Immigration and Customs Enforcement. Garza said she fears the teen will be forced to have the child in adult detention or deported back to Central America, where she witnessed her parents beat a sister who was pregnant. "It's going to get to the point where there aren't more options, and then what's going to happen?" Garza said. From: Wagner, Steven (ACF) Sent: Friday, October 13, 2017 3:59 PM To : Wolfe, Kenneth (ACF); Marriott, Brian (ACF); Lloyd, Scott (ACF); Pilato, Anna (ACF) Subject: RE: New lawsuit I concur. Thanks /\MERICAi\ pVERSIGHT EXT-18-248-C-000400 From: Wolfe, Kenneth (ACF) Sent : Friday, Octobe r 13, 20 17 2 :21 PM To : Wagne r, Steven (ACF); Marriott, Brian (ACF); Lloyd, Scott (ACF); Pilato, Anna (ACF) Subject: New lawsuit FYI, we have received requests for comment from the Associated Press and NPR so far on this. I l(b)(S) Sender: Powers, Mary (ACF) "Wo lfe, Kenneth (ACF) "; "Ma rriott, Brian (ACF) "; "Lloyd, Scott (ACF) "; "Wagner, Steven (ACF) "; "Pilato, Anna (ACF) " Sent Date: 2017/10/13 16:53 :00 /\MERICAi\ pVERSIGHT EXT-18-248-C-000401 Wolfe, Kenneth (ACF) To: "Lloyd, Scott (ACF) " Subject: RE: New lawsuit Date: 2017/10/13 17:38:02 Priority: Normal Type : Note Hi, Scott. Have you heard from Steve on this since 3:59? I want to be sure he is on board before moving forward. From: Wolfe, Kenneth (ACF) Sent : Friday, October 13, 2017 5:30 PM To : Lloyd, Scott (ACF); Pilato, Anna (ACF); Marr iott, Brian (ACF); Wagner, St even (ACF) Subject: RE: New lawsu it Steve/Brian - if you concur, the best route would be fo ~(b)(S) ltor the Associated Pres~c:1.-----------------' ~b)(S) From : Lloyd, Scott (ACF) Sent: Friday, October 13, 2017 5:07 PM To : Pilato, Anna (ACF); Wolfe, Kenneth (ACF); Marriott, Brian (ACF); Wagner, Steven (ACF) Subject: RE: New lawsuit I concur-thank you . From: Pilato, Anna (ACF) Sent: Friday, October 13, 2017 5:06 PM To : Wolfe, Kenneth (ACF); Lloyd, Scott (ACF); Marriott, Brian (ACF); Wagner, Steven (ACF) Subject: Re: New lawsuit I think that's a good idea. If we don't get a quick response we reach out to Charmaine On: 13 October 2017 16:55, "Wolfe, Kenneth (ACF)" wrote: (b)(5) (b)(5) /\MERICAi\ pVERSIGHT EXT-18-248-C-000402 From: Lloyd, Scott (ACF) Sent: Friday, October 13, 2017 4:47 PM To : Marriott, Brian (ACF); Wolfe, Kenneth (ACF); Wagner, Steven (ACF); Pilato, Anna (ACF) Subject: RE: New lawsuit (b)(5) Thank you, Scott From: Marriott, Brian (ACF) Sent: Friday, October 13, 2017 4:43 PM To : Lloyd, Scott (ACF); Wolfe, Kenneth (ACF); Wagner, Steven (ACF); Pilato, Anna (ACF) Subject: Re: New lawsuit l(b)(5) Brian On: 13 October 2017 16:24, "Lloyd, Scott (ACF)" wrote: (b)(5) From: Wolfe, Kenneth (ACF) Sent: Friday, October 13, 2017 4: 18 PM To : Wagner, Steven (ACF); Marriott, Brian (ACF); Lloyd, Scott (ACF); Pilato, Anna (ACF) Subject: RE: New lawsuit Here is the new Associated Press article, following an interview with attorney Rochelle Garza: https ://www. washingtonpost. corn/national/immigrant-teens-advocates-us-pushing-anti-abortionagenda /2017 /10/13/ b 1dl b9f4-b03e-11 e7-9b93-b97043e57a22 story.htm l /\MERICAi\ pVERSIGHT EXT-18-248-C-000403 Immigrant teen's advocates: US pushing antiabortion agenda By Nomaan Merchant IAssociated Press HOUSTON - Shortly after taking over the U.S. government office that oversees facilities for unaccompanied immigrant children, Scott Lloyd told a subordinate what to do with a teenager who wanted an abortion. Facilities under HHS "should not be supporting abortion services pre or post-release," but rather "life-affirming options counseling," Lloyd wrote in an email. And the person seeking an abortion "should not be meeting with an attorney regarding her termination" or seeking a waiver exempting her from a state requirement that minors get a parent's consent, he wrote in another. The apparent new policy is being put to the test, as lawyers have gone to court to try to force the government to allow a 17-year-old Central American being held at a Texas facility to get an abortion. They accuse the Trump administration of trying to stop any immigrant teens in government custody from terminating a pregnancy. "She's being used as a pawn," Rochelle Garza, a lawyer appointed to represent the interests of the teen, told The Associated Press on /\MERICAi\ pVERSIGHT EXT-18-248-C-000404 Thursday. She declined to give her client's name and native country due to privacy concerns. The teen is as much as 14 weeks pregnant in a state that bans most abortions after the 20th week and she's feeling hopeless, Garza said. On Wednesday, a federal judge in San Francisco said the government can 't prevent the teen from getting an abortion, but she said the case was filed in the wrong jurisdiction and declined to order the government not to interfere with the teen 's abortion access. Garza and the other lawyers, including some from the American Civil Liberties Union, filed a new complaint Friday in federal district court in Washington, D.C. The ACLU included Lloyd's emails in a filing in the case against the U.S. Department of Health and Human Services, which oversees facilities for children who arrive in the U.S. on their own. HHS didn't respond to questions about whether it has a formal policy restricting immigrants in its care from seeking abortions. But last month, it issued a draft of its department-wide strategic plan for 2018 to 2022 that defines its mission as "serving and protecting Americans at every stage of life, beginning at conception." The agency also didn't reply to detailed questions about the emails, many of which had large portions blacked out. It has roughly 5,000 children currently in custody , though it did not say how many are pregnant. It did issue a statement Wednesday saying it is "providing excellent care to the adolescent girl and her unborn child, who remain under our care until the mother's release." /\MERICAi\ pVERSIGHT EXT-18-248-C-000405 Lloyd became director of HHS' Office of Refugee Resettlement in March after working for the Knights of Columbus, a Catholic group that opposes abortion. In an email dated March 14, Lloyd followed up on a visit with a pregnant teenager living at a facility for unaccompanied children. He asked for the shelter to meet her requests for bananas and soup, and to give her a more comfortable mattress. "Please have her clinician keep a close eye on her," Lloyd wrote. "As I've said, often these girls start to regret abortion, and if this comes up, we need to connect her with resources for psychological and/ or religious counseling." He also offered to connect the teen with "a few good families" who would "see her through her pregnancy." In a March 24 email, Lloyd said a girl who was pregnant should be offered "spiritual counseling" or taken for an ultrasound to a crisis pregnancy center. Such facilities seek to discourage women from having abortions. "She should not be meeting with an attorney regarding her termination or otherwise pursuing judicial bypass at this point," Lloyd said. Susan Hays, legal director of Jane's Due Process, which helps pregnant minors in Texas to get abortions, accused HHS of being "turned over to ideological extremists who want to use the power of the federal government to impose their religion on everyone else." Hays, whose group is working with the 17-year-old now seeking an abortion, said another teen earlier this year obtained the judicial /\MERICAi\ pVERSIGHT EXT-18-248-C-000406 bypass required by Texas law and began a medication abortion, which is administered by pills taken on two successive days. The first pill was administered on a Friday, but before the second pill could be given Saturday, HHS ordered the facility holding the teen not to let her have it, Hays said. Starting but not completing the abortion could have put the teenager's life at risk. After Hays and others intervened and threatened to go to court, the teen was allowed to complete the abortion that Sunday, she said. "That is a dystopian future for teenage girls who are forced to do that, and that's what ORR is doing today," Hays said. Garza said she is wrongly being denied access to her client, even though she has been appointed a guardian under the law and obtained a judicial bypass order. The teen will turn 18 before her pregnancy would reach full term, which could lead to her being transferred to an adult detention facility run by U.S. Immigration and Customs Enforcement. Garza said she fears the teen will be forced to have the child in adult detention or deported back to Central America, where she witnessed her parents beat a sister who was pregnant. "It's going to get to the point where there aren't more options, and then what's going to happen?" Garza said. From: Wagner, Steven (ACF) Sent: Friday, October 13, 2017 3:59 PM To : Wolfe, Kenneth (ACF); Marriott, Brian (ACF); Lloyd, Scott (ACF); Pilato, Anna (ACF) Subject: RE: New lawsuit I concur. Thanks /\MERICAi\ pVERSIGHT EXT-18-248-C-000407 From: Wolfe, Kenneth (ACF) Sent: Friday, October 13, 2017 2:21 PM To : Wagner, Steven (ACF); Marriott, Brian (ACF); Lloyd, Scott (ACF); Pilato, Anna (ACF) Subject: New lawsuit FYI, we have received requests for comment from the Associated Press and NPR so far on this. I fb )(5) Sender: Recipient: Wolfe, Kenneth (ACF) (FYDIBOHF23SPDL T)/CN= RECIPIENTS/CN "Lloyd, Scott (ACF) " Sent Date: 2017/10/13 17:38:02 /\MERICAi\ pVERSIGHT EXT-18-248-C-000408 From: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; "Moreno, Mr. Pedro (ACF) "; To: "Swartz, Tricia (ACF) "; "Sualog, Jallyn (ACF) "; "De LA Cruz, James (ACF) " CC: "Biswas, Toby RM (ACF) "; "White, Laura (ACF) " Subject: Fwd: Date: 2017/10/ 13 17:45:58 Priority: Normal Type: Note From: "Haron, Judith (HHS/OGC)" Subject: Date: 13 October 2017 16:41 To: "Bena, Anna Marie (HHS/OGC) (ACF)" , "Suh, Victor (HHS/OGC) (ACF) (CTR)" , "Biswas, Toby RM (ACF)" Cc: "Woolford, Llewellyn (HHS/OGC)" Here is the full filing today. You will see there are exhibits from the discovery, including ORR emails. Sender: Bena, Anna Marie (HHS/OGC)(ACF) "Lloyd, Scott (ACF) "; "White, Jonathan (ACF) "; "Moreno, Mr. Pedro (ACF) "; Recipient: "Swartz, Tricia (ACF) "; "Sualog, Jallyn (ACF) "; "De LA Cruz, James (ACF) "; /\MERICAi\ pVERSIGHT EXT-18-248-C-000409 "Biswas,Toby RM (ACF) "; "White, Laura (ACF) " Sent Date: 2017/10/13 17:45:47 Delivered Date: 2017/10/13 17:45:58 Message Flags: Unread /\MERICAi\ pVERSIGHT EXT-18-248-C-000410 From: b)(6) k!iiestex.org> "Lloyd, Scott (ACF)" "White, Jonathan (ACF) "; CC: "Brooks,Teresa (ACF) " Subject: Brief Update IES LF SHELTERRE: State Court hearing Date: 2017/10/13 19:49:09 Priority: Normal Type: Note Good Evening Mr. Lloyd, I am writing to provide a brief update, as previously discussed , UAC has informed her Clinician and Case Manager that she wishes to make contact with her mother in home count . Several attemptsw re made but were unsuccessful, this afternoon assigned Case Manager b)(6) l(b)(5> was able to reach one of minor's brother whom stated his mother was a.... t .,...ho_m_e_a_,nd he was at school and could not talk at the moment , therefore at the request of UAC assigned Case Manager attempted to reach UAC's mother and was successful. Case Manager introduced herself to minor 's mother and then handed the call to the UAC, minor spoke to her mother for approximately 15 minutes and there were no identified issues or concerns during the call. UAC's affect was flat however she demonstrated no emotional distress and appeared to be engaged in a constructive conversation with her mother. 1 Following conversation with her mother , UAC inquired about the possibility of reunifying with her brother Jose (21 years of age) whom recently arrived in the United States, UAC was informed care provider has attempted to reach out to her sibling however efforts have been unsuccessful , but UAC was reassured Case Manager would continue efforts to identify a viable sponsor. UAC is scheduled to make contact with mother twice a week, her next call is scheduled for Sunday, October 15, 2017. Please note, at this time there are no additional updates to report, should any issues or concerns arise I will be sure to keep you posted , thank you and have a wonderful weekend . P.S. APD and myself will be attending a Texas Administrator 's conference next week and will be away from the program from Monday 10/16-Wed 10/18, however , I will be available via cell phone (text) and will have limited access to review and respond to emails in a timely manner, therefore if there is a pressing matter please call me directly or text me and I will most definitely be available to respond to you. In additionj (b)(6) i< > I Fax: 956-233-3435 Jessica.mart inez@iestex .org == small create reflect live serve love CONFIDENTIALITYNOTICE: This message contains information which may be confidential or privileged . If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited. If you have received this transmission in error, please notify me immediately by telephone and permanently delete theemail and any attachments immediately. Thank you. From: Lloyd, Scott (ACF) [mailto:Scott.Lloyd@acf.hhs.gov] Sent: Thursday, October 12, 2017 4:45 PM To: l(b)(6) l@iestex.org> Cc:White, Jonathan (ACF) ; Subject: Re: State Court hearing Brooks, Teresa (ACF) Received thank you On: 12 October 2017 17:25, l(b)(5 ) @iestex.org> wrote: Hello Mr. Lloyd, I apologize for my delay in responding to your email, I was in a meeting with program management team. Mrs. Lowenberg's contact information can be found below, please let me know if you have any additional questions or concerns, thank you Cristina Lowenberg 915-834-5736 Cristina.lowenberg@hhsc.state.tx.us From: Lloyd, Scott (ACF) [ma ilto:Scott.Lloyd@acf.hhs.gov] Sent: Thursday, October 12, 2017 2:46 PM rqt b)(6) @iestex.org> Cc:White, Jonathan (ACF) ; Brooks, Teresa (ACF) Subject: RE: State Court hearing /\MERICAi\ pVERSIGHT EXT-18-248-C-000412 Sorry for the delay: do you have the contact information for Mrs. Lowenberg? Thank you, Scott From:ICb)(6) @iestex.org] Sent: Thursday, October 12, 2017 1:47 PM To: Lloyd, Scott (ACF) Cc: White, Jonathan (ACF); Brooks, Teresa (ACF) Subject: RE: State Court hearing Good Afternoon Mr. Lloyd , I am writing to touch base with you regarding information requested by Texas residential licensing official, may I move forward with providing a copy of ORR memo and summary of case? Mrs. Lowenberg is expecting to hear from me and therefore I would like to acknowledge her request by providing her an update on the matter, if ORR determines it is best NOT to share the ORR Memo (Mar 21 2008) "Medical Services Requiring Heightened ORR Involvement", I can move forward you're your authorization of course and provide a simple synopsis of UAC 's placement and status of her placement and request to terminate, please advise and thank you in advance, I will wait to hear from you, thank you again for your continued support and guidance. l(b)(6) Fronf._ b_)C6_l ____ _. Sent : Wednesday, October 11, 2017 10:33 PM To: Lloyd, Scott (ACF) Subject : Re: State Court hearing Thank you, received and have a restfu l evening Sir. Jessica From : Lloyd, Scott (ACF) Sent: Wednesday, October 11, 2017 10:30 PM Tofb)(6) I Subject: Re: State Court hearing I see now-- I defer to the program's judgment on whether monitoring is advisab le in this situat ion given t he allegations of abuse. On: 11 October 2017 23:19, /\MERICAi\ pVERSIGHT l(b)(5l ~iestex.org> wrote: EXT-18-248-C-000413 Thank you so much for this, I wanted to be sure to inquire regarding phone call with mother because of allegations of abuse noted in legal proceedings and SIR. Just to provide brief clarification as I hope my previous message did not imply some sort of infringement on UAC. As you know, at time UAC in care allege abuse, neglect or mistreatment at the hands of previous caretakers then ask to speak to same individuals , in these cases, we may take temporary precautionary measures (with proper approval and after staffing with all involved stakeholders) not explicitly addressed in ORR policy .. .it is more along the lines of ensuring that the persons that have contact with UAC in these cases are not known/alleged perpetrators of abuse/mistreatment. Therefore, arrangements can be made for UAC to be brought to the clinical office or case management office (private office) and either the assigned Clinician or assigned Case Manager is in the room while the UAC speaks with person on phone (not on speaker, UAC sits on one end of office and staff continue working while UAC conducts phone call). This allows CM or CL to monitor UAC"s demeanor and ensure that nature and tone of call is appropriate and not affecting UAC in a negative manner, this can also be done from outside the room the UAC remains in line of sight but the staff will not overhear any portion of the discussion. Please rest assured we will adhere to all governing policies and ensure ORR remains informed of all information related to the case of this minor. I will ensure program proceeds as directed, UAC will be granted telephone call with her mother as requested, again I appreciate your patience and guidance!!! Will standby for further guidance on other matters. l(b)(6) From: Lloyd, Scott {ACF) Sent: Wednesday, October 11, 2017 9:22 PM Tol (b)(6) I Cc:White, Jonathan (ACF); Brooks, Teresa (ACF); Bowman, Matthew (HHS/OGC) Subject: Re: State Court hearing l(b)(6) !thank you for the update . se reason. I will address your other questions after double- checking. Thank you, Scott /\MERICAi\ pVERSIGHT EXT-18-248-C-000414 On: 11 October 2017 21:54Jb)(6) @iestex.org> wrote: Good Evening, Please be advised that UAC attended follow-up appointment with Obstetriciarl (b)(5 ) fb)(6 ) ~t RGVWomen's Health Center on Monday, October 9th, 2017. ~---~ on this visit. Hours prior UAC was accompanied by program's Medical Coordinator b)(5) 6 met with UACto discuss followto departing from program, Medical Coordinato (b)( ) up appointment to ensure her understanding and obtain UAC's consent to attend. Medical Coordinator informed the UAC that the purpose of visit was to inquire about the possibility of obtaining medial clearance for UAC to increase physical activity in order to partake in light to moderate group dance exercise. UAC stated she understood and verbally consented to attend ing scheduled follow-up appointment with OB/GYN. Previously UAC requested care provider seek medical clearance from OB in order for her to partake in "Zumba", UAC was having difficulty adjusting to medical restrictions and verbally requested restrictions be reviewed and reconsidered by OB/GYN. However, as previously statedf b)(5) lissued the following "UAC must remain no NO PHYSICALACTIVITYuntil further notice. NO SWIMMING, NO RUNNING, NO ZUMBA, NO DANCING, NO STRENUOUSEXERCISE.UAC MAY take BRISK WALKS.II Medical Coordinator informed program administration thatfb l(5l lalso informed UAC of lab results (drawn on 9/11/17) returned within normal limits and that ZIKA test (conducted on 9/11/17) had returned "Negative". NO ultrasound or sonogram was completed during visit on 10/9/17. To conclude the visit on 10/9/17j (b)(5 l land his Nurse, informed UAC that during the first trimester between 11-14 weeks gestation (UAC is currently 14 weeks) it is recommended that ALL pregnant females undergo "1st Trimester NT (nuchal translucency screening)"f bl(5 l explained to UAC in the presence of his nurse and program Medical Coordinator that the screening involves undergoing an ultrasound to screen for fluid build-up in the fetuses upper spine/neck t o detect cardiovascular abnorma lities, Down Syndrome and other abnormalit ies in th e fetu s. UACwas given the opportunity to ask questions and/or voice concerns. UAC stated she understood the information provided to her, stated she had no concerns or questions and voiced agreement and verbally consented to the screening/procedure. The nurse informed UAC and Medical Coordinator that the UAC would be referred to Driscoll Maternal and Fetal tor 1st Trimester Screen (NT Screen).fbl(5l Medicine wit~ (b)(6 ) explained she would provide specialty appointment time and date prior to UAC departing from medical office. I I I confirmed specialty appointment for On 10/9/17rb )(5) 10/11/2017 at 2:30PM. Please be note, UAC agreed to 1st Trimester Screen (NT Screen) during /\MERICAi\ pVERSIGHT EXT-18-248-C-000415 medical visit with OB/GYN on 10/09/17 and also issued consent to screening during inital OB visit on 09/11/2017. On 10/11/17, UAC attended speciality appointment at Driscoll Maternal Fetal Medicine for the sole purpose of undergoing 1st Trimester NT screeoi □, (Nuchal translucensy screening). UAC 5 was accompanied by Medical Coordinato~(bl( l . UAC consented to screening and was informed results would be reviewed with her at during next OB/GYN appointment with~ 5 j Sent: Monday, October 9, 2017 12:48 PM/17 To: Jessica Martinez Cc:White, Jonathan {ACF); Brooks, Teresa {ACF); Bowman, Matthew {HHS/OGC);Wagner, Steven {ACF) Subject: RE:State Court hearing l(b )(6) Regarding the appointment today: Make sure that the UAC knows that this is to get an update on whet her it is really necessary to have her exercise so severely restricted-to find out if it might be possible to allow her to do more . Please get her to consent to the appoint ment. If she does not want it, she does not have to go-we arranged it to accommodate her distress over lack of physical activity . This was a concern she voiced to the program and that we noticed in her record . We are trying to be responsive to her concerns with this request . If they offer her a sonogram at the appointment, please remind the doctor that she has already had two and suggest t hat it is not necessary, and that it should not happen in any case if she does not give consent. Regarding your other questions - if she has a counseling session today, please contact me. If not, let's wait for DOJ's response. Let me know if you have any questions. Thank you, Scott From~(bl(5l t ~(bl (6l ~iestex.org ] Sent: Monday, October 09, 2017 1:14 PM To: Lloyd, Scott (ACF) Cc: White, Jonathan (ACF); Brooks, Teresa (ACF) Subject: Fw: State Court hearing Good Morn ing Mr . Lloyd , I am writing to request further guidance regarding the following, I realize now I may have missed the opportunity to ask these questions to Mr. Wagner (AUSA) during our debriefing and i apo logize for that but the following matters have arise and I am in need of guidance ... /\MERICAi\ pVERSIGHT EXT-18-248-C-000417 • • Since the "Jane Doe Due Process" case has been transferred to federal court, does any portion of the previously issued state court restraining order remain in place?? Such as the stipulations prohibiting care provider from o • "Disturbing the peace of the child Petitioner" ...this was explained to us by UAC's attorneys as all care provider staff must refrain from speaking with UAC about her pregnancy, "her baby" , or her "decision to terminate"examples provided by attorneys were • • No sonograms • • No forcing UAC to listen to baby's heart rate • • No referring to UAC's baby or seeking discussion or making comments about her gestational period, her pregancy expectations, her feelings, etc ... • • No "encouraging" her to discuss or make contact with her parents • • No "religion based" counseling regarding o • Care provider must refrain from "Making remarks to child petitioner's family that concern petitioner's pregnancy" .... o • "Discussing any litigation concerning the child Petitioner in the presence or within hearing of the child Petitioner or on any form of social media" • UAC has a OB/GYN appointment for basic renata l care wit ~b)(5) khis afternoon at 2:30p.m. (CST),please note that O b)(5) is not aware UAC has requeted to lis not aware of current litigation re ardin the case of terminate preganancy~(b)(6) this minor, is care provider to discuss these matters directly wit (b)(5) ?? Should the child be informed that care provider will discuss her request to terminate and current litigation with OB? • • If UAC attends this prenatal care appointment , is the doctor to proceed with sonogram ??? • • Is child allowed to contact parents?? Her parents are named in the suit as "inflicting abuse on minor" is UAC able to make contact despite this claim" If UAC requests to make contact with mother/father is care provider to allow contact, if allowed is all contact to be monitored or may the UAC make contact with out monitor ing? Please advise, thank you so much in advance for your guidance! • From: Lloyd, Scott (ACF) Sent: Monday, October 9, 2017 10:02 AM To: Broo ks, Teresa (ACF); W hite, Jonathan (ACF); Jessica Martinez Cc: Wagner, Steven (ACF); Wynne, Maggie (HHS/IOS); Bowman , Matthew (HHS/OGC); Haas, Alex (CIV) Subject: RE: Stat e Court hearing Teresa, /\MERICAi\ pVERSIGHT EXT-18-248-C-000418 Many thanks for your work on this, and thank you for the update. I was very much reassured to know that you wou ld be present this morning. Barring any additional need to wrap things up with IES,please return to the rest of your day off. Let us know if you need anything-I am sure things will continue throughout the week. Sincerely, Scott From: Brooks, Teresa (ACF) Sent: Monday, October 09, 2017 10:57 AM To: Lloyd, Scott (ACF); White, Jonathan (ACF); Jessica Martinez Cc: Wagner, Steven (ACF); Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC); Haas, Alex (CIV) Subject: Re: State Court hearing Please be advised that at approximately 8:35 am CT, the Cameron County Judge , attorneys from Garza and Garza, who are/were representing the UAC at the State level, the UAC, and Mr. Paxton Warner, AUSA from the DOJ met in the Judge's chambers in a closed proceeding. Mr. Lucio, attorney for the IES staff, was also in chambers, as an observer to the proceeding as he has clients who have been affected by the legal process of the matter. DHS ICE ERO Officer, 6) fb>( was present at the Courthouse , outside of the courtroom and chambers. I was asked to wait immediately outside of the Judge's chambers. I During the discussion in chambers , Mr. Warner left chambers to inquire as to if the UAC had been "forced" to speak to her parents. I advised that the UAC had been afforded the right to speak to either or both of her parents since arriving into ORR custody , but to my awareness had not chosen to do so to date. It should be noted that the IES program did obtain a contact number for the UAC's father as the UAC had stated that she wished to speak to him at one time. Mr. Warner also asked if the IES program could provide the UAC could be provided with a new case manager as the UAC has stated that the current case manager was not effectively managing the UAC's case. (This is presumed to be referring to a possible family reunification case. At this time, it is my understanding that no viable spon sor has been identified for the UAC.) I informed Mr. Warner that IES would identify an appropriate case manager to assume over sight of the UAC's case. Finally , Mr. Warner stated that the attorneys for the UAC were concerned that an IES staff member was always within a visual "line of sight" of the UAC and the attorneys felt that this was not allowing the client sufficient privacy. I explained to Mr. Warner , that in accordance to TDFPS licensing standard s, the attorneys are not con sidered trained child care providers , and in order to maintain standards of care, the staff needed to maintain sight of the UAC , but were not in able to hear/overhear any confidential attorney- client communication. Mr. Warner took the information back to chambers. When Mr. Warner returned he advised that the UAC should be returned to her placement at the IES shelter program in Los Fresnos , TX. Mr. Warner stated that the case, in its entirety , had been moved to a Federal court venue. Mr. Warner advised that the attorneys from Garza and Garza would continue to represent the UAC in the case. /\MERICAi\ pVERSIGHT EXT-18-248-C-000419 Mr. Lucio conferred with the IES staff, whom he was representing today. Mr. Warner thanked the IES staff for their efforts in caring for this UAC and all of the UAC that IES cares for. All parties were advised that they/we were free to leave the courthouse. I thanked the DHS ICE ERO Officer for her support , and instructed IES to transport the UAC back to the program site. All parties exited the courthouse at approximately 9:45 am CT. Please advise as to if there are any questions or if additional information is needed regarding this message. Teresa Teresa Brooks Supervisory ORR Federal Field Specialist HHS ACF ORR DUCO 202.631.3 775 Teresa .Brook s@ acf.hh s.gov On: 08 October 2017 18:58, "Brooks, Teresa (ACF)" wrote: Please see t he attached with regard to the request to OHS ICE EROfor the presence of a OHSICE ERO Officer at the 107th District Court in Cameron County Texas on Monday , October 9, 2017 . Please advise as to if there are any quest ions concerning the OHS ICE ERO request or response. Please be advised that, to remain in com pliance with Texas Department of Family Protective Services Residential Child Care Licensing Standards, appropriate IESstaff will be transporting the UAC from the IESShelter Program to the Courthouse build ing. Additiona l IESstaff who are required to be present at the District Court will arrive to the Courthouse apart from the UAC. I will be meeting with all of the IES staff and with the OHS ICE ERO Office r, either immediately outs ide of the Court bui ld ing, or in the lobby of the building. We will then proceed t o the identified area of the Courthouse. Please advise of any additiona l instr uction as is felt appropriate . Sincerely, Teresa Teresa Brooks Federal Field Specialist Superviso r, Sout h Texas HHS ACF ORR DUCO 202.631.3775 Teresa.Brooks@acf.hhs .gov /\MERICAi\ pVERSIGHT EXT-18-248-C-000420 From: Brooks, Te resa (ACF) Sent: Sunday, October 08, 2017 5:20 PM To: Lloyd, Scott (ACF); White, Jonathan (ACF); Jessica Martinez Cc: Wagner, Steven (ACF); Wynne, Maggie (HHS/IOS); Bowman, Matthew (HHS/OGC); Haas, Alex (CIV) Subject: Re: State Court hearing I can be at the Courthouse at 8:30 am CT as requested. 5 I can attempt to reach Officetj(bl(l lwho is the cover ing Officer for the FOJC now to see if there is an ICE Officer who is able to be pre sent at the Court tomorrow morning. I will update all appropr iate partie s of outcome of the contact with ICE. Teresa Teresa Brook s Supervisory ORR Federa l Field Speciali st HHS ACF ORR DUCO 202.631.3775 Teresa.Brooks @acf.hhs.gov On: 08 October 2017 16:46, "Lloyd, Scott (ACF)" wrote: Hello everyone, Please see below. There should be no hearing tomorrow. However , there is need to have the UAC brought to the courthou se at the time appointed, to avoid contempt while we confirm that the state co urt knows the case has been removed. Teresa I'd like you there if at all poss ible, or field staff in the alternative. I will ask that DOJ contact us if they receive confirmation and this becomes unnecessary. Teresa, are you in contact with anyone from DHS (ICE seems most approp riate) who could ride along? If you need help I can help get someone. If she goes to the courthouse the point wou ld be to inform them that the case has been removed. There should be no transfer of custody and federa l law enfo rcement cou ld help us reinforce that point. Please let me know if you have any quest ions. Thank you, Scott /\MERICAi\ pVERSIGHT EXT-18-248-C-000421 Begin Forwarded Message: From: "Haas, Alex (CIV)" Subj ect: State Court hearing Date: 08 October 2017 17:25 To: "Bowman, Matthew (HHS/OGC)" , "Lloyd, Scott (ACF)" Cc: "Ricketts, Jennifer D (CIV)" , "Hu, Daniel (USATXS)" , "Warner , Paxton (USATXS)" , "Fabian, Sarah B (CIV)" Matt/Scott, Our colleagues from the USAO just filed the removal papers in federal court and also filed a notice electronically in state court. While this should be enough to deprive the state court of jurisdiction, we are also sending a AUSA to hand a copy to the judge as well. Because the state court order is directed to individuals working at IES who could still be held in contempt (potentially) , our strong recommendation would be for the minor to be sent with the federal field specialist to the court proceeding. With that federal officer there and the AUSA we think there is a very small likelihood of any shenanigans. You could also potentially ask someone from ICE or CBP to attend to the transport. Please let me know if you'd like to discuss Alex Sent from my Verizon, Samsung Galaxy smartphone Sender= b)(6) ~iestex.org> "Lloyd, Scott (ACF) "; "White , Jonat han (ACF) "; "Brooks, Teresa (ACF) " Sent Date: 2017/10/13 19:48:50 Delivered Date: 2017/ 10/13 19:49:09 /\MERICAi\ pVERSIGHT EXT-18-248-C-000422 Wagner, Steven (ACF) To: "Lloyd, Scott (ACF) " Subject: Re: Responseto AP Date: 2017/10/13 22:13:06 Priority: Normal Type: Note On: 13 October 2017 22:01, "Lloyd, Scott (ACF)" wrote: I don't know, but I think not. On: 13 October 2017 21 :47, "Wagner, Steven (ACF)" wrote : 5 Scott, are yo~~ (b-)(- )-------------------~ On: 13 October 2017 19:30, "Lloyd, Scott (ACF)" wrote : Deliberative From: Wagner, Steven (ACF) Sent: Friday, October 13, 2017 7:24 PM To: Marriott, Brian (ACF); Wolfe, Kenneth (ACF); Lloyd, Scott (ACF) Subject: Response to AP 1~)(5) /\MERICAi\ pVERSIGHT EXT-18-248-C-000423 1~()5) ? Wagner, Steven (ACF) Recipient : "Lloyd, Scott (ACF) " Sent Date: 2017/10/13 22:13:06 /\MERICAi\ pVERSIGHT EXT-18-248-C-000424 Wagner, Steven (ACF) "Wagner, Steven (ACF) "; "Lloyd, Scott (ACF) "; To: "White, Laura (ACF) "; "Tota, Kenneth (ACF) < kenneth.tota@acf.hhs.gov>"; "Barlow, Amanda (ACF) "; "Moomaw, Sara (ACF) "; "O'Rourke, William (ACF) " "Jones, Robin (ACF) "; "Logan, Scott (ACF) "; "Goldhaber, Ben (ACF) "; CC: "Goldstein, Naomi (ACF) "; "Fucello, Mark (ACF) "; "Deterding, Nicole (ACF) (CTR) "; "Simmons, Joann (ACF) " Subject: FY2018Spend Plans Meeeting I ORR Date: 2017/10/27 16:29:15 Start Date: 2017/11/17 15:00:00 End Date: 2017/11/17 16:00:00 Priority: Normal Type: Appointment Locati on: JOASConference Room (4026A) Wagner, Steven (ACF); Lloyd, Scott (ACF); White, Laura (ACF); Tota, Kenneth (ACF); Barlow, Amanda (ACF) (Amanda.Barlow@ACF.HHS.GOV); Moomaw, Sara (ACF); O'Rourke, William Att endees: (ACF); Jones, Robin (ACF); Logan, Scott (ACF); Goldhaber, Ben (ACF); Goldstein, Naomi (ACF) (naomi.goldstein@ad.hhs.gov); Fucello, Mark (ACF); Deterding, Nicole (ACF) (CTR); Simmons, Joann (ACF) Wagner, Steven (ACF) "Wagner, Steven (ACF) "; "Lloyd, Scott (ACF) "; "White, Laura (ACF) "; "Tota, Kenneth (ACF) "; "Barlow, Amanda (ACF) "; Recipient: "Moomaw, Sara (ACF) "; "O'Rourke, William (ACF) "; "Jones, Robin (ACF) "; "Logan, Scott (ACF) "; "Goldhaber, Ben (ACF) "; "Goldstein, Naomi (ACF) "; "Fucello, Mark (ACF) "; "Deterding, Nicole (ACF) (CTR) "; "Simmons, Joann (ACF) " Sent Date : 2017/10/27 16:29:15 Barlow, Amanda (ACF) /\MERICAi\ pVERSIGHT EXT-18-248-C-000425 To: "ACF- Senior LeadershipOfficials " "Barrett, Omar (ACF) "; "Brockett, Timothy (ACF) "; "Bush, catherine (ACF) "; "campbell, Nina T. (ACF) "; "Celentano, Sheila (ACF) "; "Daniel, Joshua (ACF) "; "Dekoladenu,William (ACF) "; "Evering, Jelani (ACF) "; "Fennell, Derrick (ACF) "; "Flippin, Meg (ACF) "; "Gnilka, Michael(ACF) "; "Goodman,Tawanda (ACF) "; "Hall, Wanda (ACF) "; "Hodnett, Toya Via (ACF) "; "Jennings,Tracie (ACF) "; CC: "Jones, Yvette M. (ACF) "; "Kramar, Iulia (ACF) "; "Lee, Lila (ACF) "; "Mai, Dinh (ACF) "; "Miles, Nicole (ACF) "; "Miller, Lora (ACF) "; "Page II, Thornell (ACF) "; "Pittman, Cheryl (ACF) "; "Simmons,Joann (ACF) "; "Simon, Sandra (ACF) "; "Taylor, Ann (ACF) "; "Thompson, Stan (ACF) 11; "Torres, Pete (ACF) "; "Tota, Kenneth (ACF) "; "Trent, Rosa(ACF) "; "Wade, (atherine (ACF) "; "Walden, Karen (ACF) "; "Brodowski, Melissa (ACF) "; "Meier, Carolyn (ACF) "; "Bing, Yvonne (ACF) "; "Cooper, Desi (ACF) "; "Diaz, Zuheil (ACF) "; "Fish, Joseph (ACF) "; "Jones, Robin (ACF) "; "Littlepage, Tomeca (ACF) "; "Moomaw, Sara (ACF) "; "Ngo-Hoang,Catherine(ACF) "; "O'Rourke,William (ACF) "; "Patterson, Michelle(ACF) "; "Weiland, Jacob (ACF) " Subject: For Action - FY2018Spend Plansdue to OLABby COB 10/25 Date: 2017/10/12 11:46:50 Priority: Normal Type : Note The Act ing Assistant Secretary has requested that each office prepare a spend plan for FY2018. There w ill be a meeting scheduled with each office to present these plans. In these meetings, Office Directo rs should be prepared to identify top priorities for FY2018, how they propose to align fu nding to meet object ives, and how they w ill measure success. The discussion will be organize d by activity type following the at tached template - grant s, contracts, other - and will include how the off ice w ill use resources (inclu ding staffing) made available through the central Federal Adm inistration account. All plans are due to Bill O'Rourke (william.orourke@acf .hhs.gov) on my staff by close of business on Wednesday , October 25. IOAS w ill be reaching out to set up meetings afte r that date. OLAB will also be offering meetings early next week to answer any questions you or your staff may have and this will be on the agenda fo r the next Senior Leadership meeting. If you have any questions, please let Bill O'Rourke or me know. Amanda /\MERICAi\ pVERSIGHT EXT-18-248-C-000427 Amanda Barlow Director, Office of Legislative Affairs and Budget Administration for Children and Families U.S. Department of Health and Human Services (202)401-5009 Amanda.Barlow@acf .hhs.gov www.acf.hhs.gov Se nder : Barlow, Amanda (ACF) "ACF- Senior Leadership Officials "; "Barrett, Omar (ACF) "; "Brockett, Timothy (ACF) "; "Bush, Catherine (ACF) "; "Campbell, Nina T. (ACF) "; "Celentano, Sheila (ACF) "; "Daniel, Joshua (ACF) "; "Dekoladenu, William (ACF) "; "Evering, Jelani (ACF) "; "Fennell, Derrick (ACF) "; "Flippin, Meg (ACF) "; Recipient: "Gnilka, Michael (ACF) "; "Goodman, Tawanda (ACF) "; "Hall, Wanda (ACF) "; "Hodnett, Toya Via (ACF) "; "Jennings, Tracie (ACF) "; "Jones, Yvette M. (ACF) "; "Kramar, Julia (ACF) "; "Lee, Lila (ACF) "; "Mai, Dinh (ACF) "; "Miles, Nicole (ACF) "; "Miller, Lora (ACF) "; "Page II, Thornell (ACF) "; "Pittman, Cheryl (ACF) "; "Simmons,Joann (ACF) "; "Simon, Sandra (ACF) "; "Taylor, Ann (ACF) "; "Thompson, Stan (ACF) "; "Torres, Pete (ACF) "; "Tota, Kenneth (ACF) "; "Trent, Rosa(ACF) "; "Wade, Catherine (ACF) "; "Walden, Karen (ACF) "; "Brodowski, Melissa(ACF) "; "Meier, Carolyn (ACF) "; "Bing, Yvonne (ACF) "; "Cooper, Desi (ACF) "; "Diaz, Zuheil (ACF) "; "Fish, Joseph (ACF) "; "Jones, Robin (ACF) "; "Littlepage, Tomeca (ACF) "; "Moomaw, Sara (ACF) "; "Ngo-Hoang,Catherine (ACF) "; "O'Rourke,William (ACF) "; "Patterson, Michelle (ACF) "; "Weiland, Jacob (ACF) " Sent Date: 2017/10/12 11:46:44 Delivered Date: 2017/10/12 11:46:50 /\MERICAi\ pVERSIGHT EXT-18-248-C-000429 Received: f ro m DM2PR09 MB055 9 .n amprd09 . p rod. ou tl ook . com (1 0 .1 61.252 .1 7 ) by BY1PR09MB0551 .n amprd09 . prod . out l ook . com (10 . 160 .11 0 . 140 ) wi t h Microsoft SMTP Ser ver (version =TLS1_2 , c ip he r =TLS _ ECDHE_ RSA_ WITH AES_ 256 _ CBC_ SHA38 4_P2 56) i d 1 5 . 20 . 77 . 7 via Ma il box Tr anspo r t ; Th u, 1 2 Oc t 201 7 1 5 : 46 :4 9 +00 0 0 Received: from DM5PR09 MB1290 . namprd09.prod . outlook . com (10 . 172 . 34 . 136) by DM2PR0 9MB0559 .n amprd09 .p rod . out loo k. com (10 . 161 .25 2 . 17 ) with Mi crosoft SMTP Server (versio n =TLS1_2, cipher=TLS _ ECDHE_ RSA_ WITH_ AES 256 CBC SHA384 P256) id 1 5 . 20 .77.7; Thu, 12 Oct 2017 15 : 46 : 48 + 0000 Authe nt icat i o n -Resu lt s : ees . h hs.g ov ; d k i m=none (message n ot sig n ed ) heade r. d=none ; ees . hhs . gov ; dmarc=none act i on= n o n e header . from =ACF. HHS. GOV; Received : from DM5 PR09MB1 2 74.n amprd09 . prod . ou t look . com (10 .1 72.34 . 20) by DM5PR09MB1290.namprd09 . prod . ou tloo k. com (10 . 17 2 . 34 .1 36 ) with Micros o f t SMTP Se r v e r (ve r sion=TLS1 _ 2 , cipher=TLS _ ECDHE_ RSA_ WITH_ AES 256 CBC SHA384 P256) id 15 . 20 .77.7; Thu, 12 Oct 2017 15:46 : 45 + 0000 Rece i ved: from DM5PR09 MB127 4.n amprd09 . p r od . ou tl ook . com ( [ 1 o. 172 . 3 4 . 2 ol ) by DM5PR09MB1274 . namprd09 . prod .o ut l ook . com ((1 0 . 1 72 . 34 . 20 ] ) with mapi id 1 5 . 20.0077 . 0 1 9 ; Thu , 12 Oct 2017 1 5 : 46 :4 5 +0000 Conte nt - Type : application/ms - tnef ; n ame = " winmail . dat " Conte nt -Transfer-Encodi ng: binary From : " Barlow , Amanda (ACF) " To : ACF - Senio r Leadership Off ic i a l s CC : "B arre t t , Omar (ACF)" , " Brockett , Timot hy (ACF) " , " Bush , Catherine (ACF) " , " Campbe ll, Nin a T . (ACF) " , " Ce l e n tano , Sheila (ACF) " , " Dan ie l, Jos h ua (ACF)" , " Dekoladenu , Wil liam (ACF) " , " Ever i ng , Je l ani (ACF) " , " Fe nn el l, Derrick (ACF )" , " Flippin , Meg (ACF) " , "Gnilka , Michael (ACF) " , " Goodman , Tawa nd a (ACF)" , " Hal l , Wanda (ACF) " , " Hod n e tt , Toya Via (ACF) " , "J e nn i ng s , Trac i e (ACF) " , " Jones , Yvette M. (ACF) " , " Krama r, Iu li a (ACF) " , " Lee, Lila (ACF) " , " Mai , Di nh (ACF) " /\MERICAi\ pVERSIGHT EXT-18-248-C-000430 , " Miles , Nicole (ACF) " , "Miller , Lora (ACF)" , " Page II, Thornell (ACF) " , " Pittm an , Cheryl (ACF) " , " Si mmons , Joann (ACF)" , " Si mon, Sandra (ACF) " , "Ta y l or , Ann (ACF) " , " Th ompson , Stan (ACF) " , " Torres , Pete (ACF) " , " Tota , Kenneth (ACF) " , " Trent , Rosa (ACF) " , " Wade , Catherine (ACF)" , " Walden , Karen (ACF) " , " Brodowski , Melissa (ACF) " , "Meier, Carolyn (ACF)" , " Bi ng , Yvonne (ACF) " , " Cooper , Desi (ACF)" , " Diaz , Zuheil (ACF) " , "F ish, Joseph (ACF) " , " Jones , Robin (ACF)" , " Littlepage , Tomeca (ACF)" , "Moomaw, Sara (ACF) " , " Ngo-Hoang , Ca th erine (ACF) " , " O ' Rourke , Will iam (ACF) " , " Patterson, Michelle (ACF) " , " Weiland , Jacob (ACF) " Subjec t: For Action - FY2018 Spe n d Pl a n s due t o OLAB by COB 1 0/25 Thread-Topic : Fo r Actio n - FY2018 Spe nd Pl ans d u e to OLAB by COB 10/25 Thread - Index : AdNDcTpRMaMyfwmlTUK02cpvYQN2hw== Date : Thu , 12 Oct 2017 15 : 46 : 44 + 0000 Message-ID : Accep t- Language : en -U S Conte nt -Language : en-US X-MS-Has-Attach : yes X- MS- Exchange - Organization - SCL : - 1 X- MS- TNEF- Correlator : MIME-Version : 1.0 X- MS-E xc h ange - Organization - MessageDirectionality : Originating X- MS- Exchange - Organization - AuthSource : DM5PR09MB1274 .n amprd09 . p r od . ou t look . com X-MS-Exc h ange-O rg an i zation-AuthAs : Internal X- MS- Exchange - Organization - AuthMechanism : 04 X- Originating - IP : [ 158 . 71 . 86 . 173) /\MERICAi\ pVERSIGHT EXT-18-248-C-000431 X-MS-Exchange-Organ i zation-Network-Message-Id: 2708d839-c066-495a122a-08d511887100 X- MS- Pub l icTraf fi cType : Email X- Microsoft - Exchange - Diagnostics : l ; DM5PR09MB1274 ; 35 : AUxnwqrLk f nXrw8/Vyc9J4HWd l icCXLBOPWIYgYjmHw3eYxwP KtC7 YHj8xJbrj2+bOgzFsgZW9Wmw7iV9t9wFQ== Return-Path : Amanda . 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BYlPR09M B0551 ; 9 : abRXFq8A8m/slitwN9YB+jKVMYvMtnGijKuXntuKcaFYhe +D4DPoQhlKxEi DX+83CcZgn/nMhM 7e/K6dClbsFmOxXUbUhSPRlgi zCXYU41EZoS HnZXi/6G i NLmgerVZb X-Microsoft-Exchange-Diagnostics: l;BYlPR09MB0551;27 : uYg5EZd0 DuZLw+tw9TxYSa ln nrQi6K HdthR j/EiA3Qf5 4 37dCNQaKdRbvG9QBCuoFgGd9LgDrRQ6hls42zgFNQlbEJjoSo9w48T2+Tc8LY/LS PQHSIXuw i 2cOKrclOHV /\MERICAi\ pVERSIGHT EXT-18-248-C-000433 From: Bulletin Intelligence To: "HHS@bulletinintelligence .com" Subject: HHS News Briefing for Tuesday, June 12, 2018 Date: 2018/06/1 2 07:33 :07 Priority: Normal Type: Note Click to acce ss mobile-optimized I =-=JI /\MERICAi\ pVERSIGHT online version, including download options and an audio reader. HHS News Briefi ng EXT-18-248-C-000434 TO: THE SECRETARY AND SENIOR STAFF DATE: TUESDAY, JUNE 12, 2018 7:30 AM EDT Today's Table of Contents Leading the News • CMS Unveils New Guidance To Help States Fight Opioid Epidemic. • Trump's Decision Not To Defend The ACA Could Be A Boon To Dems During The Midterms. The Secretary in the News • Azar To Testify About Drug Prices Before Senate Panel Today. • Trump Administration Meeting With Pharmaceutical Companies To Seek Voluntary Price Cuts. • Opinion: Trump Can Use Patent Law To Slash Prices For Naloxone. • Donna Shala la Expresses Support For Single-Payer System Similar To /\MERICAi\ pVERSIGHT EXT-18-248-C-000435 The One Advocated By Bernie Sanders . HHS in the News • White House Wants HHS To Delay Issuing Final Rule On Religious, Moral Beliefs . • Columnists Say Healthcare Will Be The Focus Of The Midterms Given Administration's Decision Not To Defend The ACA. • Healthcare Groups Want CMS To Improve Reimbursement For Remote Patient Monitoring. • Trump Administration Immigration Policy Examined . • Column: Redirecting Family Planning Funds Could Undercut STD Fight. • Whistleblower Lawsuit Against Signature Healthcare Reveals $244 Million Fraud. • HHS Seeking Public Comment About How To Set Up A Workgroup To Encourage Innovation, Investment In Healthcare. • Many American Toddlers Exceed Recommended Added Sugar Intake For Adults, Study Suggests. • CDC Data Reveal Severity Of Latest Flu Season. • Ebola Vaccines Could Signal Hope In Congo As Outbreak Continues. • Laser Eye Surgery May Be Riskier Than Many People Think, Research Suggests. • Anheuser-Busch Cancels Funding For NIH Alcohol Study. /\MERICAi\ pVERSIGHT EXT-18-248-C-000436 • House To Vote On 34 Opioid Bills This Week . • Boston Globe Highlights Work Of Alzheimer's Disease Researcher Focused On Preclinical Phase. • Northwestern University Researcher Interviewed About Participating In NIH All Of Us Research Program. • Editorial: NCI Cancer Immunotherapy Study Has App lications For New Pittsburgh Therapy Center. • House Panel Questions FDA's Efforts To Track Illegal Opioids. • Experts Describe Federal Efforts To Prevent Foodborne Illnesses. • Federal Court Bars Mississippi Compounding Pharmacy From Making, Distributing Drugs . Opioid Crisis • Naloxone Use To Expand Among Police Departments, School Campuses In San Diego County. • Former Sen. Bill Frist Highlights Cigna's Efforts To End Opioid Epidemic. Mental Illness • Word Choice May Be Indicative Of Depression, Studies Involving Linguistic Analysis Programs Suggest. Prescription Drug Pricing /\MERICAi\ pVERSIGHT EXT-18-248-C-000437 • Drugmaker Reboots Female Libido Drug At Half Price. • Drug Pricing Advocates Condemn Democrats For Supporting Drug Industry. Health Care &Insurance Reform • Dems, Who Once Shied Away From Healthcare, Are Hoping The Issue Will Propel Them To Victory In The Midterms. • Trump's Opposition To Parts Of New VA Healthcare Law May Endanger Its Implementation. • Experts Caution Against Use Of Cheaper Outpatient Surgical Centers. • Less Than 10% Of American Adults Get Recommended Preventive Healthcare, Study Indicates. • Cisco, Other Large US Employers Trying To Manage Workers' Health To Control Costs. • Opinion: Supreme Court Leaning In Favor Of Pro-Life Cause. • Midwest Has Fewest Abortion Clinics Per Woman Than Any Other Region, Study Indicates. • Air Ambulance Companies Leave Patients With High Bills. • Commentary Considers Health Reform. Human Services News • Experts: Don't Let Social Security Solvency Fears Affect Claiming /\MERICAi\ pVERSIGHT EXT-18-248-C-000438 Decision. • Ryan Making One Last Push To Overhaul TANF, SNAP Before He Retires From Congress. • Jefferson County Decision To Forfeit Head Start Funding Resulted In The Loss Of Family Advocate Jobs. • CBP Commissioner Discusses Illegal Border Crossings During Interview. • Louisiana Child Care Program Improved Controls, Auditor Says. Food &Import Safety • Opinion: Labeling Requirements Drive Up Costs For Consumers. • Tyson To Recall 3,120 Pounds Of Breaded Chicken Over Plastic Contamination. • Tennessee E. Coli Outbreak Leaves Six Children Hospitalized, Two In Serious Condition. • Arizona Family Awarded $1.95 Million In Foster Farms Salmonella Case. Medicaid &CHIP • Ohio Decides Not To Implement Reimbursement Five-Percent Cut To Medicaid For Hospitals. • Nursing Homes, Assisted-Living Facilities Suing Montana Over Medicaid Reimbursement Cuts. /\MERICAi\ pVERSIGHT EXT-18-248-C-000439 • New Hampshire Substance Abuse, Mental Health Treatment Providers Worried About Proposed Cuts To Medicaid Reimbursement. • Michigan Governor Signs Bill To Repeal, Replace Tax That Funds Medicaid. • Fate Of Medicaid Expansion In Maine May Depend On Outcome Of November Election For Governor. Health &Medical News • Young Women Get Less Exercise Than Young Men, Study Suggests. • Research Explores Why People Get "Hangry." • Erectile Dysfunction May Be Linked To Increased Risk Of Heart Disease, Study Suggests. • Healthy Lifestyle Associated With Improved Memory In Old Age, Study Indicates. • Millennial Men And Women Invest Differently, • Morningstar Analyst Supports State-Sponsored PNC Survey Reveals. Auto-Enrollment For Retirement Savings. • Tallahassee Targeting Multigenerational Families To Increase Retiree Draw. • Ford Works On Self-Driving Delivery Service With Postmates. • Experts Worried About Unproven Tesla Self-Driving Features. • Uber-Like Flight Hailing Service Skyryde Starts Service In Los Angeles. /\MERICAi\ pVERSIGHT EXT-18-248-C-000440 • Researchers Create Virtual Reality Platform To Help Children Cope With Doctor's Appointment Anxiety. • Feeding Children Honey After Swallowing A Small Battery Can Prevent Serious Injury, Study Suggests . • Physician Advises Parents To Keep Kids Safe While Swimming. • Using Prophylactic NSAIDs Before And After Cataract Surgery May Reduce Development Of Cystoid Macular Edema In Diabetic Patients, Study Suggests. • Young Surgeons Face High Debt, Financial Instability, Study Suggests. • Opinion: Retail Health Clinics Set The Stage For Today's MegaMergers . • Tick Paralysis Strikes Five-Year-Old In Mississippi. • Red Cross Blood Drive Campaign Sees Major Brands Dropping A, B, and O From Their Names. • KKR To Buy Envision Healthcare For $5.57 Billion. • Surgeons Use 3D-Printed Organs To Determine Best Way To Operate. • Legacy Of Racism Hurting Health Of African Americans. • South Carolina Primary Vote To Gauge "Temperature" Of Electorate . • Opinion: Physician-Assisted Suicide "Can Never Be Medical Care." • American Medical Association Votes To Keep Reviewing Its Guidance On Physician-Assisted Suicide. • Cherokee Hospital Testing 186 Patients For HIV, Hepatitis After Nurse /\MERICAi\ pVERSIGHT EXT-18-248-C-000441 Reused Syringes. • Louisiana Regulators Prepare For Expanded Medical Marijuana Program. • Physician Offers Advice About Genetic Screening For Pregnant Women. • Guided Nanospears Can Administer Genetic Therapies Targeting Cancer, Researchers Say. • US Adults With Hypertension Incur Nearly $2,000 More In Annual Healthcare Costs, Study Indicates. • Loneliness May Cause Premature Death By Damaging Heart, Research Suggests. • CRISPR-Cas9 May Increase Cancer Risk In Cells, Research Suggests. • Congressional Action On Marijuana Could Potentially Lead To Studies On Benefits Of Medical Marijuana For Cancer Patients. • Genetic Test For Prostate Cancer Can Identify Individuals Who Have A Higher Risk Of Developing The Disease, Researchers Say. • Rhode Island Nursing Homes Decry State Budget Cut That Would Lead To Layoffs, Closures. • THCA Sounds Alarm Over Texas' LTC Staffing Crisis. • Despite Prevention Efforts, South Dakota's STD Rates Rising. • Pennsylvania, Nation Losing Fight Against Lyme Disease. • Epidemiologists Predict California Will See Another Cycle Of Pertussis Cases. /\MERICAi\ pVERSIGHT EXT-18-248-C-000442 • Cost Of Kansas City's Measles Outbreaks Exceeded $170,000 . • Stryker Reportedly Eyeing Boston Scientific For Takeover. • Juvenescence Takes Stake In Company Generating Cell-Based Therapies For Age - Related Diseases . • Experts Push For "Medicalized Approach" To Suicide Prevention. • Opinion: Ending The Stigma Is The Key To Suicide Prevention. • Oral Migraine Drug Succeeds In Study, Manufacturer Says. • Layoffs A Symptom Of A Deeper Problem With IBM's Watson Health, Former Employees Say. • Children Exposed To Cigarette Smoke Have Higher Risk Of Hearing Loss, Research Indicates. • Studies Link Abdominal Fat To Increased Rates Of Coronary Heart Disease, Increased Risk For Cancer, And Risk Of Developing Dementia Decades Later . • Experts Release Blueprint For Improving End-Of-Life Care. Global Health • Rollout Of HIV Prevention Drug Tied To Reduction In Condom Use Among Men Who Have Sex With Men In Australia, Study Suggests. • HIV/AIDS Epidemic Getting Worse In Russia. • Rift Valley Fever Kills Five In Kenya, Official Says. • British Authorities Seize Mother's Cannabis - Based Medication For Son /\MERICAi\ pVERSIGHT EXT-18-248-C-000443 With Epilepsy, Prompting Stand-Off. • Opinion: Chinese Communist Leaders Must Be Held Accountable For Human Rights Violations. • National Register In Australia Could Curb Financial Abuse Of Elders. National News • Trump, Kim Pledge "Complete Denuclearization" After Historic Summit. • Trump To Hold Rally In MN8 Next Week. • Trump Hails High Court Ruling Allowing Ohio To Drop Inactive Voters From Rolls. • Trump-Recruited GOP Candidate Frustrated By Trump's "Affinity" For Heitkamp . • Obama Meeting With Potential 2020 Democratic Presidential Candidates. • New D'Souza Film Compares Anti-Trump "Resistance" To Democrats' Opposition To Lincoln. • Trump Highlights Good Economic News. • Pai: Expiration Of Net Neutrality Means A Return To Clinton-Era Framework. • Pentagon Officials Distance Themselves From LGBT Pride Month Observances. • Biden Heckled During Book Tour Stop In Delaware. /\MERICAi\ pVERSIGHT EXT-18-248-C-000444 • Poll: Scott "Dominating" Nelson Among Florida Voters 50 And Older. • McClatchy Analysis: Sanford Fighting For Political Life In SC1 GOP Primary. • In AL2, Rouby Faces Runoff Amid Questions About Her Loyalty To Trump. • Democrats Consulting With Hollywood Ahead Of Midterms. • Democrats Hope Anti-Trump • Female Gubernatorial Sentiment Will Help Unseat Comstock. Candidates Say They Face Resistance To Female Executive Power. • Bill Clinton : Norms Of "What You Can Do To Someone Against Her Will" Have Changed. • Broadway Veterans, Trump Critics Struggle With De Niro's Tony Comments. • Twitter CEO Draws Fire For Chick-Fil-A Post Dur ing Pride Month. Editorial Wrap-Up • New York Times . • Washington Post. • Wall Street Journal. The Big Picture /\MERICAi\ pVERSIGHT EXT-18-248-C-000445 • Headlines From Today's Front Pages. Last Laughs • Late Night Political Humor. Leading the News CMS Unveils New Guidance To Help States Fight Opioid Epidemic . The Hill (6/11, Roubein, 2. 71M) reports that on Monday, CMS unveiled "guidance aimed at helping states leverage Medicaid to combat the opioid epidemic ." The article says "the gu idance focused on information related to covering services for infants born exposed to opioids and how to enhance federal funding for telemedicine and programs that keep tabs on patients' prescriptions ." HHS Secretary Alex Azar stated, "The number of American infants born dependent on opio ids each day is heartbreaking .... Today's announcement Administration and HHS's commitment support treatment reflects the Trump to helping states use Medicaid to for this condition and other challenges produced by our country's crisis of opioid addiction ." /\MERICAi\ pVERSIGHT EXT-18-248-C-000446 Fierce Healt hcare (6/11, Stankiewicz, 146K) reports that the new guidance "includes summaries of different treatment modalities, including hospital and home-based services, as well as ways Medicaid can support parents with substance abuse disorder." The agency "said states can create bundled rates for such services, instead of the traditional fee-for-service model." Tim Hill, acting director of the Center for Medicaid and CHIP Services, is quoted as saying, "Through discussions with states, we have recognized their growing challenge in providing treatment services to the expanding number of infants with NAS [neonatal abstinence syndrome]. ... We have also recognized that states may not be fully aware of available options under Medicaid that can play a critical role in the care of these infants, as well as the limitations on Medicaid coverage." Healthcare Finance News (6/11, Morse, 93K) reports that so far, "CMS has approved substance use disorder related section 1115 demonstration projects in Louisiana, West Virginia, Indiana, New Jersey, Kentucky, Utah, Illinois, and Vermont to improve access to treatment for Medicaid beneficiaries." The article adds that Hill also said, "By leveraging and improving the technological capabilities of state Medicaid programs, we are providing Medicaid agencies, providers, and patients with the tools they need to improve health outcomes associated with addiction." Healt h Exec (6/11, Leider) also covers the story. CMS Says States Can Use Federal Funding To Make IT Improvements /\MERICAi\ pVERSIGHT To EXT-18-248-C-000447 Better Address Opioid Crisis. Fierce Healt hcar e (6/11, Sweeney, 146K) reports, "Federal funding is available to state Medicaid programs to enhance the use of technology to help states manage the opioid crisis, according to new guidance from" CMS. According to the agency, a lot of "funding is already available through existing legislation." CMS is also urging "Medicaid program directors to use telehealth and telepsychiatry to coordinate care for patients with substance abuse disorder ." Tim Hill, acting director of the Center for Medicaid and CHIP Services, told Medicaid directors that "CMS doesn't need to approve telehealth coverage changes for opioid treatment unless the state elects to cover telehealth encounters differently than in-person visits." Trump's Decision Not To Defend The ACA Could Be A Boon To Dems During The Midterms. On its website, CNN (6/8, Merica, 82 .6M) reports that the Trump Administration's move to refuse "to defend key provisions of the Affordable Care Act could deal Democrats a sizable win going into the midterm elections, handing a party already prepared to run on health care a cudgel to use against vulnerable Republicans." Several polls show voters consider healthcare the top issue in the midterms, "and Democratic candidates have responded by making it the cornerstone of their attacks on Republicans." The article adds that last week, the Administration "clearly outlined" its stance "on key - and popular - provisions in the Affordable Care Act, telling a court that the law should be invalidated and that the individual mandate is unconstitutional." The Justice Department also argued "in favor of invalidating protections for" people with pre-existing /\MERICAi\ pVERSIGHT conditions. EXT-18-248-C-000448 Fortune (6/11, Mukherjee, 3.91M) reports that the Administration's decision "could wind up being a political gift to Democrats in the 2018 mid -term elections, as it targets one of Obamacare's single most popular provisions." The article says the Administration is hoping the "courts will ultimately dismantle these Obamacare tenets," and its support of this suit against the ACA is an effort to hasten the process . However, "it could prove a political land mine (and boon to Democrats) going into the 2018 mid-term elections, if polling and recent campaigns are any indication." Politico (6/11, Diamond, 3.51M) reports that over the weekend, Democrats "seized" on the Administration's "move to revive their charge that the GOP can't be trusted to protect Americans ' health insurance." Meanwhile, "few congressional Republicans rushed to defend the administration's pre-existing move, instead emphasizing their support for preserving condition protections." The Daily Inte lligencer (NY) (6/11, Levitz, 551K) reports that the Administration move is against the GO P's "political interests." The article says "Democratic consultants are cheering" the Administration's decision. The piece adds that Democrats' "No. 1 strategic objective has been to force health care to the front of voters' minds - both to exploit the party's advantage on that issue, and to undermine public support for the Trump tax cuts by reminding voters that the GOP always intended to pay for its regressive giveaway with cuts to Medicaid and Obamacare." Kaiser Health News (6/11, Bartolone) reports that on Friday, California /\MERICAi\ pVERSIGHT EXT-18-248-C-000449 Attorney General Xavier Becerra vowed "to redouble his efforts as the Affordable Care Act's leading defender, saying attacks by the Trump Administration threaten health care for millions of Americans." He argued that the Administration's decision is, "simply put, an attack on the health care that millions of Americans have come to count on, and California, being the most successful state in implementing the Affordable Care Act, stands to lose perhaps more than anyone else." Commentary. Contributor Bruce Japsen writes in a Forbes (6/11, 10.34M) piece that physicians' groups "are once again rallying to the defense of the Affordable Care Act after the U.S. Justice Department filed a brief that doesn't defend the law's popular protections for patients with preexisting conditions." During "the American Medical Association annual meeting this week, doctors are discussing numerous ways to protect patients, updating its lobbying agenda to include ways to support the ACA." Japsen says groups such as the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American Psychiatric Association also criticized the Administration, saying, "The elimination of these protections could result in millions of people facing limited access to health care coverage and higher cost as a result of insurers being allowed to return to discriminatory coverage and pricing practices." Sarah Kliff writes in a Vox (6/11, 1.66M) piece that President Trump and the GOP are so intent on "killing Obamacare they've decided, just months before the midterm elections, to take aim at the most popular part of the law: coverage for preexisting conditions." Kliff says the suit "is, in some ways, a perplexing move mere months before midterm elections. Polling finds that both Democrats and Republicans think it's a good idea to ensure that sick people have access to health insurance." /\MERICAi\ pVERSIGHT EXT-18-248-C-000450 Yuval Rosenberg writes in the Fiscal Times (6/11, 7K) that the Trump Administration's decision to not defend the ACA is "political dynamite" because polls show the protections for pre-existing conditions are popular and may affect as many as 52 million non-elderly Americans. Rosenberg adds, "Democrats, who have already been hammering a health care message, are pouncing at the new opportunity." The Secretary in the News Azar To Testify About Drug Prices Before Senate Panel Today. In a news roundup, Politico (6/11, Pittman, 3.51M) reports HHS Secretary Alex Azar on Tuesday "will defend the Trump administration's plan to lower the cost of medicines" before the Senate Health, Education, Labor, and Pensions Committee. Politico reports lawmakers are expected to "to try to pin down Azar on aspects that were lacking when the administration rolled out its blueprint last month," noting that "Inside Health Policy reported last week the administration would soon announce that drug companies will lower their asking price on insulin." /\MERICAi\ pVERSIGHT EXT-18-248-C-000451 The C-SPAN Video Libra ry (6/12, 28K) posts a feed for Secretary Azar's scheduled testimony before the HELP Committee. Trump Administ ration Meeting With Pharmaceutical Companies To Seek Voluntary Price Cuts . The Hill (6/11, Sullivan, 2 . 71M) reports officials from the Department of Health and Human Services have been meeting with pharmaceutical companies to "seek voluntary cuts in drug prices." The Hill adds, "Voluntary cuts in prices would allow the administration to immed iately tout benefits of President Trump's drug pricing plan, which was announced last month, rather than having to wait for any regulatory actions to be put forward and take effect." An HHS spokesperson said Monday when asked for comment, "We are working with stakeholders across the spectrum including drug companies, [pharmacy benefit managers], distributors, patients, health care professionals, physicians, insurers, etc., to respond to President Trump's call to action and help patients pay less for their prescription drugs." HHS Secretary Alex Azar hinted at such talks last month, saying, "We look forward to working with industry to build a better drug-pricing /\MERICAi\ pVERSIGHT system." EXT-18-248-C-000452 Opinion: Trump Can Use Patent Law To Slash Prices For Naloxone. In an op-ed for the Washington Post (6/11, 15.68M), Public Citizen president Robert Weissman and Baltimore City Health Commissioner Leana Wen write that since President Trump declared the opioid crisis a public health emergency, "he and his administration have yet to take the steps that would help those fighting the epidemic on the front lines." Weissman and Wen call on the President to "use existing lega l authority to slash prices for the lifesaving drug naloxone ... and for its easy-to-use, patented delivery devices." They note that during the post - Sept. 11 anthrax scare, "amid public debate about employing government-use authority, then-Secretary of Health and Human Services Tommy Thompson demanded that the ciprofloxacin patent holder, Bayer, match the price of generic makers." They argue that the Administration "can choose to lower prices and save lives" or "perpetuate the rationing of lifesaving treatments." Donna Shalala Expresses Support For Single-Payer System Similar To The One Advocated By Bernie Sanders . Colby Itkowitz writes in the Washington Post (6/11, 15.68M) "Power Post" blog that during her tenure as HHS Secretary under President Clinton, "Donna Shalala fended off accusations that she was too liberal for the job. Now, as a candidate for Congress in a competitive Democratic primary, the former secretary must dust off her old progressive bona fides." In the past, Shalala insisted that a single-payer system was not feasible. Now, however , "Shalala says she supports universal health care under a Bernie Sanders-style system that isn't too /\MERICAi\ pVERSIGHT EXT-18-248-C-000453 different than 'Medicare for All."' HHS in the News White House Wants HHS To Delay Issuing Final Rule On Religious, Moral Beliefs. Modern Healthcare (6/11, Dickson, Subscription Publication, 239K) reports that the White House wants HHS to delay issuing a final "ru le that will require hospitals and physician practices to create standards and procedures to protect their employees' religious and moral beliefs until it can elaborate how the policy will affect the industry." The department "received more than 72,000 comments on the rulemaking before the March deadline," and it " is still dralting a final version of the rule, but proactively asked the Office of Management and Budget to allow it to confirm that providers were both complying with the rule and notifying staff and patients of their rights." The article says 0MB denied HHS requests because the department "did not provide industry comments on how these changes would affect their business," and it failed to "provide 0MB with adequate estimates of the time it would take providers to implement the rule." /\MERICAi\ pVERSIGHT EXT-18-248-C-000454 Columnists Say Healthcare Will Be The Focus Of The Midterms Given Administration 's Decision Not To Defend The ACA. Former Acting CMS Administrator Andy Slavitt and Nicholas Bagley, a law professor at the University of Michigan and a former Justice Department attorney, write in a USA Today (6/11, 11.4M) column that President Trump and the GOP "just put America's health care squarely on the November ballot." Following their failure to repeal the ACA, "the Trump administration, in cahoots with 20 conservative states, has asked the courts to strike down several pillars of the ACA - including its protections for Americans with pre-existing health conditions." Slavitt and Bagley add, "Nothing has defined the domestic agenda over the 18 months like health care. It's only fitting that it will define the election too." Healthcare Groups Want CMS To Improve Reimbursement For Remote Patient Monitoring. mHea lth Inte lligence (6/11, Wicklund) reports that on Monday, nearly 50 healthcare organizations and vendors which "are lobbying the Centers for Medicare &Medicaid Services to improve reimbursement opportunities for remote patient monitoring" Administrator Seema Verma. The groups want "CMS to modify and add /\MERICAi\ pVERSIGHT wrote to CMS EXT-18-248-C-000455 Current Procedural Terminology (CPT) codes that would enable Medicare reimbursement of mobile health programs that collect patient-generated health data in the home." Trump Administration Immigration Policy Examined. Vox (6/11, Lind, 1.66M) features an article which explains the Trump Administration's immigration policy. Vox examines how the government is separating families at the border, how many families are being separated, the policy behind the separations, and what happens to the children. The piece says that under federal law, "unaccompanied alien children are sent into the custody of the Office of Refugee Resettlement, which is part of the Department of Health and Human Services. The ORR is responsible for identifying and screening the nearest relative or family friend living in the US to whom the child can be released." Opinion: Trump Administration's "Zero Tolerance " Policy Is "Cruel And Un-American." Ar izona Republic (6/11, 1.21M) columnist EJ Montini writes that the Trump Administration's un-American," "zero tolerance" immigration policy "is cruel and and discusses the many children being separated from their parents at the border. Montini says, "After the cruelty of the current policy got some public attention, Homeland Security is said to have established a hotline through which confused, despairing arrested parents might be able to locate their children. Perhaps the department could set up another hotline to help the administration /\MERICAi\ pVERSIGHT locate its EXT-18-248-C-000456 humanity." Opinion: Trump's Immigration Policy Is "Completely Impractical." Dyana Mason, Assistant Professor of Planning, Public Policy and Management at the University of Oregon, writes in the Conversation illfil (6/11, 98K) that many of the immigrant children being "deliberately" separated from their parents at the border "are under the age of 4 and are infants." Mason adds, "When I researched this largely hidden aspect of immigration policy, I found little evidence that this patchwork system can absorb what promises to be an influx of thousands more children. And I have no doubt that forcibly separating kids from their families is completely impractical and bound to make a bad situation worse." Column: Redirecting Family Planning Funds Could Undercut STD Fight. Michelle Andrews writes for the Wash ington Post (6/12, 15.68M) that a Trump Administration effort to shift family planning funding "could cripple other federal efforts to curb an explosion in sexually transmitted diseases (STDs), some public health officials fear. " The Department of Health and Human Services has proposed changes to Title X rules that, "if adopted in their current form, would require that Tit le X services be physically and financially separate from abortion services" and could push some medical practice to "choose not to prescribe birth control pills or other Food and Drug Administration-approved /\MERICAi\ pVERSIGHT methods of EXT-18-248-C-000457 contraception." Whistleblower Lawsuit Against Signature Healthcare Reveals $244 Million Fraud. The Tennessean (6/11, Kelman, 513K) reports on a whistleblower lawsuit filed against Signature Healthcare in which the provider was accused "of artificially lawsuit "prompted inflating therapy time to maximize profits." The Signature to sign a $30 million settlement to resolve the claims," but federal prosecutors in that settlement "say the total fraud was much larger - about $244 million." The piece quotes HHS Office of Inspector General special agent Derrick L. Jackson as saying, "Signature was charged with illegally boosting profits by providing excessive amounts of therapy to patients whether they needed it or not . . . . The decision to provide therapy should never be based on corporate financial considerations rather than a patient's medical needs." HHS Seeking Public Comment About How To Set Up A Workgroup To Encourage Innovation, Investment In Healthcare . In continuing coverage, ExecutiveGov (6/11, Crews) reports that HHS is seeking "comments on how to structure a workgroup to facilitate highlevel discussions between HHS leaders and outside parties that support /\MERICAi\ pVERSIGHT EXT-18-248-C-000458 innovation or invest in the healthcare sector." A notice posted in the Federal Register last week said HHS intends "to create a workgroup to explore technological approaches to address healthcare challenges and drive communication activities meant to encourage industry competition." Many American Toddlers Exceed Recommended Added Sugar Intake For Adults , Study Suggests. USA Today (6/11, Carrig, 11.4M) reports a study by researchers at the Centers for Disease Control and Prevention suggests toddlers are consuming too much added sugar, with many actually exceeding adult recommendations . Investigators said that consuming foods with added sugar at such an early age can affect food preferences later in life. Lead study author Kirsten Herrick, a nutritional epidemiologist at the CDC, said, "Once kids start eating table food, they're often eating the same types of foods that Mom and Dad have in their diet, and other research has demonstrated that adults exceed recommendations for added sugar too." Newsweek (6/11, 2.18M) reports the study suggests "99% of children aged between 19 to 23 months eat over seven teaspoons of added sugar each day on average." Also, results indicate that non-Hispanic black children aged between 12 to 23 months ate the most sugar, "while white children ate the least." Researchers analyzed "data from more than 800 infants and toddlers, aged between six and 23 months old, who took part in the National Health and Nutrition Examination Survey between 2011 and 2014." The findings were presented "at /\MERICAi\ pVERSIGHT EXT-18-248-C-000459 Nutrition 2018, the annual meeting of the American Society for Nutrition held in Boston." CDC Data Reveal Severity Of Latest Flu Season. The Pittsbu rgh Post-Gazette (6/11, Daly, 507K) reports new data from the CDC show that this past flu season killed 172 children - "one more than the high set in 2012-13." According to the CDC, "about 80 percent of this season's pediatric deaths were in children who had not received a flu shot," the piece says, adding that local health officials experienced high rates of flu cases, hospitalizations, The Scientist (6/11, Charuchandra, and deaths. 153K) reports Daniel Jernigan, head of the CDC's flu division, said the flu season was "bad across the population" and that it "was happening to everyone, and it seemed to be happening everywhere." Ebola Vaccines Could Signal Hope In Congo As Outbreak Continues. The AP (6/11, Mednick, Neergaard) reports health workers tackling the /\MERICAi\ pVERSIGHT EXT-18-248-C-000460 Ebola crisis in the Democratic Republic of Congo are offering a vaccine to impacted and at-r isk populations, drawing international attention as onlookers wait "to see if a promising but still experimental vaccine might help stop this terrifying disease faster than traditional measures doctors have tried since Ebola was identified 40 years ago." However, even if it is effective, "there are serious hurdles" including logistical issues and gaining community trust. The article quotes CDC Ebola expert Dr. Pierre Rollin as saying, "People die every day and everywhere but nobody's interested. Suddenly because of Ebola people are interested and that makes you suspicious .... Why would they trust us?" STAT (6/11, Branswell, 27K) reports some experts "have watched with frustration the snail's pace progress of the efforts to study Ebola drugs during outbreaks," and many "are beginning to wonder if, with the advent of Ebola vaccines, the window for doing this kind of research may be closing for good." The piece says that within the scientific community, "There remain deeply divergent positions ... about how to design outbreak trials," noting that "generating the human efficacy data that regulatory agencies like the Food and Drug Administration look for has been almost impossible." Op-Ed: Trump's Reversal On Ebola Funding Cut Is Welcome News For Disease Prevention, Treatment Efforts. K. Riva Levinson, president and CEO of KRL International LLC, writes in The Hill (6/11, 2.71M) that President Trump has deviated from his 2014 Twitter statements that America "cannot allow EBOLA infected people back" by electing to reinstate the $252 million he had previously rescinded from the International this will help the international Disaster Assistance account. She says community address issues that actors learned from the 2014 Ebola outbreak, during which the National /\MERICAi\ pVERSIGHT EXT-18-248-C-000461 Institute of Health assisted in leading response efforts . Laser Eye Surgery May Be Riskier Than Many People Think, Research Suggests. The New Yor k Times (6/11, Rabin, Subscription Publication, 19.33M) reports "roughly 9.5 million Americans have had laser eye surgery, lured by the promise of a quick fix ridding them of nett lesome glasses and contact lenses," but "serious questions remain about both the short - and long -term risks and the complications of this increasingly common procedure." The article highlights a trial conducted by the Food and Drug Administration, the Nationa l Eye Institute, and the Navy Refractive Surgery Center finding that "people who did not have dry eyes or visual aberrations before Lasik were at high risk for developing these problems." Research suggests "28 percent of these participants developed dry eyes after surgery, and 45 percent reported a new visua l aberration three months after surgery." Dr. Malvina Eydelman, the study's lead author and the director of the FDA's Center for Devices and Radiological Health's division of ophthalmic and ear, nose and throat devices, "said the researchers had concluded that the multimillion dollar trial was too small to produce meaningful results, and that the purpose of the study had shifted from determining how many patients have problems functioning to developing a questionnaire that might be used in future research." /\MERICAi\ pVERSIGHT EXT-18-248-C-000462 Anheuser-Busch Cancels Funding For NIH Alcohol Study . The Scientist (6/11, Williams, 153K) reports Anheuser-Busch InBev announced on Friday that it no longer plans to assist in funding the National Institutes of Health's "study on the effects of moderate alcohol consumption," withdrawing its $15 million funding commitment. The piece says scientists with the National Institute of Alcohol Abuse, which is leading the $100 million study, "met with industry leaders and 'gave talks strongly suggesting that the study's results would endorse moderate drinking as healthy,"' according to the New York Times . The piece adds that NIH Director Francis Collins "announced that the agency was reviewing the process around funding for the trial and would determine whether it should proceed, and that enrollment had been suspended for the time being." House To Vote On 34 Opioid Bills This Week. Congressio nal Qua rte rly (6/11, Raman, Subscription Publication) reports that on Tuesday the House "will begin a voting marathon on 34 bills designed to address the opioid epidemic," and while most are unlikely contentious, "two bills have previously stirred controversy." One bill set for a Friday vote "would create a new class on the controlled substances schedule for compounds related to fentanyl " and ease related prosecutions, but critics warn it could justify "broad bans on drugs and hinder drug research." National Institute on Drug Abuse Director Nora Volkow testified in April, "We need to have countermeasures, only way that we're going to have countermeasures and the is [by] doing research." CQ reports that the House will vote Thursday on a bill to help /\MERICAi\ pVERSIGHT EXT-18-248-C-000463 prevent the importation of synthetic opioids, but a rival bill in the Senate "would impose stricter requirements on" the US Postal Service and Customs and Border Protection "than the or iginal House bill." The Washington Times (6/11, Howell, 460K) reports that notable bills include Jessie's Law, which "orders the Health and Human Services Department to come up with best practices for hospitals and physicians to share the information" on consenting patient's record of drug addiction before prescribing treatment. Boston Globe Highlights Work Of Alzheimer 's Disease Researcher Focused On Preclinical Phase. In an over 2,800 word article, the Boston Globe (6/11, Kendall, 945K) highlights the work of Reisa Sperling, "one of the world's foremost researchers of Alzheimer's disease," who leads Brigham and Women's Hospital's Center for Alzheimer's Research and Treatment. Sperling's work focuses on the preclinical phase of Alzheimer's disease with the aim of better understanding the early stages of the disease "before significant memory problems set in." The article mentions that the National Institute on Aging has awarded a five-year $70 million grant to Sperling and her colleagues to "build a research infrastructure called the Alzheimer's Clinical Trials Consortium, a network of 35 testing sites at academic medical centers across the country." Laurie Ryan, the leader of dementia research at the National Institute on Aging's Division of Neuroscience, said, "This should be a game changer." /\MERICAi\ pVERSIGHT EXT-18-248-C-000464 Northwestern University Researcher Interviewed About Participating In NIH All Of Us Research Program. The Chicago Tribune (6/11, Schencker, 2.37M) reports on an interview with Northwestern University research assistant professor Joyce Ho, who discussed the university's role in the All of Us Research Program, noting that the Illinois Precision Medicine Consortium - of which the university is a member - "has received $51 million from the National Institutes of Health to gather data and samples from 93,000 volunteers over the next five years." Ho examined prec ision medicine's comprehensive approach to analyz ing health, how the program will work, and its potential implications for the future of medical treatment. Editorial : NCI Cancer lmmunotherapy Study Has Applications For New Pittsburgh Therapy Center . In an editorial, the Pittsburgh Post-Gazette (6/12, 507K) applauds the findings of a recent study led by National Cancer Institute researcher Steven A. Rosenberg which showed "success in using a type of immunotherapy to treat metastatic breast cancer in a Florida woman." The Post-Gazette heralds the findings as the kind "of lifesaving [breakthrough] that could be possible at a new immunotherapy center planned for Pittsburgh" called the UPMC Immune Transplant and Therapy Center. The editorial says NCI researchers identified some of /\MERICAi\ pVERSIGHT EXT-18-248-C-000465 !/~f'·•',.~ l~t--------- DEPARTMENTOF HEALTH & HUMAN SERVICES ·-.,••,,"(y ADMINISTRATIONFOR CHILDREN AND FAMILIES Mary E. Switzer Building 330 C ST, S.W. Washington, D.C. 20201 Case No: 18-F-0029 Civil Action I 8-cv-0248 November 20, 2018 Ms. Katie O 'Connor Legal Counsel Campaign for Accountability 611 Pennsylvania Avenue, SE, #337 Washington, D.C. 20003 Dear Ms . O'Connor: This is the fourth interim response of the Administration for Children and Families to Ms. Katie O'Connor ' s October 27, 2017, Freedom oflnformation Act (FOIA) request for records related to services for pregnant unaccompanied immigrant minors. Specifically, Ms. O'Connor sought the following items: 1. All records related to Office of Refugee Resettlement ("ORR") policy regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. This request includes memoranda, directives , policy statements, policy interpretations, policy guidance, talking points, and other similar documents reflecting ORR policy . 2. All records related to ORR Director Scott Lloyd's visits to ORR grantee shelters that house unaccompanied immigrant minors. This request includes calendar entries , travel and accommodation requests and approvals, itineraries , briefing memoranda , and meeting notes. 3. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and representatives of the Susan B. Anthony List, Concerned Women for America , the Heritage Foundation , the Center for Family and Human Rights ("C-Fam "), National Right to Lifo, Alliance Defending Freedom, Legal Works Apostolate, or the Knights of Columbus regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters . This request includes communications to or from anyone using email addresses from the following domains: a. @sba-list.org b. @cwfa.org c. @heritage.org d. @c-fam.org e. @nrlc.org f . @adflegal.org g. @ legalworks.com h. @kofc.org 4. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged Case No. 18-F-0029 Civil Action l 8-cv-0248 Page 2 of 2 between representatives of ORR and representatives of the White House regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. 5. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and members and staff of the U.S. Congress regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. Your request was sent to the Office of Refugee Resettlement (ORR) and the Office of the Chief Information Officer for a search for responsive records. Please find enclosed 595 pages of responsive records responsive in part to Item 1 above. Some of the infonnation on the enclosed pages has been withheld under the FOIA exemptions (b)(S) and (b)(6). The exemption (b)(S) protects inter-agency or intra-agency memorandums or letters which would not be available by law to a party other than an agency in litigation with the agency. The exemption protects agency deliberations, both internal and with agency contractors and consultants, attorney-client privileged records and attorney work product. In this case, the withheld infonnation includes predecisional discussions within the agency and between agency staff and contractors about management of ORR programs and/or individual children and sensitive communications between agency staff seeking legal advice and counsel on policy and other matters. The FOIA exemption (b)(6) permits the withholding of records which, if released, would constitute a clearly unwarranted invasion of personal privacy. In this case, the withheld information consists of the names, identity and/or other private infonnation of private individuals and/or the identities of federal employees in sensitive positions and the work cell phones of federal employees. The withheld information also includes the locations of shelters housing vulnerable unaccompanied children and refugee centers. Public disclosure of this infonnation would constitute an invasion of privacy of those individuals whose identifying information was disclosed. In particular, disclosing the locations of shelters subject the children to unwanted publicity and harassment. In withholding the information, the individual's privacy interest was balanced against any public interest in disclosure. In each instance where infonnation was withheld, it was detennined that the individual's privacy interests outweighed any public interest in disclosure of the withheld information. Disclosure of the withheld info11nation would invade the privacy of the subject individuals but would reveal nothing about the operations or activities of the government. Sincerely yours, e este m1t Acting FOIA Officer Administration for Children and Families Northwestern University Researcher Interviewed About Participating In NIH All Of Us Research Program. The Chicago Tribune (6/11, Schencker, 2.37M) reports on an interview with Northwestern Univers ity research assistant professor Joyce Ho, who discussed the university's role in the All of Us Research Program, noting that the Illinois Precision Medicine Consortium - of which the university is a member - "has received $51 million from the Nat ional Institutes of Health to gather data and samples from 93,000 volunteers over the next five years." Ho examined prec ision medicine's comprehens ive approach to analyz ing health, how the program will work, and its potential imp lications for the future of medical treatment. Editorial : NCI Cancer lmmunotherapy Study Has Applications For New Pittsburgh Therapy Center . In an editorial, the Pittsburgh Post-Gazette (6/12, 507K) applauds the findings of a recent study led by National Cancer Inst itute researcher Steven A. Rosenberg which showed "success in using a type of immunotherapy to treat metastatic breast cancer in a Florida woman." The Post-Gazette heralds the findings as the kind "of lifesaving [breakthrough] that could be poss ible at a new immunotherapy center planned for Pittsburgh" called the UPMC Immune Transplant and Therapy Center. The editoria l says NCI researchers ident ified some of /\MERICAi\ pVERSIGHT EXT-18-248-D-000001 the woman's "immune cells that seemed able to fight the cancer, mult iplied them and infused them into her." Rosenberg is quoted as saying, "All cancers have mutations, and that's what we're attacking with this immunotherapy .... It is ironic that the very mutations that cause the cancer may prove to be the best targets to treat the cancer." House Panel Questions FDA's Efforts To Track Illegal Opioids . Reuters (6/11, Lynch) reports members of the House Energy and Commerce Committee sent a letter to Food and Drug Administrator Scott Gottlieb questioning whether the agency was "doing enough to stop the flow of illegal drugs" into the US as the nation battles the opioid epidemic. Republican Chairman Greg Walden (OR) and ranking Democrat Frank Pallone (NJ) wrote, "We have concerns about whether the FDA is appropriately devoting its resources to prioritize these efforts against unapproved opioids." FDA spokeswoman Lyndsay Meyer confirmed t he agency received the letter and planned to respond. Experts Describe Federal Efforts To Prevent Foodborne Illnesses . The Poughkeeps ie (NY) Journa l (6/11, Robinson, 111K) interviewed federal regulators and food-safety experts and surveyed public health data in an ongoing investigation /\MERICAi\ pVERSIGHT of foodborne illness. Dr. Stephen EXT-18-248-D-000002 Ostroff, FDA deputy commissioner for foods, explained that with an outbreak, the task of sourcing breakouts is akin to an incomplete puzzle, saying, "the product that was consumed is no longer available to test and that makes it so much more difficult, even if we can trace it back through supply chain." The article notes that the "FDA conducted about 156,000 food -safe ty inspections across the country between 2010 and 2017," pointing out labeling gaps and that "insect, bird or vermin contamination was the most common critical deficiency." Federal Court Bars Mississippi Compounding Pharmacy From Making, Distributing Drugs. The Jackson (MS) Clar ion Ledger (6/11, 287K) reports that the Justice Department announced that a federal court has barred a compounding pharmacy, Delta Pharma Inc in Ridley, Mississippi, and two of its officers from distributing adulterated drugs under a consent decree. The defendants cannot manufacture, hold, or distribute drugs until the FDA notifies them in writing that "they appear to be in compliance with ... specific remedial measures." Last year, the FDA uncovered "numerous unsanitary conditions" during an inspection, prompting the legal case. The Washingto n Times (6/11, Mordock, 460K) reports the FDA inspectors "noted numerous unsanitary practices including using tubes that may not have been sterilized to process drugs" and "did not take steps to ensure chemicals or particles from the tubes would contaminate the medicines, according to court documents." /\MERICAi\ pVERSIGHT EXT-18-248-D-000003 Opioid Crisis Naloxone Use To Expand Among Police Departments, School Campuses In San Diego County . The San Diego Union-Tribune "almost all police departments (6/7, Hernandez, 664K) reports that in" San Diego County "intend to supply their officers with naloxone, including the police forces for some universities and colleges," amid "efforts to prevent opioid overdose deaths." The article spotlights police departments in San Diego County that have "stoc ked up on naloxone in the past year," and notes that "the drug is available to school resource officers" at some schools. Former Sen. Bill Frist Highlights Cigna's Efforts To End Opioid Epidemic. /\MERICAi\ pVERSIGHT EXT-18-248-D-000004 In an op-ed in The Tennessea n (6/11, 513K), Bill Frist, a former Senate majority leader in Midd le Tennessee, states that "private sector health insurers ... have a role to play" in end ing the opioid epidemic, highlighting Cigna as "a company that is demonstrating real leadership" in this effort . Frist states Cigna "recently announced that it achieved a 25% reduct ion in opioid use among its customers," achieved through collaboration and "the gains were with 1.1 million prescrib ing clinicians using an integrated analysis of pharmacy, medical, and mental health benefits to personalize the level of customer care." Frist says that it is also necessary to educate physic ians on "non-addictive manage pain," change "federal reimbursement opioid prescribing over non-addictive alternatives to rates that incentivize alternatives," make it easier for people to access and afford addiction rehabilitation and mental health treatment, and facilitate treatment for people who have act ive addictions. Mental Illness Word Choice May Be Indicative Of Depression, Studies Involving Linguistic Analysis Programs Suggest. /\MERICAi\ pVERSIGHT EXT-18-248-D-000005 The Wall Street Journal (6/11, Bernstein, Subscription Publication, 6.13M) reports that according to certain linguistic analys is programs, part icular words may ind icate someone is suffering from depression, based on findings from several studies published in psychological journals. Prescription Drug Pricing Drugmaker Reboots Female Libido Drug At Half Price. Bloomberg News (6/11, Koons, 4.46M) reports Sprout Pharmaceuticals is relaunching its drug, Addyi, the "first-ever" FDA "approved drug for low libido in women," at a pr ice point that is half of what it once was. Bloomberg points out that the price cut is "a rare step" in the industry, as "drugs typically go up in price on an annual basis, sometimes even twice a year." The "prescription carries a boxed warning" that requires women taking Addyi "to sign an agreement acknowledging the r isk of drinking while taking the drug ." /\MERICAi\ pVERSIGHT EXT-18-248-D-000006 Drug Pricing Advocates Condemn Democrats For Supporting Drug Industry. STAT Plus (6/11, Mershon, Subscription Publication, 27K) reports 50 congressional Democrats endorsed a letter which a drug pricing advocacy group, Patients for Affordable Drugs, cla ims advances the pharmaceutical industry's "talking points." The advocacy group responded by letter Monday to House Speaker Paul Ryan, Minority Leader Nancy Pelosi, and the 50 Democrats "condemning" their support for chang ing the "financial liabi lity in the so-called 'donut hole,"' which is one of the industry's "chief lobbying priorities." Health Care &Insurance Reform Dems , Who Once Shied Away From Healthcare , Are Hoping The Issue Will Propel Them To Victory In The Midterms. The Los Angeles Times (6/11, Barabak, 4.03M) reports that for years, /\MERICAi\ pVERSIGHT EXT-18-248-D-000007 Democrats have been shying away from the issue of healthcare "as though it were a heap of flaming rubble, which, politically speaking, it was." They lost control of Congress after the ACA was passed. But new polls indicate support for the ACA is "increasing as it becomes more imperiled, and the result has been a political sea change." The article says criticism of "GOP repeal efforts has emboldened Democrats, who think they can seize back the House, dramatically expand coverage and turn healthcare from an albatross to an advantage even in red states like Idaho, with the help of Republicans like Christy Perry." Trump 's Opposition To Parts Of New VA Healthcare Law May Endanger Its Implementation. Joe Dav idson writes in the Wash in gton Post (6/11, 15.68M) "Power Post " blog that President Trump said he was "very happy" to sign the VA Mission Act, which seeks to improve veterans' healthcare. Since then, however, Trump has expressed dissatisfaction law, and the Administration with portions of the has "sent Congress a memo outlining objections to proposed funding measures for the new program." According to a top Democrat, these "objections could lead the Department of Veterans Affairs to 'cannibalize itself."' Davidson adds that the new law includes "sweeping, histor ic changes," as Trump said, yet "how the job gets done is now open to question because of the signing statement Trump issued after his Rose Garden statement and the administration's /\MERICAi\ pVERSIGHT opposition to certain funding measures." EXT-18-248-D-000008 Experts Caution Against Use Of Cheaper Outpatient Surgical Centers. Dr. Dhruv Khullar and Austin Frakt, director of the Partnered EvidenceBased Policy Resource Center at the VA Boston Healthcare System, write in the New York Times (6/11, Subscript ion Publication, 19.33M) "The Upshot" blog that while "cost variation across care settings has led policymakers to consider paying more evenly for medical services regardless of where they're delivered, and to shift care from expensive, high-intensity settings to cheaper, low-intensity Medicare hospitalizations ones," a study of "found that almost all patients are more likely to survive at teaching hospitals, which tend to be more expensive." Khullar and Frakt explain that "sometimes more is more." Outpatient surgical centers do not always have the resources and staff needed to handle potential complications, and teaching hospitals have more advanced technologies, "subspecia lty expert ise, more clinicians involved in care, and greater availability of ancillary services ." Additionally, "research suggests that hospitals that spend more and do more may have better patient outcomes and lower mortality rates." Less Than 10% Of American Adults Get Recommended Preventive Healthcare, Study Indicates. Reuters (6/11, Lehman) reports that according to a new study surveying nearly 2,800 American adults over age 35, "only 8 percent were gett ing all of the highly recommended preventive serv ices with the greatest potential for improv ing health." Reuters exp lains the survey /\MERICAi\ pVERSIGHT EXT-18-248-D-000009 included questions "about the receipt of 15 high-priority preventive services including blood pressure and cholesterol checks, screening for osteoporosis and several cancers, counseling on tobacco use, obesity, alcohol use and depression, plus vaccinations and asp irin use." The st udy was published online June 4 in Health Affairs. Cisco, Other Large US Employers Try ing To Manage Workers ' Health To Control Costs. Reuters (6/11, Humer) reports that Cisco Systems, Inc . is among "a handfu l of large Amer ican emp loyers who are getting more deeply involved in managing their workers' health instead of looking to insurers to do it ." Last year, the company "began offering its employees a plan it negotiated directly with nearby Stanford Health med ical system," and a clinic is located at Cisco's San Jose campus. Reuters adds that other large companies, such as Amazon.com Inc., JPMorgan Chase &Co., and Berkshire Hathaway Inc. are "closely watching" whether these efforts pay off . Opinion : Supreme Court Leaning In Favor Of Pro-Life Cause. Father Frank Pavone, national director of Priests for Life, wr ites in an analysis for the Washington Examiner (6/11, 340K) that two recent /\MERICAi\ pVERSIGHT EXT-18-248-D-000010 Supreme Court actions "indicate there are winds blowing in favor of the pro-life cause." On May 29, the Court "decl ined to hear a case that sought to overturn an Arkansas law on chemical abortion " which "requ ires abortion providers to have contracts with physicians who have hospital admitt ing privileges." On June 4, "the justices unanimous ly vacated an order of the U.S. Court of Appeals for the D.C. Circu it that had allowed a pregnant, undocumented m inor in federal custody to have an abortion back in October." Midwest Has Fewest Abortion Clinics Per Woman Than Any Other Region , Study Indicates. The Chicago Tribune (6/7, Lourgas, 2 .37M) reports a new study published in the Journa l of Medica l Internet Research found that the Midwest has fewer abortion clinics than any other region in the United States based on the population of women of child-bearing age. Accord ing to the article, "Illinois - often referred to as an oasis for abortion care in the middle of the country - had an estimated 25 clin ics, roughly one for every 120,135 women of reproductive neighboring Wisconsin, by comparison, age. In researchers found three facilities provid ing abortions, about one for every 423,590 women ." Air Ambulance Companies Leave Patients With High Bills. /\MERICAi\ pVERSIGHT EXT-18-248-D-000011 Bloomberg News (6/11, Tozzi, 4.46M) reports on the growing size of the air ambulance fleet in the US and the increasing cost of using an air ambu lance for medical emergencies. Air ambulance operators believe that because " US government health programs, includ ing Medicare and Medicaid, don't cover their expenses, they must ask othe rs to pay more - and when health plans balk, pat ients get stuck with the tab." As a result of "favorable treatment under federa l law," air-ambulance companies have "few restrictions on what they can charge for their services" and "states have no power to put in place their own curbs." According to the article, Sen. Jon Tester (D-MT) has "introduced legislation that would roll back the special status of air-ambulance companies." In addition, the FAA reauthor ization bill passed by the House in April "would make medica l services prov ided by air ambu lances subject to state regulation." Commentary Considers Health Reform. Several outlets offer opinions on health reform. In an editorial, the New York Times (6/11, Subscript ion Publication, 19.33M) argues that Democrats who hope "to make health care a centerpiece of midterm election campaigns just got a gift from the Trump administration," as the Justice Department has "declined to defend the Affordable Care Act aga inst a lawsuit filed by 20 Republicanled states," and is "arguing for the repeal of enormously popu lar consumer protections, includ ing coverage of pre - existing conditions ." The Times concludes, "Add this latest move to a growing list of similar /\MERICAi\ pVERSIGHT EXT-18-248-D-000012 efforts - eliminating more short-term administration's the mandate tax penalty to begin with, allowing plans on the market - and it becomes clear where the priorities lie: not in helping more Amer icans get good health care, not even in support ing the will of the people, but in dismantling what some political opponents built, just for the sake of doing so ." Catherine Rampell writes in her column in the Washington Post (6/11, 15.68M) that "if the GOP real ly thinks gutting protections for people with preexisting health conditions is good policy, they should pass a damn law." Rampell points out that Republicans passed "literally dozens" of bills repealing the ACA whi le President Obama was in office, but then they "chickened out" last year "because they feared the blowback from voters." Unable to take such action legislatively, the Trump Admin istration is attempt ing to have the courts declare that protect ions for pre-existing condit ions are unconstitutiona l, she argues. Rampell calls all of the Republican lawmakers who are "keeping their heads down" amid these moves "cowards." Jennifer Rubin wr ites in the Washington Post (6/11, 15.68M) "Right Turn" blog that after fa iling to repeal the ACA, President Trump and congressional Republicans "have decided to make it worse and help states get rid of it in the courts." She argues, "As a policy matter, their approach will cause hardship to Amer icans, espec ially rural Trump voters; as a political matter, it defies logic." Rubin adds that " everyth ing the Trump administration has done with regard to the ACA is designed to raise prices. Republicans' refusal to reverse these steps will surely be fodder for Democrats in the midterms." In an editorial, the Wall Street Journal (6/11, Subscription Publicat ion, 6.13M) analyzes the position Republican cand idates find themselves in /\MERICAi\ pVERSIGHT EXT-18-248-D-000013 after failing to repeal the Affordable Care Act and with prem iums expected to rise by double-digit percentage points in the run-up to the midterm elections. The Journal argues that despite finger-pointing by Democrats, the problems stem from the structure of the law itself, not the actions of the Trump Administration or the repeal of the individual mandate. Michael Hiltzik writes in his Los Angeles Times (6/11, 4.03M) column that legal experts "who pay attention to the courthouse fortunes of the Affordable Care Act could tell something weird and bad was in the wind last Thursday, when three career attorneys at the Department of Justice abruptly withdrew from the team defending the law against a right -wing attack by Texas and 19 other red states." Hiltzik asks, "Just how indefensible does an argument in a government cause all the career litigators ... to withdraw?" be unusual for the government may be unprecedented the government br ief have to be to He says while it may not to refuse to defend a federal law, "it for virtually the entire legal team representing in a case to withdraw en masse." Corey R. Lewandowski, who served as a campaign manager to Donald J. Trump, writes in an op-ed for The Hill (6/11, 2. 71M) that President Trump "inherited a mess from his predecessors." The biggest issue "is an entitlement Thankfully, t ime bomb that is soon to explode the national debt. President Trump is up for the task of entitlement reform." Lewandowski adds that a conservative group has recommended that Congress "raise Social Security and Medicare ret ireme nt ages to account for increased life expectancies and work capacities; transition to a flat, anti-poverty benefit for future beneficiaries so that the programs do not pay the highest benefits to those with the least need; and reduce the payroll tax to allow individuals to save more on their own for retirement /\MERICAi\ pVERSIGHT and disability." EXT-18-248-D-000014 The New Yor k Daily News (6/8, 3. 71M) says in an editorial after failing to get Congress to repeal the ACA, the Trump Administration now wants "a judge to undo the rest of the law through the courts." The paper argues, "This is a brazen act of execut ive overreach. If it succeeds, it wi ll endanger the coverage of thousands of sick Americans." Contributor Sally Pipes writes in a Forbes (6/11, 10.34M) piece that in 2017, "Canada's single-payer healthcare system forced over 1 million patients to wait for necessary medical treatments." This was a new record. Pipes argues that long, costly "delays are the norm in Canada and other single - payer nations, which ration care to keep costs down . Yet more and more Democratic leaders are pushing for a single-payer system - and more and more voters are clamoring for one." Charles Wallner, executive director of the Faith Community Alliance of Greater Cincinnati, writes in a Cincinnati Enquirer (6/11, 246K) op-ed that hea lthcare access through Medicaid "has been critical in helping Ohioans to enter the workforce and supporting them in their work." The state "should be focused on strengthening preventive care and treatment residents ' connection to the that keeps them healthy and connected to the workforce. Instead, Ohio is pursuing a bad idea dressed up as health care reform." The Charleston (WV) Gazette-Mail (6/11) editor ializes that in 1992, West Virginia formed a study group to look at allowing anyone to buy into its Public Employees Insurance Agency. The editorial suggests the state shou ld return to the idea once again because it cou ld provide an economical "s ingle-payer health care for everyone." The editor ial argues that Republicans in Washington, DC, "aren't interested in fixing this" and the state should address health coverage on its own. /\MERICAi\ pVERSIGHT EXT-18-248-D-000015 Human Services News Experts: Don't Let Social Security Solvency Fears Affect Claiming Decision. CNBC (6/11, 4.81M) reports the "Social Security Board of Trustees said the trust funds that help support the system will run out of money in 2034," but "experts say you should not let fear about the program's future affect your eventual claiming decision." They say they expect Congress to act to address that issue, and that retirees and nearretirees are unlikely to be affected. Additionally, if nothing is done, it won't be good, but it result in payouts of 75 to 80 cents on the dollar, not a complete stop of payments. Compromise Social Security Reforms Suggested. Robert Pozen, a senior lecturer at the MIT Sloan School of Management, in an op-ed in The Hill (6/11, 2.71M), predicts that, "given the intense /\MERICAi\ pVERSIGHT EXT-18-248-D-000016 hostility between the parties, they are not likely to agree on a compromise package of reforms before Social Security is on the brink of insolvency" in 2034. Still, Pozen suggests a "compromise package of reforms" that include "a 2 percent surcharge on all earnings above the maximum earnings subject to the payroll tax without raising benefits"; increasing the "normal retirement increases in life expectancy; retirement, age to 68 around 2040," indexing to and "in calculating init ial benefits at phase in a formula based on consumer price index growth over a worker's career for the top th ird of earners, who have other retirement plans subsidized by taxes and corporations." Social Security Said To Face "Manageable Financing Shortfall." Alicia H. Munnell writes in a column in MarketWatch (6/11, 1.49M), "The 2018 Social Security Trustees Report, released last week, shows that the program faces a 75-year deficit of 2.84 percent of taxable payrolls virtually unchanged from last year's projection of 2.83." The deficits are partly due to "a worsening of economic assumptions" and "persistent increases in disability rolls." Munnell concludes, "Social Security faces a manageable financing shortfall over the next 75 years, which should be addressed soon to share the burden more equitably across cohorts, to restore confidence in the nation's major retirement program, and to give peop le time to adjust to needed changes." Johns Hopkins Lecturer Calls For Social Security Changes. Johns Hopkins Univers ity School of Advanced International Studies senior lecturer Jason J. Fichtner, in an op-ed in CO Roll Call (DC) (6/11, 117K), writes that the Social Security crisis "is already well upon us." He warns, "To ensure that Social Security remains viable for the most vulnerable in our society, policymakers must soon address its severe /\MERICAi\ pVERSIGHT EXT-18-248-D-000017 and urgent financial challenges." Fichtner calls for "bipartisan solutions," recommending policy reforms suggested by "an expansive project housed at the Bipartisan Policy Center" that would "improve retirement security and personal savings." Ryan Making One Last Push To Overhaul TANF , SNAP Before He Retires From Congress. Congressio nal Qua rte rly (6/11, McPherson, Subscription Publication) reports House Speaker Paul Ryan (R-WI) "has spent his 20- year congressional career primarily focused on two issues, taxes and poverty." He "led a major rewrite of the tax code last year, but when he retires at the end of this term he won't have many accomplishments to tout on poverty." The article says "Ryan is spending his final year in office making one last anti-poverty push." That is why the House is mulling "another overhaul to TANF [Temporary Assistance for Needy Families], as well as major changes to the Supplemental Nutrition Assistance Program (SNAP), otherwise known as food stamps ." Jefferson County Decision To Forfeit Head Start Funding Resulted In The Loss Of Family Advocate Jobs. The Lou isville (KY) Cour ier-Journal (6/11, McLaren, 419K) reports that /\MERICAi\ pVERSIGHT EXT-18-248-D-000018 after the Jefferson County Public School board in Kentucky voted in late May to abandon its "beleaguered" Head Start program, half a dozen young women walked out of the meeting "out of work, no longer contracted by the district to support preschool students and the ir families, " even after Superintendent Marty Pollio said no jobs would be lost. The posit ions, known as fam ily advocates, are requ ired by the federal Head Start and Early Head Start programs, both of which serve children from low-income households. According to the article, "though the positions will exist if another organization scoops up the Head Start grant forfeited by JCPS, the women's shock illustrated how many in Jefferson County were caught off-guard by the distr ict's decision to forfeit $15 million in federal grant money and a program that serves the community's most vulnerable kids." CBP Commissioner Discusses Illegal Border Crossings During Interview. The Los Angeles Times (6/11, Hennessy - Fiske, 4.03M) runs a n interview w ith US Customs and Border Protection Commissioner Kevin McAleenan "dur ing his visit to agents in Texas' Rio Grande Valley, the epicenter of migration in recent years ." McAleenan tells the Times , "We've had consistent levels of apprehensions and inadmissible crossing since March. March and Apr il were pretty much level at 50,000, both between apprehensions between ports of entry at that 36,000-37,000 level, and inadmissibles arriving at ports of entry between 12,000 and 13,000. So we remain day to day at those levels, which presents a number of challenges operationally." McAleenan adds that "it's too early to say what the increased ability to apply consequences for crossing the border illegally - what effect that will have on the traffic coming towards us." /\MERICAi\ pVERSIGHT EXT-18-248-D-000019 Louisiana Child Care Program Improved Controls, Auditor Says. The AP (6/12) says a report issued Monday by Louisiana Legislative Auditor Daryl Purpera's office "says the education department enacted most of the recommendations has made by auditors to track spending on the Child Care Assistance Program ." A 2012 aud it of the program when it was managed by the Department of Children and Family Serv ices identified $46,000 in improper payments, but the education department, "which took control in 2015, trimmed improper payments to about $24,000." Food &Import Safety Opinion: Labeling Requirements Drive Up Costs For Consumers. /\MERICAi\ pVERSIGHT EXT-18-248-D-000020 Richard Berman, pres ident of the public relations fi r m Berman and Co., writes for the Washington Times (6/11, 460K) that " the Coalition for Accurate Product Labels reports that in the first half of 2018, 11 states introduced close to three dozen proposa ls for warning labels or ingredient disclosures that went beyond nat ional standards, and in many cases exceeded the bounds of known evidence ." Arguing that labels "have landed us in a regulatory muck of mean ingless warnings and unnecessary added costs to businesses, which are inevitably passed on to consumers," Berman denounces San Francisco's 2015 ordinance on labeling of sugar-sweetened beverages, noting that the FDA recognizes that "added sugars can be a part of a healthy dietary pattern." Tyson To Recall 3,120 Pounds Of Breaded Chicken Over Plastic Contamination. USA Today (6/11, Price, 11.4M) reports the "U.S. Department of Agriculture's Food Safety and Inspect ion Serv ice said Friday Tyson must reca ll 3,120 pounds of frozen breaded chicken tenders." The company informed FSIS on Friday that "the breading of the frozen, uncooked chicken tenders may have been contaminated with foreign material in the form of blue and clear soft plastic," the article says. FSIS classified the health risk as "low." /\MERICAi\ pVERSIGHT EXT-18-248-D-000021 Tennessee E. Coli Outbreak Leaves Six Children Hospitalized, Two In Serious Condition . The Knoxville (TN) News Sentinel (6/11, Gosnell, 252K) reports that East Tennessee Children's Hospita l (ETCH) is still treating six children following a recent E. coli outbreak associated with raw milk and contact with farm animals. "Two of the children are in the pediatric intensive care unit in serious condition, ETCH spokeswoman Erica Estep said Monday." In a Monday update, the Knox County Health Department said, "While it would be rare, it's possible that our community is experiencing two unrelated E. coli clusters at the same time," adding, "The common link among the majority of those who are ill continues to be consumption of raw milk from a local cow-share dairy, French Broad Farm in Knox County." Arizona Family Awarded $1.95 Million In Foster Farms Salmonella Case. In a 2,700-word feature, the Arizona Republic (6/11, White, 1.21M) reports Arizona couple Amanda and James Craten were awarded $1.95 million in a lawsuit against Foster Farms over the near-death of toddler Noah, who "was hospitalized in 2013 with an abscess in his brain as a result of a salmonella infection" linked to chicken produced by the farm. The article chronicles the ordeal and describes the likely infection vector. /\MERICAi\ pVERSIGHT EXT-18-248-D-000022 Medicaid &CHIP Ohio Decides Not To Implement Five-Percent Cut To Medicaid Reimbursement For Hospitals. The Cleve land Plain Dealer (6/11, Hancock, 1.03M) reports that Ohio "has canceled a planned $1.1 bill ion ... Medicaid cut to hospita ls, saying an uptick in the economy and reshuffling money in t he health care program has prevented the reduction." Officials exp lained that this was due to the fact that "the number of people enrolled and the amount of money it has cost to cover their health care was lower than state project ions." The article says the state had been mulling a five-percent cut to Medicaid reimbursement for hospitals that "treat some 3 million program recipients who qualify based on their incomes, health conditions and disabilities, among other factors." Nursing Homes, Assisted-Living Facilities Suing Montana Over Medicaid Reimbursement Cuts. /\MERICAi\ pVERSIGHT EXT-18-248-D-000023 The AP (6/11, Volz) reports that on Monday, several nursing homes and assisted-living fac ilities in Montana "sued the state ... to halt cuts to their reimbursements for prov iding care to Medicaid patients, cuts that have caused other Medicaid providers to curtail services or close altogether ." The article says that in January, the state Department of Public Health and Human Services reduced "the Medica id provider reimbursement rates .. .as part of spending reductions across state government aimed at closing a budget shortfall." The state wants to extend the 2.99-percent cut through the next fiscal year which begins in July, but the facilities "are ask ing a judge to block the cut, reinstate the 2017 rate and to reimburse them for the approximately $3 million that they have lost since January because of the reduction." Montana Public Radio (6/11, Yamanaka) reports the Montana Health Care Association and "some of its members" filed the lawsuit. Executive director of the Montana Health Care Association Rose Hughes "said these cuts mean families are being denied services when they seek help from assisted living fac ilities ." New Hampshire Substance Abuse, Mental Health Treatment Providers Worried About Proposed Cuts To Medicaid Reimbursement. The Concord (NH) Monitor (6/11, DeWitt, 35K) reports, "Without some action, the state's newly approved Medicaid expansion program could saddle substance abuse and mental health treatment /\MERICAi\ pVERSIGHT providers with EXT-18-248-D-000024 lower payouts that could force cuts to staffing and services around January, when the law takes effect, they say." The article says New Hampshire legislators voted last month to extend Medicaid expansion for another five years. These providers are worried because of "a change that was intended as an improvemen t." The new deal stipulates that "recipients will receive care through managed care organizations an insurance alternative - designed to reduce health care costs." This means the current "daily rate of $300 to $500 per patient would drop to $162.60 a day." Michigan Governor Signs Bill To Repeal, Replace Tax That Funds Medicaid . The AP (6/11) reports Michigan Gov. Rick Snyder (R) on Monday "signed into law a plan to repeal and replace Michigan's tax on health insurance claims that is used to help fund Medicaid for low-income residents." The measures "require the state to seek a federal waiver to implement the tax change. The waiver is expected to be approved." Fate Of Medicaid Expansion In Maine May Depend On Outcome Of November Election For Governor. Dy lan Scott writes in a Vox (6/11, 1.66M) piece that a majority of Maine /\MERICAi\ pVERSIGHT EXT-18-248-D-000025 voters approved "Med icaid expansion last November, but it still hasn't happened yet. And it may just be their vote to choose the next governor that finally finishes the job." Scott says Gov. Paul LePage (R), who will soon leave office, has used every means "at his disposal to stop Maine from expanding Medicaid to 70,000 of Maine's poorest res idents," despite voters' expressed wish to expand the program. Scott adds that advocates of Medica id expansion "are pursuing legal action against LePage to force him into implementing it quickly," however, "if courts don't rule in their favor or if the fight drags out, the fate of Medicaid expans ion is very much at stake in the fall election." Health &Medical News Young Women Get Less Exercise Than Young Men, Study Suggests. The NPR (6/11, Watson, 3.55M) "Shots" blog provides coverage of a study by researchers at Duke University suggesting that young women, part icularly black women, get less exercise than young men, and that women's "exercise rates drop sign ificantly after high school." Offering possible explanations why young women's exercise rates are lower than young men, one researcher not involved with the study said, "I think /\MERICAi\ pVERSIGHT EXT-18-248-D-000026 our society culturally sends different messages to young girls in terms of their bodies and how they spend their time ... A lot of teen girl socialization is less focused on being physically active together, whether it's teen sports, or pick up games, or even going to the gym." In terms of why black women are affected disproportionately, one study author said, "We know that there is an unequal distribution of things like athletic fields [and] high schools that serve more minority populations are less resourced ... I think that's just compounded when people leave the structured school environment." The findings were published in JAMA Pediatrics. The Washington Times (6/11, Kelly, 460K) reports the study found that "45% of black females age 18 to 24 years reported no physical activity," and that "black females age 25 to 29 reported a little over a ha lf hour of activity per day." Moreover, "White adolescent males were most likely to report any phys ical activity and younger age, being white, and having a higher income was associated with more time dedicated to exercise." The study authors wrote, "These data highlight opportunities targeted physical activ ity programming for and policy efforts to reduce the risk for chronic diseases and improve overall health throughout the lifespan." Addit ional coverage is provided by The Guardian (UK) (6/11, Davis, 4.03M). Research Explores Why People Get "Hangry." /\MERICAi\ pVERSIGHT EXT-18-248-D-000027 USA Today (6/11, Molina, 11.4M) reports that resea rch published in Emotion suggests "environmental cues and a person's emotiona l awareness can decide whether someone becomes 'hangry."' Newsweek (6/11, Gander, 2.18M) reports that researchers came to this conclusion after conducting "two online experiments on 400 part icipants." TIME (6/11, Sifferlin, 19.27M) reports that study co-author Kristen Lindquist said, "Despite the colloquial term 'hanger,' we found that this effect was not specific to anger." Lindquist added, "Peop le in our stud ies were more likely to feel intense negativ ity in general when they were hungry and someth ing bad happened - suggesting that feeling hungry can turn up the dial on lots of negative emotions such as anger, stress or disgust." Also cover ing the story is the NPR (6/11, Chen, 3.SSM) "Shots" blog. Erectile Dysfunction May Be Linked To Increased Risk Of Heart Disease, Study Suggests. TIME (6/11, Park, 19.27M) reports that research published in Circulation suggests erectile dysfunction may be linked to a higher risk of heart disease. Investigators found that "among a group of 1,900 men aged 60 to 78, those with erectile dysfunction were tw ice as likely as men without the condition to have a heart attack, stroke, or die of a heart /\MERICAi\ pVERSIGHT EXT-18-248-D-000028 problem ." The New York Post (6/11, Gollayan, 4.46M) reports that Michael Blaha, a co-author of the study, said, "The onset of ED should prompt men to seek comprehensive cardiovascular r isk evaluation from a preventive cardiologist." HealthDay (6/11, Mozes, l0K) reports, "The link between impotence and heart disease appears to be 'a two-way street,' Blaha said, given that men who have had a heart attack appear to face a hig her risk for ED." Healthy Lifestyle Associated With Improved Memory In Old Age , Study Indicates . Xinhua News Agency (CHN) (6/12, 11K) reports on a Finnish study showing that "a healthy lifestyle, including physical exercises, brain stimulants and healthy d iet," has the potential to "improve brain hea lth and prevent late-age memory disorders." The investigation, pub lished Monday, examined 1,262 Finns over the age of 60 with an increased risk for memory d isorders . "The control group had nearly 30 percent of the increased risk of deteriorating memory functions, while those who rece ived intens ive guidance had improved menta l ability and physical performance," Xinhua reports. The research was part of the Finnish Geriatric Intervent ion Study to Prevent Cognitive Impairment and Disability. /\MERICAi\ pVERSIGHT EXT-18-248-D-000029 Millennial Men And Women Invest Differently, PNC Survey Reveals. In an exclusive, USA Today (6/12, Shell, 11.4M) reports on the insights highlighted in PNC Investments' 2018 Millennials &Investing Survey. "Nearly seven out of 10 (67%) female Millennials, for example, said their parents encouraged them to 'save' money, versus just 58% of males," and similarly, "only 29% of females surveyed said their parents 's howed (them) ways to grow wealth."' By contrast, "37% of males said their financial education was focused on wealth-building, the survey found." USA Today reports the men surveyed "demonstrated a more aggressive approach to risk taking than the ir female peers," with 14 percent saying they "embrace risk," double the percentage of women who said they welcomed risk. Morningstar Analyst Supports State-Sponsored Auto-Enrollment For Retirement Savings. Mar ketWatch (6/11, Vlastelica, 1.49M) reports Aron Szapiro, director of policy research at Morningstar, says that government incentive programs for retirement increase the invest ing "co uld dramatically number of Americans who participate in retirement minimal cost to taxpayers," /\MERICAi\ pVERSIGHT programs, at and he "stressed that such incentives EXT-18-248-D-000030 should be considered, noting the dire state of savings." He adds t hat auto-enrollment in such plans "is the most powerful tool we've ever seen," adding that "that this kind of regulation was far more effective in gett ing individuals to contribute than tax incentives." Tallahassee Targeting Multigenerational Families To Increase Retiree Draw. The New York Times (6/8, Olson, Subscription Publicat ion, 19.33M) reported Tallahassee, Florida is not seeing the same growth as the rest of the state, and a "key part" of its efforts to "attract new residents" targets retirees with "some unusual tactics - including subsidizing a few people to move there." A new campaign called "Choose Tallahassee" is recruiting "baby boomers who are hitting ret iremen t age and looking to move someplace warmer and more affordable but who may not have thought of Tallahassee" compared to other destinations. Its campaigns are separately targeting boomers who "live elsewhere" and their children who live in Tallahassee, each promoting the benefits of having the other closer: for the boomers, the advantages of tech support and labor provided by nearby adult children; and for residents, the benefits of parents in proximity, such as free childcare. Ford Works On Self-Driving Delivery Service With Postmates. /\MERICAi\ pVERSIGHT EXT-18-248-D-000031 Fortune (6/11, Corbett, 3.91M) reports that Ford is working on developing a self-driving delivery service program with Postmates. Currently, the pilot program offers delivery options from more than 70 businesses in Miami and Miami Beach, "with the option of having the order delivered in a self-driving research vehicle." The article explains that the vehicles used in the pilot are not autonomous, but instead "are manually driven cars with sensors that are being used to research the first and last mile of the delivery service." Experts Worried About Unproven Tesla Self-Driving Features. The Washington Post (6/11, Harwell, 15.68M) reports Tesla CEO Elon Musk tweeted that in August the company's cars will activate "full selfdriving features," although a company spokesman said that does not mean full autonomy. Meanwhile, "safety experts worried the grand promises of full self-driving capabilities could lull drivers into a false sense of security for technologies that are still largely unproven on the road." Uber-Like Flight Hailing Service Skyryde Starts Service In Los Angeles. /\MERICAi\ pVERSIGHT EXT-18-248-D-000032 The Washington Post (6/11, Kunkle, 15.68M) reports on the launch of Skyryde, an "Uber-like flight-hailing service," in Los Angeles. Skyryde is using small planes that have "four to six seats and instrumentation allows pilots to fly in everything that but the most extreme weather." Skyryde launched its services on April 20 and has been used by 16 passengers since its inception . According to Skyryde Founder Jerome Brenndon Adkins, "a typical Skyryde flight might take a passenger from the University of California at Los Angeles to Long Beach" at a fare of around $300. Adkins "hopes that the same concepts pioneered by Uber ... wi ll lower Skyryde's price from what might seem exorbitant now to something closer to $100." An FAA spokesman said that the agency is aware of the serv ice and "the venture appears to have passed regulatory muster in several respects." Researchers Create Virtual Reality Platform To Help Children Cope With Doctor's Appointment Anxiety. U.S. News &World Report (6/11, 1.97M) contributor Jeremy Patterson from the Research Institute at Nationwide Children's Hospita l discusses how virtual reality can help children deal with nervousness or anxiety during a doctor's appointment . Patterson expla ins that researchers at the Institute have created a "first-of-its-kind VR platform called Voxel Bay," which "provides pat ients with an immersive environment of penguins, pirates and dragons during infusions and other procedures." Addit ionally, the system's headsets are " built for purpose and are a fun part of the experience." VR games are installed "onto smartphones, so they're wireless, and nurses or families can follow the progress of the games by watching a tablet and adjust if the patient needs more distraction ." /\MERICAi\ pVERSIGHT EXT-18-248-D-000033 Feeding Children Honey After Swallowing A Small Battery Can Prevent Serious Injury, Study Suggests . The Philadelphia I nquirer (6/11, Giordano, 1.07M) reports "a team of pediatric ear, nose, and throat specialists from the Children's Hospital of Philadelphia and Nationwide Children's Hospital has discovered that giving a child honey to eat after he or she has swallowed a small battery can prevent serious injury and possibly even death." Study authors expla ined, " Our recommendat ion would be for parents and caregivers to give honey at regular intervals before a child is able to reach a hospital, while clinic ians in a hospital can use sucralfate before remov ing the battery." The findings, which "will be incorporated into t he National Capita l Poison Center's guidelines for management of button battery ingestions," were pub lished in The Laryngoscope. Science Blog (6/11) also reports. Physician Advises Parents To Keep Kids Safe While Swimming. Dr. Perri Klass writes for the New York Tim es (6/11, Subscript ion Publication, 19.33M) that "even if kids have had swim lessons, parents /\MERICAi\ pVERSIGHT EXT-18-248-D-000034 must still supervise them in the water." Dr. Klass quotes Dr. Benjamin Hoffman, who is the chairman of the American Academy of Pediatrics Council on Injury, Violence, and Poison Prevention, as saying, "Infant swim is not a drowning prevention exercise," because children are developing water competence in swimming lessons. Dr. Klass notes that until 2010 the AAP advised against swimming lessons for children under the age of four due to concerns that "parents whose young children take swimming lessons will be lulled into a false sense of security," but after a 2009 study by researchers at the National Institute of Child Health and Human Development, the AAP recognized "that swimming lessons for young children were not a risk and might be protective - as long as parents continued to be protective as well." Using Prophylactic NSAIDs Before And After Cataract Surgery May Reduce Development Of Cystoid Macular Edema In Diabetic Patients , Study Suggests. MD Magazi ne (6/11, Disanto) reports researchers found "that using prophylactic non-steroidal anti-inflammatory drugs (NSAIDs) pre- and post-cataract surgery may help reduce the severity and frequency of the development of cystoid macular edema (CME) in the eyes of diabetic patients." The fi nd ings were "published in the International Journal of Ophthalmology." /\MERICAi\ pVERSIGHT EXT-18-248-D-000035 Young Surgeons Face High Debt, Financial Instability, Study Suggests. Reuters (6/11, Crist) says a new study published in the American College of Surgeons found that "young surgeons often face debt burdens that make it difficult for them to start their careers and pay off their loans." According to the study, "more than one in three, or 38 percent, reported more than $200,000 in educational debt. When nonstudent loan debt, mortgage liability, vehicle debt, and credit card debt were factored in, the average trainee owed more than $220,000." Overall, the researchers found that 82 percent of respondents had moderate- or high -risk debt-to-asset rat ios. Opinion: Retail Health Clinics Set The Stage For Today 's MegaMergers. Hal Rosenbluth and Peter Miller, co-founders of Take Care Health Systems, write in STAT (6/11, 27K) about retail health clinics and say that "the media spotlight is on some of health care's giants as they jockey for position around the themes that retail clinics set in motion." The duo argue that any major mega-merger must focus on aligning incentives, educating consumers on healthcare, and accommodate the social determinants /\MERICAi\ pVERSIGHT of health. EXT-18-248-D-000036 Tick Paralysis Strikes Five-Year-Old In Mississippi. The Washington Post (6/11, Wootson, 15.68M) reports on a five-yearold girl in Mississippi who woke up one morning unable to walk. Her mother found a tick on her head and took her to a hospital where she was diagnosed with tick paralysis, a condition that is caused by female ticks on the verge of laying eggs. After the tick eats a blood meal and is engorged, it secretes a neurotoxin into the host. According to the Post, "paralysis begins in the legs, then spreads to the upper extremities. It can manifest as fatigue, numbness and an increasing inab ility to move," and in the later stages, if no action is taken, "the toxin ultimately makes it impossib le for a person to breathe, resulting in respiratory failure." The article says the child quickly recovered after the tick was removed. Red Cross Blood Drive Campaign Sees Major Brands Dropping A, B, and O From Their Names. NBC News (6/11, Fox, 5. 76M) reports on its website that major brands are dropping the letters A, B, and O in t heir logos to support the Red Cross's new blood drive campaign starting Monday. "Without A, Band 0, we can't save anybody," the Red Cross says, adding, "Each year, fewer and fewer people are donating blood." According to the article, "only about 38 percent of the population is even eligible to give blood, and only about 10 percent of those people - that's 3 percent of the population - give blood yearly." /\MERICAi\ pVERSIGHT EXT-18-248-D-000037 KKR To Buy Envision Healthcare For $5.57 Billion. In continuing coverage, Bloomberg News (6/11, Mittelman, 4.46M) reports that KKR &Co. will buy Envision Healthcare Corp. for $46 a share "after an almost yearlong sale process for the medical company." The article says, "The all-cash deal values Envis ion at $5.57 billion. Including debt, the acquisition is valued at $9.9 billion." Also reporting are the Associated Press (6/11) and Bloomberg View (6/11, Sutherland, 4.46M). Surgeons Use 3D-Printed Organs To Determine Best Way To Operate . The Washington Post (6/8, Blakemore, 15.68M) reports that surgeons are using 3D-printed organs to figure out the best way to operate on patients. Using CT scans that are manipulated via special software, a team of engineers creates a model that replicates the organ and use computer models predict how blood flow would respond to each patient's unique anatomy. The process helps physicians decide how best to approach the surgery, according to the Post. /\MERICAi\ pVERSIGHT EXT-18-248-D-000038 Legacy Of Racism Hurting Health Of African Americans. In a 7,543-word feature in The Atlantic (6/11, 3.08M), Olga Khazan writes about "how African Americans became stuck in profoundly unhealthy neighborhoods, and ... how the legacy of racism can literally take years off the ir lives ." In the US, "black peop le suffer disproportionate ly from some of the most devastating health problems," but, excepting a few specific ailments, scientists believe the underlying causes aren't genetic but "social and environmental forces that affect African Americans more than most other groups." Khazan adds, "America's racist and segregationist history continues to harm black people in the most intimate of ways - seeping into their lungs, the ir blood, even their DNA." South Carolina Primary Vote To Gauge "Temperature" Of Electorate. The Greenville (SC) News (6/11, Wilkinson, 112K) reports that a nonbinding ballot initiative on the legalization of medical marijuana will be included on the Democratic primary ballot in South Carolina on Tuesday. Bill Nettles, a former US attorney for South Carolina, said the ballot "allows the party to take the temperature of the electorate," on the issue. /\MERICAi\ pVERSIGHT EXT-18-248-D-000039 Opinion: Physician-Assisted Suicide "Can Never Be Medical Care." Matt Valliere, executive director of the Patients' Rights Action Fund, writes in T he Hill (6/11, 2 . 71M) about physician -ass isted suic ide, and says that "su icide can never be med ical care." Valliere argues, "As the medical community continues to point out its dangers, Congress should summarily reject assisted suicide public policy by passing H.Con. Res.SO - a truly bipartisan bill ' expressing the sense of the Congress that assisted suicide puts everyone, inc luding those most vulnerable, at risk of deadly harm and undermines the integr ity of the health care system."' American Medical Association Votes To Keep Reviewing Its Guidance On Physician-Assisted Suicide. The Washington Post (6/11, Bever, 15.68M) reports that delegates at the Amer ican Medical Association's annual meeting in Chicago voted Monday to continue reviewing its gu idance on physician-assisted suicide. The AMA's House of Delegates "voted by a margin of 56 to 44 percent to have the AMA's Council on Ethical and Judicial Affairs keep studying the current guidance," according to the article . /\MERICAi\ pVERSIGHT EXT-18-248-D-000040 Modern Healthcare (6/11, Johnson, Subscription Publication, 239K) also covers the story. Cherokee Hospital Testing 186 Patients For HIV, Hepatitis After Nurse Reused Syringes . The Tul sa (OK) World (6/11, Overall, 358K) reports that W.W. Hast ings Hospital in Tahlequah, Oklahoma, a Cherokee Nation facility, is testing 186 pat ients for HIV and hepatitis after a nurse alleged ly reused syringes to admin ister medicat ions. According to the article, "the nurse violated protocols by using the same via l of medication and syr inge to inject more than one intravenous bag." As of Monday, 64 patients had been screened, and none had tested positive. Hospita l CEO Brian Hail said, "Pat ients were never directly in contact with any needle. Medication was administered into an IV bag or tubing. The likelihood of blood - borne pathogens traveling up the lines into an IV bag or IV tubing to cause cross contamination from using the same syringe is extremely remote." Louisiana Regulators Prepare For Expanded Medical Marijuana Program. /\MERICAi\ pVERSIGHT EXT-18-248-D-000041 The Baton Rouge (LA) Advocate (6/11, Thompson, 141K) reports that "regulators crafting Louisiana's medical marijuana policies affecting physicians expressed concern Monday that key rules still need to be revised, while the growing number of state-approved treatab le conditions will likely cause the state's nascent program to grow significantly." According to the article, "questions linger about how the drug will be administered, such as determining the appropriate dosage for a 30-day supply, and whether to lift an existing cap on the number of patients that doctors can recommend to be treated using medical marijuana." Physician Offers Advice About Genetic Screening For Pregnant Women. U.S. News &World Report (6/8, 1.97M) contributor Elaine K. Howley offered guidance on genetic screening for pregnant women. Discuss ing the elevated risks associated with diagnostic tests such as amniocentesis and CVS, Howley quoted Dr. Deanna Mascho-Cawley, an OB-GYN at Geisinger in Danville, Pennsylvania, as saying, "According to the American College of Obstetricians and Gynecologists, any patient can be offered or should be offered that diagnostic testing as well. We just tailor the counseling based off the patient's risk factors and the ir desires because of those additional risks that are associated with those procedures." /\MERICAi\ pVERSIGHT EXT-18-248-D-000042 Guided Nanospears Can Administer Genetic Therapies Targeting Cancer , Researchers Say. The Daily Beast (6/12, Schultz, 1.69M) reports a recent study in the journal American Chem ical Society Nano "describes a method of creating nanospears 5,000 times thinner than human hair that successfully targeted, pierced, and entered a cancer cell within a lab dish." The authors explained in an email, "The capability to guide the nanospears magnetically elim inates the need for potent ially harmfu l chemical propellants that have been used in prior examples of nanorobotic delivery," adding, "A key feature of the nanospears is that we can guide them individually or in groups" to deliver some genetic therapies. US Adults With Hypertension Incur Nearly $2,000 More In Annual Healthcare Costs, Study Indicates. Reuters (6/11, Wiener) reports that research indicates "each year, U.S. adults with high blood pressure incur almost $2,000 more in annual healthcare costs." The data indicated that "nationally, healthcare for adults with high blood pressure .. .costs an extra $131 billion per year ." The find ings were published in the Journal of the American Heart Association. Reuters points out that "last year, the American Heart Association, the American College of Cardiology and several other health organizations lowered the threshold for high blood pressure in adults to 130/80 millimeters of mercury ." /\MERICAi\ pVERSIGHT EXT-18-248-D-000043 Loneliness May Cause Premature Death By Damaging Heart , Research Suggests . Newsweek (6/11, Spear, 2.18M) reports that research suggests "loneliness may actually cause premature death by damaging the heart." The study "suggested that feeling loneliness may double a person's risk of dying of cardiovascular disease." The findings were presented at the European Society of Cardiology's annual nursing conference. CRISPR-Cas9 May Increase Cancer Risk In Cells , Research Suggests. Reuters (6/11, Kelland) reports that two studies suggests CRISPR-Cas9, "a gene-editing technology that is being explored by scientists worldwide as a way of removing and replacing gene defects might inadvertently increase cancer risk in cells." STAT (6/11, Begley, 27K) reports that "In the studies ... scientists found that cells whose genomes are successfully edited by CRISPR-Cas9 have the potential to seed tumors inside a patient," which "could make some /\MERICAi\ pVERSIGHT EXT-18-248-D-000044 CRISPR'd cells ticking time bombs, according to" the investigators. To view the studies, click here and here. Congressional Action On Marijuana Could Potentially Lead To Studies On Benefits Of Medical Marijuana For Cancer Patients. Fox News (6/11, Carlton, 16.38M) reports, "President Trump recently told reporters he will likely support a congressional effort to end the federal ban on marijuana, which could finally help cut through the red tape blocking scientists from conducting large -sca le trials on the benefits of medical marijuana in cancer patients." Fox News adds, "According to new research published in the Journal of Clinical Oncology, less than 30 percent of oncologists surveyed felt knowledgeable enough about medical marijuana to make recommendations." Dr. Andrew Epstein, an ASCO patient care expert, told Fox News, "The amount of information we have is still relatively nascent and evolving and therefore its upon us as a community to re-up our skills in knowing about this aspect of supportive oncology." Genetic Test For Prostate Cancer Can Identify Individuals Who Have A Higher Risk Of Developing The Disease , Researchers Say. Forbes (6/11, Forster, 10.34M) contributor /\MERICAi\ pVERSIGHT Victoria Forster writes that EXT-18-248-D-000045 research published in Nature Genetics indicates "a new DNA 'spit test' for prostate cancer can identify men who have an increased risk of developing the disease." The research was partially funded by the National Cancer Institute. Forster points out that research recently presented at t he American Society of Clinical Oncology meeting "showed that only a minority of men with prostate cancer respond to immunotherapy, likely those men whose cancers have defects in genes involved in repairing DNA. " HealthDay (6/11, Preidt, lOK) reports, "According to the new study, t he scientists identified 63 new genetic variants associated with increased risk of prostate cancer, and combined them with more than 100 previously identified variants to create the new test." The new "test identifies the 1 percent of men who are at highest risk for prostate cancer." Also covering the story are BBC News Online (U K) (6/11, 1.57M) and The Guardian (UK) (6/11, Sample, 4.03M). Rhode Island Nursing Homes Decry State Budget Cut That Would Lead To Layoffs , Closures. The AP (6/11, McGuinness) reports nursing homes in Rhode Island denounced leg islators ' most recent budget proposal because it would cut their funding and "likely lead to facility closures and layoffs." Rhode Island Health Care Association president Virginia Burke, "Closures. The /\MERICAi\ pVERSIGHT EXT-18-248-D-000046 impact will be closures .... Facilities would not be able to keep operating." She also ind icated that "the 8.5 percent cut would mean a loss of close to $30 million for the fac ilities," which "are already financially strapped." Burke also "said nursing homes have not seen any money from the judgment as the state continues its appeal process," and that the cut "would take effect in three weeks." THCA Sounds Alarm Over Texas' LTC Staffing Crisis. The Midland (TX) Reporter-Te legram (6/12, McEwen, 42K) reports Texas prov iders "are ringing alarm bells" about the staffing crisis impacting nursing homes throughout the state. According to the Texas Health Care Association, "the 97 percent turnover rate for certified nurse aides and the 90 percent turnover rate for registered nurses and licensed vocational nurses are affecting nursing homes statewide." THCA president and CEO Kevin Warren explained, "It's a huge concern when you look at the fact we're seeing direct care staff ... have a turnover rate of 90 to 97 percent .... It's a significant problem that we need to work on and come together to address." He also pointed out that "staffing has always been a challenge, but he has not seen such high turnover rates in the more than 20 years he's worked in the industry." The article lists recommendations from Warren on improving staffing levels. /\MERICAi\ pVERSIGHT EXT-18-248-D-000047 Despite Prevention Efforts, South Dakota 's STD Rates Rising . The Sioux Falls (SD) Argus Leader (6/11, Pfankuch, 175K) reports prevention efforts to combat sexually transmitted diseases in South Dakota "have not reversed a trend of increasing STD rates in rural and urban regions of the state" as cases reach "near-historic infection rates." Health officials worry "that if infection rates continue to rise ... a health crisis could result among sexually active South Dakotans who engage in high-risk behaviors." Their concerns have been compounded by the emergence of "a new antibiotic-resistant form of gonorrhea and cases of congenital syphilis." Pennsylvania, Nation Losing Fight Against Lyme Disease . The Pittsburg h Tribune-Review (6/11, Erdley, 334K) reports on an article in Scientific American indicating that "the battle against Lyme diseases isn't progressing." The piece says Lyme has been particularly bad in Pennsylvania, which "led the country" for the past six years "with the most new cases of Lyme - more than 12,000 residents contracted the disease in 2016." The article notes that the pressure to develop a vaccine is growing "ever more pressing as the tick" responsible for its spread "expands its reach across the country." Op-Ed: Rising Number Of Lyme Disease Infections Punctuates Need For Prevention Efforts. /\MERICAi\ pVERSIGHT EXT-18-248-D-000048 Mary Beth Pfeiffer, author of "Lyme: The First Epidemic of Climate Change," writes for Scientific American (6/11, 3.12M) that "little has been done to curb the spread of ticks or to control the harm inf licted by the Lyme bacterium," which she argues is "the product of a false image of Lyme disease, embraced by health officials and repeated in reviews of the medical literature, as an illness that is easy to diagnose and readily treatable." She argues that "we must recognize that the power of ticks has been underestimated and our response inadequate." Epidemiologists Predict California Will See Another Cycle Of Pertussis Cases. The Orange County (CA) Register (6/11, Walker, 635K) reports on the "cyclical nature" of pertussis, noting that California four years ago "was in the grips of an outbreak" and that "outbreaks tend to occur every three to five years." Epidemiologists have issued warnings that the Southern California reg ion should anticipate "another surge right about now." While "there are no signs as yet of an epidemic, statewide or locally," the piece urges parents to take precautions. Cost Of Kansas City 's Measles Outbreaks Exceeded $170,000. /\MERICAi\ pVERSIGHT EXT-18-248-D-000049 The Kansas City (MO) Star (6/11, Marso, 636K) reports an analysis led by health officials shows "that more than $ 170,000 in taxpayer resources was spent" in efforts to combat two measles outbreaks in Kansas City that resulted in "35 total cases - 22 in Kansas and 13 in Missouri." Some of the funding came from federal sources, while "some of it came out of redirected state and local resources and none of it includes other costs that are difficult or even imposs ible to quant ify." The article goes on to examine the cost breakdown of treatment and prevention efforts during the outbreaks . Stryker Reportedly Eyeing Boston Scientific For Takeover. The Wall Street Journal (6/11, Matt ioli, Dummett, Cimilluca, Subscription Publication, 6.13M) reports Stryker Corp. recently initiated an attempt to take over competitor Boston Scientific Corp., which would form a medical dev ice behemoth worth more than $110 billion, according to sources. The Journal says it is unknown whether Boston Scientific is amenab le toward the offer , which comes amid a jolt of activity in the healthcare sector as companies address industry and regulatory shifts. Reuters (6/11, Banerjee, Berkrot) reports the combination "would give Stryker a strong position in stroke preventing intervent ional cardiology. " If a deal were to mater ialize, "Stryker would get Boston Scientific's line of stents, defibrillators and its Watchman atria l device to prevent migration of blood clots." /\MERICAi\ pVERSIGHT EXT-18-248-D-000050 The Minneapolis Star Tribune (6/11, Carlson, 1.16M) reports Boston Scientific shares "shot up nearly 10 percent in midday trading Monday" on the news. The companies have not commented on the alleged deal. Juvenescence Takes Stake In Company Generating Cell-Based Therapies For Age-Related Diseases . MedCit y News (6/11, DeArment) reports UK-based Juvenescence Limited, which develops "therapies to slow or reverse the effects of aging," announced Monday it has raised $50 million in a Series A funding round. The company also "made a $5 million equity investment in AgeX Therapeutics, a subsidiary of pub licly traded company BioTime focused on developing cell-based therap ies for age-related degenerative diseases." AgeX is noted as having previously raised $10.8 million last year, including "a $386,000 grant from the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health ." Experts Push For "Medicalized Approach " To Suicide Prevention. Modern Healthcare (6/11, Johnson, Subscription Publication, 239K) reports that the recent suicide deaths of designer Kate Spade and TV /\MERICAi\ pVERSIGHT EXT-18-248-D-000051 host Anthony Bourdain "highlight what has become a growing public health issue, as rates of suicide throughout the country have increased sharply over the past two decades." Some experts are calling for a "more medicalized approach toward treating anxiety and depression," much like "early screening for conditions such as diabetes and breast cancer has led to better outcomes and survival rates." The article explains that "such an approach would require changes in the way much of the medical community views mental health disorders" and would require eliminating "lingering stigmas" among both providers and patients, such as "knowing the signs of a potential disorder or when to refer patients to a behavioral healthcare specialist for help ." Opinion : Ending The Stigma Is The Key To Suicide Prevention. Petula Dvorak writes in the Wash ington Post (6/11, 15.68M) that even though 123 people die of suicide every day, "we still don't want to talk about it." Dvorak argues, "The silence, the stigma and the fear keep us from having real conversations such a determined - and taking action - when it comes to killer" that is the tenth leading cause of death in the US and the second highest among teens. The piece concludes that "the key" to suicide prevention is: "Helping others. Breaking the silence. Ending the stigma." Oral Migraine Drug Succeeds In Study, Manufacturer Says . /\MERICAi\ pVERSIGHT EXT-18-248-D-000052 Reuters (6/11, Banerjee) reports Allergan Pie announced Monday that its oral migraine drug, atogepant, a study, with a statistically met its "main goal across all doses in significant reduct ion in monthly headache days in pat ients with episodic m igraine." The results come after the FDA approved Amgen's calc itonin gene-related peptide (CGRP) treatment last month. Layoffs A Symptom Of A Deeper Problem With IBM's Watson Health, Former Employees Say. STAT Plus (6/11, Ross, Swetlitz, Subscription that IBM's Watson Health project is "grappling Publication, 27K) reports with a deeper problem - that the company has struggled to turn its new trove of patient data into workable products, and that instead of attracting a wave of new hospital clients, Watson Health is starting to shed business," accord ing to former IBM employees who were recently laid off by the company. The article d iscusses how IBM has had reported problems with integrating its three acquisitions which brought in "vast stores of patient hea Ith data ." Children Exposed To Cigarette Smoke Have Higher Risk Of Hearing Loss, Research Indicates . /\MERICAi\ pVERSIGHT EXT-18-248-D-000053 Newsweek (6/11, Dovey, 2.18M) reports researchers from Japan have found that "exposure to smoking, both in utero and in the first few months of a child's life, is associated with higher prevalence of hearing impairment," according to a study pub lished in Paediatric and Perinatal Epidemiology. Among the findings, "children exposed to on ly their mothers' past smoking had a 26 percent increased risk of hear ing impairment," and those exposed to only "secondhand smoke at four months had a 30 percent increased risk." In addit ion, "those whose mothers smoked during their pregnancy had a 68 percent increased risk of hearing impairment." Studies Link Abdominal Fat To Increased Rates Of Coronary Heart Disease, Increased Risk For Cancer, And Risk Of Developing Dementia Decades Later. In the New York Times (6/11, Subscription Publication, 19.33M) "Personal Health" column, Jane E. Brody writes that if a person's "waist measures 35 or more inches for women or 40 or more inches for men, chances are you're harboring a potentially dangerous amount of abdom inal fat." Brody goes on to detail studies linking v iscera l fat w ith increased rates of coronary heart disease, an increased risk for cancer, and even the "risk of developing dementia decades later." /\MERICAi\ pVERSIGHT EXT-18-248-D-000054 Experts Release Blueprint For Improving End-Of-Life Care. NJ Spotlight (6/12, Stainton) reports on recommendations released Monday by the nonprofit New Jersey Health Care Quality Inst itute as "part of a strategic plan for end-of-life care." Targeted investments for improving end of life carer include "developing a statewide database to keep residents' requests and wishes readily accessible" and offering "higher reimbursements for treatment consultations and palliative care." The 15-page report "outlines ways in which state officials can work with hospitals, medical schools, local communities, provide more appropriate ... medical treatments and other groups to and support services to patients nearing the end." Global Health Rollout Of HIV Prevention Drug Tied To Reduction In Condom Use Among Men Who Have Sex With Men In Australia , Study Suggests. The New York Times (6/11, Baumgaertner, Subscription Publication, 19.33M) reports researchers found that "the rollout of a drug t hat /\MERICAi\ pVERSIGHT EXT-18-248-D-000055 prevents HIV infection was followed by a reduct ion in condom use among gay and bisexual men in Australia." The findings were published in Lancet HIV. HIV/AIDS Epidemic Getting Worse In Russia. In an over 2,800 word art icle, Science Magazine (6/11, Cohen, 441K) reports that the HIV/AIDS epidemic in Russia is getting worse. The article highlights some of the contributing factors to the problem, including some of the barriers that many patients with HIV face in rece iving treatment in Russia. Rift Valley Fever Kills Five In Kenya, Official Says. Reuters (6/11, Mureithi) says Kenya has reported the deaths of five people in the past week due to the reemergence of Rift Valley Fever disease, marking "the first reports of the disease since an outbreak killed more than 200 people a decade ago." Abdihakim Billow, a health official of the area "where the deaths were reported, said two people died in hospital while the other three died at home," adding that "another two peop le thought to be ill from the disease had been hospita lized." /\MERICAi\ pVERSIGHT EXT-18-248-D-000056 British Authorities Seize Mother's Cannabis-Based Medication For Son With Epilepsy, Prompting Stand-Off . Reuters (6/11, Shirbon) reports that the mother of a boy with epilepsy who journeyed to Canada "to buy cannabis-based medication she says is keeping her son alive" had her supplies confiscated by British custo ms officials upon her return on Monday. The mother says that without the cannabis oil, her 12-year-old son has up to 100 seizures a day, each of which is potentially fatal. According to Reuters, "t he case has ignited a debat e about the medicinal use of cannabis, a drug which is illegal in Britain and which the British authorities do not recognize as having any med icinal benefits." Opinion : Chinese Communist Leaders Must Be Held Accountable For Human Rights Violations. Chen Guangcheng, author of "The Barefoot Lawyer: A Blind Man's Fight for Justice and Freedom in China," writes in the Washington Post (6/11, 15.68M) that the Chinese Communist Party "is considering abandoning one of its longest-running and most abusive practices: its reproduction planning policy, commonly known as the one-child policy," but says that returning reproductive rights to the peop le "does not exempt the Communist Party from responsibility for decades of trauma and murder /\MERICAi\ pVERSIGHT EXT-18-248-D-000057 committed under the euphemistic rubric of population planning." Guangcheng "urges the American government to use the tools at its disposal - such as the Global Magnitsky Act - to hold Communist Party leaders accountable and to take a stand for human rights for all." National Register In Australia Could Curb Financial Abuse Of Elders. The Sydney (AUS) Morn ing Herald (6/8, Collett, 18K) reports older Australians who are "socially isolated and reliant on others for their care" are "particu larly vulnerable to financ ial abuse." Last week, "the Australian Banking Association, the Counc il of the Ageing (COTA Australia) and National Seniors called on the nation's attorneys -general to agree to standardise the reporting systems for suspected cases of financial abuse of elders," the article says, adding that such a system "could quickly verify the authority of a power of attorney when they present themselves as acting on behalf of a customer." National News /\MERICAi\ pVERSIGHT EXT-18-248-D-000058 Trump, Kim Pledge "Complete Denuclearization " After Historic Summit. At Tuesday's historic summit in Singapore, President Trump and North Korean leader Kim Jong-un signed a joint statement committing "complete denuclearization to the of the Korean Peninsu la." Details of the agreement were still emerging early Tuesday morn ing, but initial media reports are crit ical of its lack of specifics. Reuters (6/12, Kim), for example, says the statement "gave few details," the Wall Street Journal (6/12, Bender, Gordon, Cheng, Subscription Publication, 6.13M) refers to a lack of specific commitments, and Bloomberg News (6/12, Wayne, Sink, 4.46M) says the two leaders "la id out goals ... without specifying what immediate steps either side would take." CNN (6/11, Liptak, 82.6M) reports "there was no mentioning the previous US aim of 'complete, verifiable and irrevers ible denuclearizat ion .' And Kim's commitments did not appear to go beyond what he already pledged to do in April when he met South Korean President Moon Jae-in." Accord ing to the AP (6/12, Miller, Lucey, Lederman, Klug), the President pledged unspecified "security guarantees" to the North. The two leaders "coupled the summit agreement with lofty promises" by Trump to handle "a very dangerous problem" and Kim's prediction for "major change ." The AP says the document "largely amounted to an agreement to cont inue discussions," and "did not include an agreement to take steps toward end ing the technical state of warfare between the US and North Korea ." The New York Time s (6/12, Landler, Subscription Publication, 19.33M) /\MERICAi\ pVERSIGHT EXT-18-248-D-000059 reports Trump concluded the meeting saying that denuclearization on the Korean Peninsula would begin "very quickly." In the statement, wh ich Trump called "comprehens ive," the President "comm itted to provide security guarantees" to North Korea, and Kim "reaffirmed firm and unwavering commitment to complete denuclearization his of the Korean Peninsula ." According to the Times, the statement "was short on details," but Trump told reporters, "We're starting that process very quickly - very, very quickly - absolutely," referring to denuclearization. The statement said the two nations would hold "follow -on negotiations" led by Secretary of State Pompeo and a high-level North Korean offic ial "at the earliest possible date, to implement the outcomes" of the summit meeting. The AP (6/12) reports that during a "free-wheel ing press conference before returning to the US," Trump told reporters he thinks "we'll probably need another summit" - or at least a second meeting - with Kim. He also insisted that Kim "understands what the US has been pushing for in the talks." Said Trump , "I think he's going to do these things." During Tuesday's meeting, the Washington Post (6/12, Nakamura, Rucker, Fifield, Gearan, 15.68M) reports, Trump said he had "developed a very special bond" with Kim, but the document " is an outline, with no specifics or deadlines and leaves the details on key issues such as how the United States would verify that North Korea had given up its nuclear prog ram for future talks." St ill, Trump "cast his meet ings with Kim in the most positive light." The President told reporters, "We are very proud of what took place today. I think our whole relationship with North Korea and the Korean Peninsula is go ing to be a very much different situation than it has in the past. We both want to do something, we both are going to do something. We have developed a very special bond." /\MERICAi\ pVERSIGHT EXT-18-248-D-000060 USA Today (6/12, Jackson, 11.4M) likewise says Trump "claimed success," saying, "We had a really fantastic meeting" that went "better than anybody could have expected, top of the line, really good." To the Los Angeles Times (6/11, Bierman, 4.03M), the two leaders "appeared to open a new chapter ... in America's long-hostile re lations with North Korea." At the signing ceremony, Kim said, "The world will see a major change," adding that he and Trump "decided to leave the past beh ind." Politico (6/11, Johnson, Toosi, 3.51M) says that while the "text of the agreement contained few concrete steps," Trump called the document "pretty comprehensive" and Kim "a worthy negotiator." Kim, the Washington Times (6/12, Miller, 460K) reports, said the meeting "was the start of a working relationship between the two countries." Fox News (6/12, DeMarche, 16.38M) reports that during a press conference after the talks, Trump "did not refer to the document as a treaty or agreement," and "said Kim agreed to destroy a 'major' missile testing site, but did not offer specific details." The Washington Examiner (6/12, Morrongiello, 340K) reports Kim "departed the summit site at around 2 p .m. Tuesday, just as hundreds of journalists were shuttled over for a late afternoon press conference with Trump." Reuters (6/12) says Kim "is due to leave Singapore at 9 p.m . loca l time, two sources familiar with the plans said ." Trump: US-South Korean Milit ary Exercises On Hold. /\MERICAi\ pVERSIGHT EXT-18-248-D-000061 NBC News (6/11, Allen, 5. 76M) reports that after Tuesday's talks, President Trump "confirmed military exerc ises involving American and South Korea forces would be put on hold for now." The AP (6/12, Miller, Lucey, Lederman, Klug) says Trump "announced that he will be freezing US military 'war games' with ... South Korea while negotiations between the two countries continue." Trump Shows Kim His Presidential Limousine. Breitbart (6/11, Spiering, 1.28M) reports that after Tuesday's talks, Trump "showed Kim the interior of his presidential limousine 'The Beast' as they walked together outside the hotel." Number Of US Journalists Perm itted To Cover Talks Limited. Accord ing to Politico (6/11, Schwartz, 3.51M), "the number of American journalists allowed to witness" the ceremony "was lim ited to seven - a smaller group than would usually be present for such a summit, and one that excluded representat ives from the major wire services." The size "appeared designed to match the number of North Korean 'journa lists' present, according to a press poo l, and led to tension between US media and White House officials on the ground in Singapore ." White House Press Secretary Sarah Sanders told Politico, "We have worked very hard to provide access to the media at this event and continually expanded coverage throughout the morning." Trump To Depart Singapore Early. /\MERICAi\ pVERSIGHT EXT-18-248-D-000062 Reuters (6/11, Holland) reports the White House said Monday that discussions with North Korea had moved "more quickly than expected" and Trump would leave Singapore on Tuesday night. He had earlier been scheduled to leave on Wednesday. Two US officials told Bloombe rg News (6/11, 4.46M) that Kim "set a deadline for ending" the summit, prompting Trump "to set an earlier-than-expected departure time." The officials said Trump "had been willing to stay longer if negotiations were progressing, but since Kim set definite plans for departure, so did Trump. " The AP (6/11, Miller, Lucey, Lederman) too says Trump announced on the eve of the meeting "that he will be leaving Singapore early because the nuclear negotiations have moved 'more quickly than expected.' That was before the two had even met, and it was not clear whether it was good news or not." Ahead of Tuesday's summit, Trump tweeted, "Meetings between staffs and represen tat ives are going well and quickly ... but in the end, that doesn 't matter. We will all know soon whether or not a real deal, unlike those of the past, can happen!" He cont inued , "The fact that I am having a meeting is a major loss for the U.S., say the haters &losers. We have our hostages, testing, research and all missle launches have stoped, and these pundits, who have called me wrong from the beginning, have nothing else they can say! We will be fine!" Pompeo: Denuclearization "Ultimate Objective" Of Summit. Ahead of today's summit, Reuters (6/11, Spetalnick, Brunnstrom) reports Secretary of State Pompeo said the "ult ima te objective" of the /\MERICAi\ pVERSIGHT EXT-18-248-D-000063 summit had not changed and the US was "eager to see" if North Korea was sincere about denuclearization. Pompeo told reporters Trump was "fully prepared" for the talks, and was optimistic that the outcome would be "successful," while warning that there was still "lots of work left to do." Bloomberg News (6/11, Jacobs, Olorunnipa, Tweed, 4.46M) reports Pompeo also said the US plans to keep sanctions in place until North Korea denuclear izes yet is prepared to offer "unique" guarantees to the regime. In what Bloomberg calls a "stern message to Pyongyang," he also stressed that complete denuclearization "is the only outcome that the United States will accept" from North Korea. Breitbart (6/11, Caplan, 1.28M) reports Pompeo said the US is prepared to take actions to provide North Korea with "sufficient certainty" denuclearization that "is not something that ends badly for them." The Washington Times (6/11, Miller, 460K) likewise says Pompeo said the US "is prepared to offer new security assurance," but "refused to elaborate." To the Los Angeles Times (6/11, Bierman, 4.03M), Pompeo also "publicly downplay[ed] expectations that the nuclear summit will lead to anything beyond future talks," and the Washington Post (6/11, Nakamura , Rucker, 15.68M) says Trump too "has sought to lower expectations for the summit in recent days, suggesting that it would be the start of a lengthy process to get Pyongyang to begin dismantling its nuclear and ballistic missile programs." Kellyanne Conway said on Fox News' Hannit y • Video (6/11, 3.26M), /\MERICAi\ pVERSIGHT EXT-18-248-D-000064 "This President knows that somet imes negotiations like th is take one, two, three, four, five or more meetings. You can't change 70 years of war and a country that has isolated itself from most of the rest of the world as it becomes nuclear capable. And you can't expect that to turn around in a day or a meeting. Let's remember what's changed from past President attempts. It is the leadership and the vision of President Trump. It's his ability to reframe the way we look at relations around the globe. And I will tell you, this is not an American issue. The denuclearization of the Korean Peninsu la is everybody's business ." Sean Hannity said on Fox News' Hannity • Video (6/11, 3.26M), "There has been a lot of talk will they be talking beyond denuclear ization about human rights? Will he they be talking about possible reunification of North and South Korea somewhere down the line? All of those issues, I'm sure, will be d iscussed at some point . But as the President was very clear when he left Washington, he was saying this is a process. There w ill be nothing signed here, he said. He said this might take two, three, four, five meetings or maybe even more. But it is certa inly worth it if we can make the wor ld a safer place. But, again, the core argument and mandate of the United States and this is very clear. It is complete, verifiable, irreversible denuclearization of the Korean peninsula." Hannity To Interv iew Trump After Summit. Axios (6/11 , Swan , 2.49M) reports that it has learned Trump's "first sit down television interv iew after his historic summit" with Kim is expected to be with Hannity, "his friend and confidant." A Fox News spokeswoman "confirmed the interview" will air in full on Fox News' Hannity on Tuesday. /\MERICAi\ pVERSIGHT EXT-18-248-D-000065 WPost Analysis: Trump's Feud With Trudeau "Looks Like A Stunt." Callum Borchers writes for the Washington Post (6/11, 15.68M) "The Fix" blog that Trump's "ra tionale for lashing out at Canadian Prime Minister Justin Trudeau does not add up." In a tweet, Trump pointed to "Justin's false statements at his news conference" and "the fact that Canada is charging massive Tariffs." But Borchers notes that Canadian tariffs "were in place long before the summit and did not prevent Trump from initially endorsing the G7 statement on trade." He notes that "w hat was new was Trudeau's news conference Saturday, where he said that Canadians 'will not be pushed around."' According to Borchers, "It appears as though Trump is the one performing a stunt, raging at Trudeau in theatrical fashion without a clear reason to be so worked up. In fact, [White House economic adviser Larry] Kudlow suggested in his appearance on CNN that Trump's anger at Trudeau is an act for an audience of one: North Korean leader Kim Jong Un." Kim Takes Late-Night Sightseeing Tour In Singapore. Reuters (6/11, Holland) reports that Kim, "one of the world's most reclusive leaders, made an evening tour of sites on Singapore's waterfront." He was joined by Singapore's foreign minister, Vivian Balakrishnan, "who took a selfie." Reuters says the "rare public appearance of Kim, waving and smiling to onlookers, adds to the more affable image of the young leader that has emerged since his summit in April with South Korean leader Moon Jae-i n ." Bloomberg News (6/11, Zha i, Lee, 4.46M) similarly says the trip "marked a rare outing in a modern metropolis for a reclusive leader" who has "sought to overhaul his image this year." To the Washington Post (6/11, Fifield, 15.68M), "the Singaporean hosts seemed to be /\MERICAi\ pVERSIGHT EXT-18-248-D-000066 daring Kim to think big, to dream of the kind of glittering future his country could have if it opens up to t he outside world, as they took him on the late-evening tour." Dennis Rodman: Kim "Trying To Progress His Country." Dennis Rodman said on CNN's Cuomo Prime Time • Video (6/11, 839K), "If President Trump goes in there with a great heart, with his heart on the table, and lets Kim Jong-un see him, really emotional, as far as speaking to him." Kim, Rodman added, "is trying to progress his country. And Donald Trump is going to do a great job and try to reach out and make sure our hands, America's hands always open .... If Trump can pull this off, more power to him." The Gateway Pundit (6/11, Taylor, 201K) notes that Rodman wore a red Trump "Make America Great Again" hat during his "emotional interview" with CNN. Politico Analysis: "Trump Made Diplomacy Great Again." Blake Hounshell writes for Politi co Magazine (6/11, 3.45M) that when "candidate Barack Obama said in a 2007 debate that he'd meet with the leaders of rogue states - includ ing North Korea - without preconditions, critics pounced .... Flash forward to today, and what are Republicans saying about the current president's willingness - eagerness, even - to cut a nuclear deal with the most roguish leader of them all, North Korean strongman Kim Jong Un?" Not much, according to Hounshell, who notes that Democrats "have largely welcomed Trump's North Korea diplomacy." /\MERICAi\ pVERSIGHT He argues that "whethe r he succeeds or fails, to his EXT-18-248-D-000067 supporters, is almost beside the point - the president is mak ing diplomacy great again." NYTimes Editorial Board Member Suggests Summit A Distraction From Russia Probe. The Dail y Caller (6/11, Nista, 420K) reports New York Times editoria l board member Mara Gay suggested Monday on MSNBC that today's summit "exists to distract from the Russia investigat ion." Said Wallace, "This is not just a meet ing about foreign policy, this is about Donald Trump's political survival. He has said to friends that he plans on taking a win in North Korea to the voters. That's their midterm message; that's all they've got." T rump To Hold Rally In MN8 Next Week . The Minneapolis Star Tribune (6/11, Golden, Van Berkel Star, 1.16M) reports the President "will make his first post -election vis it to Minnesota ... on June 20 at the Duluth Enterta inment Convention Center." The Duluth (MN) News Tribune (6/11, Olsen, 195K) notes that "Trump, who campaigned in Superior in April 2016 , will be the first sitting president to visit Duluth since George W. Bush in 2004. " As KSJR-FM Collegeville, MN (6/11, 92K) reports, Duluth is "the battleground /\MERICAi\ pVERSIGHT for the open and highly competitive 8th Congress ional EXT-18-248-D-000068 District seat," which Trump won in 2016 even as Rep. Rick Nolan (DMN) "held onto the seat in a close election and Minnesota chose Hillary Clinton for president." Nolan "ea rlier this year announced he would not seek re-election to the district, giving Republicans a key opportunity to flip the seat." While "four Democrats are headed for an August primary at this point," St. Louis County Commissioner Pete Stauber "is the lone Republican in the 8th District race. He's a retired Duluth police officer who's also served on the Hermantown City Council and in younger years played minor league professional hockey." The Washington Examiner (6/11, Quinn, 340K) indicates, moreover, that "both of Minnesota's senators, Democrats Amy Klobuchar and Tina Smith, are on t he ballot this November." The Hill (6/11, Samuels, 2.71M) quotes "Michael Glassner, COO of the Trump campaign," as saying in a statement, "The President will meet with Minnesota patriots to report the latest developments for our surging economy, including record-low unemployment and fair trade reforms, and his historic summit with North Korean leader Kim Jongun." The Hill adds that the event "could be viewed as a sign of confidence from Trump on his chances in Minnesota." The President "narrowly lost the state, which has been won by every Democratic candidate for president since 1972." The St. Paul (MN) Pioneer Press (6/11, Woltman, 453K) notes that "in an emailed statement, Jennifer Carnahan, chairwoman of t he Republican Party of Minnesota, said she is excited to welcome the president back to the state." Said Carnahan, "The importance of Minnesota this election cycle - in inf luenc ing the balance of power in Washington D.C. for the next two years and ensuring we send the Presiden t conservative reinforcements - depends on our ability to Make Minnesota Red .... We look forward to the momentum and positive energy his visit will bring to Minnesota Republicans and our opportunities /\MERICAi\ pVERSIGHT this election cycle." EXT-18-248-D-000069 Trump Hails High Court Ruling Allowing Ohio To Drop Inactive Voters From Rolls. President Trump took to Twitter yesterday to write, "Just won big Supreme Court decision on Voting! Great News!" Trump was referring to a case involving Ohio, which is receiving widespread print media coverage this morning. The AP (6/11, Sherman) reports that the Supreme Court has ruled that states "can target people who haven't cast ballots in a while in efforts to purge their voting rolls." In a "5-4 vote that split the conservative and liberal justices, the court rejected arguments in a case from Ohio that the practice violates a federal law intended to increase the ranks of registered voters." The AP adds "Ohio's contested voter purge stems from an inoffensive requirement in federal law that states have to make an effort to keep the ir voter rolls in good shape by removing people who have moved or died." Ohio "pursues its goal more aggressively than most, relying on two things: voter inact ivity over six years encompassing three federal elections and the failure to return a card ... asking people to confirm that they have not moved and continue to be eligible to vote." CNN (6/11, De Vogue, Vazquez, 82.6M) cautions on its website that "at least six other states have similar laws, and the ru ling could embolden others to follow suit and enact what critics say are aggressive purges of voter rolls." The Washington Times (6/11, Dinan, 460K), in fact, reports "the ruling is already boosting conservative groups pushing to have other states clean up their voter rolls." /\MERICAi\ pVERSIGHT EXT-18-248-D-000070 Politico (6/11, Gerstein, 3.51M) calls the ruling "a victory for the Trump administration," and NPR (6/11, Totenberg, Montanaro, 3.SSM) noted that "the Obama Justice Department had sided with the lead plaint iff in the case, Larry Harmon, a software engineer from the Akron area," but "once [President] Trump was elected, the DOJ did an about-face and switched positions." The Los Angeles Times (6/11, Savage, 4.03M) says "the legal dispute played out against a backdrop where two major part ies had opposite views. Republicans spoke of 'voter fraud' and election rolls they said were stocked with ineligible and illegal voters, wh ile Democrats complained of "voter suppression" by GOP states which, they said, made it harder for minorities and the poor to cast ballots ." To USA Today (6/11, Wolf, 11.4M), along those lines, "the ruling could be a major victory for Republicans, who tend to benefit from lower voter turnout, and a stinging loss for Democrats, who do best in high-turnout elections." That is "because minorities, young people and those with lower incomes are most likely to be disenfranchised by the state's policy." Newsweek (6/11, Goodkind, 2.18M) also reports "a number of civil rights groups argued that the decision would likely aid Republicans but hurt Democrats and voters of color ." The Cleveland Plain Dealer (6/11, Eaton, 1.03M) notes "Oh io Secretary of State Jon Husted called the ruling in the case known as Husted v. A. Philip Randolph Institute 'a victory for election integrity, and a defeat for those who use the federal court system to make election law across the country ."' Husted "is Attorney General Mike DeWine's running mate in this year 's governor's race." DeWine said yesterday, "I am pleased that the United States Supreme Court agreed that Ohio was fo llow ing federal law in maintaining accurate voter rolls .... I congratulate throughout /\MERICAi\ pVERSIGHT our attorneys this case for their exceptional work in documenting how this EXT-18-248-D-000071 process used by Democrat and Republican secretaries of state is indeed lawful." The Columbus (OH) Dispatch (6/11, Torry, Ludlow, 399K) reports Sen. Sherrod Brown, "a former secretary of state, assailed the ruling, saying 'Ohio should be working to make voting easier, not harder. Instead, today's decision empowers Ohio to further strip away the right to vote for thousands of Ohioans, threatening the integrity of our state's election process."' CO Roll Call (6/11, Ruger, 117K) reports House Minority Leader Pelosi "called the decision dangerous and 'a grave step backward in our nation's progress to advance a future in which every person can enjoy their full, equal right to be heard at the ballot box."' It was, Reute rs (6/11, Chung) reports, "a ruling powered by the five conservative justices and denounced by liberal Justice Sonia Sotomayor as an endorsement of the disenfranchisement of minority and low- income Americans." The Columbus (O H) Dispatch (6/11, Torry, Ludlow, 399K) reports that in his ruling, Justice Alita said Ohio's system "does not violate federal laws approved in 1993 and 2002 by Congress." Wrote Alita, "We have no authority to second-guess Congress or to decide whether (the Ohio's law) is the ideal method for keeping its voting rolls up to date .... The only question before us is whether it violates federa l law. It does not." Meanwhile, says the Washington Post (6/11, Barnes, 15.68M), Sotomayor wrote in her dissent, "Communities that are disproportionate ly affected by unnecessarily harsh registration laws should not tolerate efforts to marginalize their influence in the polit ica l process, nor should allies who recognize blatant unfa irness stand idly by." Alita retorted, "Justice Soto mayor's dissent says nothing about what is relevant in this case - namely, the language of the" National /\MERICAi\ pVERSIGHT EXT-18-248-D-000072 Voter Registrat ion Act, and "has not pointed to any evidence in the record that Ohio instituted or has carried out its program with discriminatory intent." NPR (6/11, Totenberg, Montanaro, 3.SSM) reported "the first line of the opin ion lays out evidence for why Alito sees the need to clean up voter rolls ." Wrote Alito, "It has been estimated that 24 million voter registrations in the United States - about one in eight - are either invalid or significantly inaccurate," and "about 2. 75 million people are said to be reg istered to vote in more than one State." Alito was referencing "a Pew Center on the States" report, "the same study that incoming Trump White House officia ls cited - misleading ly - to make the case that voter fraud was occurring and imm igrants in the US illegally were voting." Fox News (6/11, Mears, 16.38M) reports on its website that "Alito, in his opinion, clarified that states could not use the failure to vote as the sole reason for removal from the register." Officials "would be required to show someone had changed their residence, was incarcerated or met other criteria." The New York Times (6/11, Liptak, Subscription Publication, 19.33M) indicates, however, that "the central question in the case was whether a failure to vote could be the reason to send out the not ice." Politico (6/11, Gerstein, 3.51M) reports that "Stuart Naifeh, sen ior counsel at Demos, which led the legal team challenging the state's practices," said yesterday that the ruling "threatens the ability of voters to have their voices heard in our elect ions." The Wall Street Journa l (6/11, Kendall, Bravin, Subscription Publication, 6.13M), Washingto n Examiner (6/11, Quinn, 340K) and The Hill (6/11, Wheeler, 2. 71M), among other news outlets, run similar reports on the ruling. /\MERICAi\ pVERSIGHT EXT-18-248-D-000073 More Commentary. The Washington Post (6/11, 15.68M) editor ializes that "though the court majority determ ined that" Ohio's approach to purging the voter rolls "is legal, it is not wise," as "states should be encourag ing more civic part icipation, not less." The Post adds that in the US, "polit ical legitimacy flows from popular approval," and "systematically discouraging sections of the populace from voting is cynical and detrimental to the democracy." USA Toda y (6/11, 11.4M) offers similar arguments in an editor ial titled "Supreme Court Upholds Ohio's Vote Suppression Scheme." In an editorial, the Wall Street Journa l (6/11, Subscription Publicat ion, 6.13M) defends the ruling, hailing it as a step toward more accurate voter rolls. Pete Hutchison, pres ident of Landmark Legal Foundation, writes in USA Today (6/11, 11.4M) that "the dissenting justices object to the Ohio Legislature's policy decisions," but "the job of judging is to apply the law as written and not to second-guess the peop le's representatives. Monday's decision is a victory for ballot integrity ." Trump-Recruited GOP Candidate Frustrated By Trump's "Affinity " For Heitkamp . The Washington Post (6/11, Sullivan, 15.68M) reports, "President /\MERICAi\ pVERSIGHT EXT-18-248-D-000074 Trump is aggressively campaigning for Republican Senate candidates around the country and belittling their Democratic rivals, with one notable exception - Sen. Heidi Heitkamp of North Dakota." The President's "affinity for Heitkamp, who got a shout-out and a handshake at a recent White House bill signing, has frustrated top Republicans who see winning her Democratic seat as crucial to holding onto their fragile 51-to-49 majority." Rep. Kevin Cramer (R-ND), "whom Trump personally recruited to run against Heitkamp," has contacted Chief of Staff Kelly "to appeal for political help" and has "traded warning shots with Trump 's legislative affairs director, Marc Short." Obama Meeting With Potential 2020 Democratic Presidential Candidates . CNN (6/11, Merica, 82.6M) reports on its website, "Barack Obama has met with several Democrats considering running for president in 2020, a Democrat close to the former president tells CNN, offering them advice on running in the Trump era and discussing how to position the party going forward." CNN adds that "to date, according to the Democrat, Obama has met with Vermont Sen. Bernie Sanders; Massachusetts Sen. Elizabeth Warren; former Vice President Joe Biden; former Massachusetts Gov. Deval Patr ick; New Jersey Sen. Cory Booker; former New Orleans Mayor Mitch Landrieu; Los Angeles Mayor Eric Garcetti; South Bend, Indiana, Mayor Peter Buttigieg; former Missouri Secretary of State Jason Kander; and former Attorney General Eric Holder." Politico (6/11, Devere, 3.51M) says "Obama is concerned about how his /\MERICAi\ pVERSIGHT EXT-18-248-D-000075 own party is responding" to President Trump, "and how it can be best positioned to w in in the midterms and in the next pres idential cycle to beat back the president and his politics." Obama, adds Politico, "doesn't see himself as the person to come up with the plan," but "he is eager to be a sounding board and counselor." New D'Souza Film Compares Anti-Trump "Resistance" To Democrats' Opposition To Lincoln. The Hill (6/11, Concha, 2 . 71M) reports "conservative filmmake r Dinesh D'Souza, who was recently pardoned by President Trump, is mak ing comparisons for his next film between the Democratic resistance to Trump and how Democrats didn 't accept President Lincoln's reelection during the Civil War." The Tw itter "account for D'Souza's next film, 'Death of a Nation,"' stated yesterday, "Not since 1865 have #Democrats so dramatically refused to accept the outcome of a presidential election." D'Souza also weighed in on Tw itter, asking, "Lincoln united his party and saved Amer ica from the Democrats for the first time. Can Trump - and wen-- come together and save America for the second time?" Trump Highlights Good Economic News. /\MERICAi\ pVERSIGHT EXT-18-248-D-000076 In a tweet Monday afternoon, Trump touted his economic record, writing, "Stoc k Market up almost 40% since the Election, with 7 Trillion Dollars of U.S. value built throughout the economy. Lowest unemployment rate in many decades, with Black &Hispanic unemployment lowest in History, and Female unemployment lowest in 21 years. Highest confidence ever!" Stocks Rise Slightly. Trump's tweet came on a day that stocks posted slight gains. Reuters (6/11, Brown) reports that the Dow climbed 5. 78 points to 25,322.31, the S&P 500 added 2. 97 points to close at 2,782, and the Nasdaq ended the day 14.41 points higher at 7,659.93. Fed weighs Historically Low Unemployment In Considering Rate Decision. The Wall Street Journal (6/11, Tim iraos, Subscription Publication, 6.13M) reports that as the Federal Reserve prepares to announce whether it will raise the benchmark short-term interest rate on Wednesday, it is considering how far unemployment may fall without stoking inf lation . The Journal adds that the US unemployment rate has only his its current level of 3.8% tw ice before in the past 50 years, one of which, in the 1960s, spurred high inflation. The article adds that the Fed is projected to increase its short-term rate to between 1. 75% and two percent, adding that Fed Chairman Jerome Powell's view of the near-term future of US unemployment will drive Fed interest rate decisions. /\MERICAi\ pVERSIGHT EXT-18-248-D-000077 Maher Hopes For Recession So We Can "Get Rid Of Trump." Writing on Townhall (6/11, 209K), Matt Vespa cites a RealClear Politics report which said that comedian Bill Maher said Friday that he is hoping for a recession so we can "get rid of Trump." On his HBO show Real Time, Maher said, "Can I ask about the economy because this economy is going pretty well? I feel like the bottom has to fall out at some point. And by the way, I'm hoping for it. Because I think one way you get rid of Trump is a crashing economy. So, please, bring on the recession. Sorry if that hurts people, but it's either root for a recession or you lose your democracy." Pai: Expiration Of Net Neutrality Means A Return To Clinton-Era Framework . The Washington Tim es (6/11, Munoz, 460K) reports that as net neutrality regulations ended Monday, FCC Chairman Ajit Pai "touted a return to past policies," saying the "new approach is actually more like the policy set in place by former President Bill Clinton." Pai told CBS This Morning, "President Clinton's framework, it served us well from '96 until 2015, and I'm confident going forward." Reuters (6/11, Shepardson) says that while the net neutrality rules expired Monday, "a court battle remains ahead." /\MERICAi\ pVERSIGHT EXT-18-248-D-000078 Pentagon Officials Distance Themselves From LGBT Pride Month Observances . The Washington Post (6/11, Sonne, 15.68M ) reports that for the first time since the practice became routine in the wake of President Obama's repeal of the military's ban on homosexuals serving openly, senior Pentagon officials "are distancing themselves from the Defense Department's annual LGBT Pride Month celebrations." While an official Pentagon memo is typically distributed at the beginning of LGBT Pride Month in June, the absence of the memo this year "has raised questions among service members and Defense Department civilian employees who remain troubled by President Trump's surprise proclamation last July that he would ban transgender individuals from serving in the military. " Biden Heckled During Book Tour Stop In Delaware. The Wilmington (D E) News Journal (6/11, Price, 304K) reports that former Vice President Joe Biden was heckled during a book tour stop in his hometown of Wilmington, Delaware on Sunday. As Biden "was ta lking about sexua l assault," the heck ler asked, "What about the girls you molested on C-SPAN at the Senate swearing in?" The taunt drew boos and shouting from the audience, but Biden "qu ieted the crowd enough to respond: 'This is not Trump world,' which drew a deluge of applause and cheers, even as catcalls and boos aimed at the heckler continued ." /\MERICAi\ pVERSIGHT EXT-18-248-D-000079 Poll: Scott "Dominating" Nelson Among Florida Voters 50 And Older. Politico (6/11, Caputo, 3.51M) reports that a forthcoming Politico/AARP poll shows that Gov. Rick Scott "is v irtually tied" with Sen. Bill Nelson in the Florida Senate race, and is "dominating" those nearing or at retirement Nelson "by 9 points among age - a group that casts the majority of Florida's votes." Overall, "Scott leads Nelson overall by 40 percent to 39 percent, but Scott's support grows to 44 percent while Nelson's shrinks to 35 percent with those 50 and older." McClatchy Analysis: Sanford Fighting For Political Life In SC1 GOP Primary. McClatchy (6/11, Douglas, Duma in, 81K) reports that Rep. Mark Sanford (R-SC) is fighting for his political life in his Tuesday primary "thanks to his disagreements with President Donald Trump." Recent polling shows Sanford and State Rep. Kat ie Arrington "in a statistica l tie" in SCl. /\MERICAi\ pVERSIGHT EXT-18-248-D-000080 In AL2, Rouby Faces Runoff Amid Questions About Her Loyalty To Trump. The New York Times (6/11, Blinder, Mart in, Subscr iption Publication, 19.33M) reports that President Trump "has become a one-man litmus test in some of his party's pr imaries, imperiling incumbents in races where policy issues seem to matter less to voters than personal loyalty to the president." In AL2, Republican voters "face a peculiar choice in a runoff" - Rep. Martha Roby (R-AL), "who condemned Mr. Trump but has since voted near ly in lock step with him," or Bobby Bright, "who was once a Democrat who supported Nancy Pelosi, but now sounds much like the president." That Rouby was "forced into a runoff by questions of personal fealty illustrates the potency of the issue in this year's Republican primaries ." Democrats Consulting With Hollywood Ahead Of Midterms. Politico (6/11, Siders , 3 .51M) reports that the DNC and Democratic lawmakers are "quietly consulting" with Hollywood actors, writers, and producers for "help with voter turnout and messaging ahead of t he midterm elections and 2020 presidential campaign." DNC Chairman Tom Perez, several House members, and others have met with a group "formed by members of the entertainment industry in the wake of the 2016 election," to discuss "targeted voter-registration programs with visiting Democrats, as well as the party's framing of issues ranging from abortion rights to gun control." /\MERICAi\ pVERSIGHT EXT-18-248-D-000081 AP Ana lysis: Democratic House Cand idates Pushing Liberal Messages. The AP (6/11, Barrow, Beaumont) reports that Democrats' m idterm House candidates are "shaping up to test what liberal messages the party can sell to the moderate and GOP-leaning voters who will help determine control of the House after the November election ." According to the AP, "the crop of nominees is trending more liberal than many of the 'Blue Dog' Democrats swept away in Republicans' 2010 m idterm romp." As a result, "voters now represented by a Republican will be asked to consider some or all of the mainstream Democratic priorities that may have been cons idered 'too libera l' in the past : more government involvement in health insurance, t ighter gun laws, a path to citizenship for people in the country illegally, revers ing parts of the GOP tax law, support for LGBTQ rights ." The question is whether that w ill result in "Democrats gain ing the 23 new seats they need for a majority." Democrats Hope Anti-Trump Sentiment Will Help Unseat Comstock. The Washington Times (6/11, Sherfinski, 460K) reports that Democrats " are counting on an anti-Trump back lash, a desire to overturn the Republican-led Congress and a surge of interest in gun control to unseat suburban Republicans" like Rep. Barbara Comstock (R-VA) in VAl0. But Comstock "sa id she has been a top target in her past two elect ions yet emerged with a 16- percentage - point victory in 2014 and won reelection by 6 points in 2016, even as Hillary Clinton carried the district /\MERICAi\ pVERSIGHT EXT-18-248-D-000082 by close to double digits ." Comstock "is highlighting her vote for Republican tax cuts and her work combating violent gangs in the region as she tries to shore up the pro-Trump elements of her party." Female Gubernatorial Candidates Say They Face Resistance To Female Executive Power. The New York Times (6/11, Martin, Burns, Subscription Publication, 19.33M) reports that while women "have emerged as the animating force behind the backlash to President Trump, with many storm ing to victory in congressional primaries, several are find ing governor's races to be more cha llenging as they struggle to build as much politica l and financ ial support as the ir male rivals ." From today through September, "female cand idates for governor will be on the ballot in Democratic primaries across 17 states, including pivotal battlegrounds such as Florida, Wisconsin and Colorado," but "severa l said they are facing entrenched resistance to female power at the execut ive level, and male opponents with deeper campaign coffers and, in some cases, far less pol itical exper ience." Bill Clinton: Norms Of "What You Can Do To Someone Against Her Will" Have Changed. /\MERICAi\ pVERSIGHT EXT-18-248-D-000083 The Dail y Caller (6/11, Athey, 420K) reports that in an interview with PBS on Friday, former President Bill Clinton "made a disturbing statement about sexual consent ." Asked about the resignation of Sen . Al Franken and what that says about changing norms, Clinton said, "I think it's a good th ing that we should all have higher standards," Clinton said . "I think the norms have really changed in terms of, what you can do to somebody against their will, how much you can crowd their space, make them miserab le at work." USA Today (6/11, Cummings, 11.4M) reports that Clinton "said that Franken was 'a diff icu lt case' for him because while there may be facts he doesn't know about the allegations, many of Franken's past female colleagues came to his defense." Clinton said, "Maybe I'm just an oldfashioned person ... but it seemed to me that there were 29 women on 'Saturday Night Live' that put out a statement for him, and that the first and most fantastic story was called, I believe, into question ." Referring to Franken's resignation, he added that it is "a grievous thing to take away from the people a decis ion they have made .... But it 's done now ." Poll: 53% See Clinton As A Sexual Predator . Katie Pavlich writes on Tow nhall (6/11, 209K) that the latest Rasmussen Reports po ll found that "just 24% of Likely U.S. Voters consider Clinton a victim of his political opponents . Fifty -three percent (53%) describe the ex-president as a sexual predator instead . Another 24% are undec ided." /\MERICAi\ pVERSIGHT EXT-18-248-D-000084 Broadway Veterans, Trump Critics Struggle With De Niro's Tony Comments. The Washin gt on Post (6/11, Zeitchik, 15.68M) reports that actor Robert De Niro's speech at the Tony Awards, in which he said, "F---Trump . .. . It's no longer down with Trump .. . but F- -- Trump," made "a Broadway extravaganza and a beloved American actor ... a lighting-rod referendum on Trumpism." The Post adds that a post -ceremony parties, "the Trump moment was on many Broadway veterans' minds . They just couldn't figure out what to make of it or whether what he did was a good thing ." The Washin gto n Time s (6/11, Chasmar, 460K) reports that MSNBC host Joe Scarborough said De Niro and those who applauded his comments are unw ittingly aid ing the President's re-election. Scarborough said, "If people that applauded De Niro 's statement last night don't understand that they are help ing Donald Trump's re-election every time they do someth ing like that, they don't understand." Twitter CEO Draws Fire For Chick-Fil-A Post During Pride Month. USA Today (6/11, Carrig, 11.4M) reports that Twitter CEO Jack Dorsey apologized after a tweet in wh ich he said he ordered food from Chick-filA drew critic ism on socia l media. Dorsey was crit icized "for supporting Chick-fil-A during" June, wh ich is LGBTQ Pride Month. In 2012, Chick- /\MERICAi\ pVERSIGHT EXT-18-248-D-000085 fil-A "came under fire from gay rights supporters ... because of comments made by the fast food chicken chain's CEO, Dan Cathy, expressing opposition to same-sex marriage" and the company's donations to ant i-gay groups. Amid the backlash from his original tweet, Dorsey wrote, "You're right. Completely forgot about their background." Under the headline "Jack Dorsey Chickens Out," a Wall St reet Journa l (6/11, Subscription Publication, 6.13M) editorial takes issue with the criticism of Dorsey and argues the Chick-fil-A restaurants serves everyone and Cathy was expressing his personal beliefs when he voiced opposition to gay marriage. Rubio Defends Chick-F il-A. The Washingto n Times (6/11, Richardson, 460K) reports that Sen. Marco Rubio "stood up for Chick-fil-A" in a series of tweets. Rubio "questioned the prudence of boycotting a company for holding a mainstream Christian view on marriage." He wrote, "This lunacy has gone too far. The CEO of @Twitter bullied into apo logy for patronizing @ChickfilA because owners support "biblical definition of marriage. Holding a personal view taught by mainstream Christianity boycott worthy." is now Rubio followed that with another, saying, "@ChickfilA isn't deny ing serv ice to anyone. But if you eat there you must be attacked by the twitter mob b/c owner agrees with what his church teaches about marriage? Why would twitter mob stop at biz owned by Christians? Who is next? Christian schools? Christ ian charities?" In a final tweet, Rubio wrote, "The message from latest @ChickfilA incident is this: "Your church can still teach traditional marriage (which by the way we will still label as a bigoted belief) but don't you dare repeat it outside of church or we will come after you, your business and/or your job." /\MERICAi\ pVERSIGHT EXT-18-248-D-000086 Editorial Wrap-Up New York Times. "The Healthcare Stalkers." The New York Times (6/11, Subscription Publication, 19.33M) similarly argues in an editorial that Democrats who hope "to make health care a centerpiece of midterm election campaigns just got a gift from the Trump administration," Department as the Justice has " declined to defend the Affordable Care Act against a lawsuit filed by 20 Repub lica n-led states," and is "arguing for the repeal of enormously popular consumer protections, including coverage of pre- existing conditions." "America Isolated." The New York Times (6/11, Subscription Publication, 19.33M) writes on its editorial page that last weekend's G7 summit was "a confirmation that so long as Mr. Trump is in the White House, and maybe beyond /\MERICAi\ pVERSIGHT EXT-18-248-D-000087 that, something fundamental in t he community of Western democracies will be missing. America, the leader of the free world and the architect of so much of the modern world order, had decided to go its own way." The Times argues that "it's past time to recognize that this pres ide nt has transformed 'America First' into 'Amer ica Alone,' and that this is the last place a great and powerful nation wants to be." Washington Post. "Why Are Republicans So Determined To Discourage People From Voting?" The Washington Post (6/11, 15.68M) editorializes that "though the [Supreme Court] majority determined that" Ohio's approach to purging the voter rolls "is legal, it is not wise," as "states should be encouraging more civic participation, not less." The Post adds that in the US, "political legitimacy flows from popular approval," and "systematically discouraging sections of the populace from voting is cynical and detrimental to the democracy." "Canada Has Every Right To Be Insulted." The Washington Post editorializes that Canada "has every right to be insulted that Mr. Trump would invoke national security in their trade dispute. Canada has stood with the United States in every modern war and crisis. There is no doubt that the United States could rely on Canadian steel and aluminum if another crisis developed, obviating the stated rationale for impos ing the tariffs." Trump's "trade offensive," it argues, "is an insult." /\MERICAi\ pVERSIGHT EXT-18-248-D-000088 Wall Street Journal . "The Autumn Of Obamacare." A Wall Street Journal (6/11, Subscription Publication, 6. 13M) editor ial says that whi le Democrats are blaming Republicans for double-digit healthcare premium increases, the problem is the structure of the ACA. As the election approaches, the Journal adds, Republicans will have to refute the Democrats' false claims. "Jack Dorsey Chickens Out." A Wall Street Journal (6/11, Subscription Publication, 6.13M) editorial takes issue with criticism of Twitter CEO Jack Dorsey over a tweet in wh ich he said he ordered food from Chick - fil -A. The Journal argues the Chick-fil-A restaurants serves everyone and that Chick-fil-A CEO Dan Cathy was expressing his personal beliefs when he voiced opposition to gay marriage. "A Victory For Voting Law." In an editorial, the Wall Street Journa l (6/11, Subscr iption Publicat ion, 6 .13M) defends the Supreme Court ruling on states purging voter rolls , hailing it as a step toward more accurate voter rolls. /\MERICAi\ pVERSIGHT EXT-18-248-D-000089 The Big Picture Headlines From Today 's Front Pages. Wall Street .Journal: Trump Greets Kim To Kick Off Summit The Fed's Biggest Dilemma: Is The Booming Job Market A Problem? Stryker Makes Takeover Approach To Boston Scientific Buyer Beware When A Stock Joins The S&P 500 /\MERICAi\ pVERSIGHT EXT-18-248-D-000090 New York Times: Trump, After Talks With Kim, Says Denuclearization Will Begin 'Quickly' Sessions Says Domestic And Gang Violence Are Not Grounds For Asylum Supreme Court Upholds Ohio's Purge Of Voting Rolls New York City Housing Authority, Accused Of Endangering Residents. Agrees To Oversight Democratic Women Are Running For Governor. Men And Money Stand In Their Way. The Nine Steps Required To Really Disarm North Korea Washington Post: Trump And North Korea's Kim Meet For Historic Summit Just ices Uphold Ohio's System For Purging Rolls Of Nonvoters /\MERICAi\ pVERSIGHT EXT-18-248-D-000091 President Increasingly Relies On Unilateral Action To Wield Power Smiles And Hands hakes Could Mask Divide Over Nuclear Arms Is MS- 13 Overtaking A Middle School In MD.? Financial Times: Cit i Issues Stark Warning On Automat ion Of Bank Jobs Martin Sorrel l's Downfall: Why The Ad King Left WPP Dugue Readies To Become Colombia's Youngest President Spa in To Take In 629 Migrants Stranded At Sea After Italy Refuses Washington Times: Trump, Kim Jong-Un Sign Document, Pledge To Work Together For Peace /\MERICAi\ pVERSIGHT EXT-18-248-D-000092 Jeff Sessions Sets Higher Bar For Asylum Claims USS Pueblo Still Held Hostage By North Korea As Trump, Kim Meet Va. Democrats Banking On Anti-Trump Backlash In Bid To Unseat Rep. Barbara Comstock Redskins Replacement Players From 1987 To Get Super Bowl Rings Murky U.S. Drone-Strike Policy Threatens To Backfire As Other Nations Acqu ire Technology Story Lineup From Last Night's Network ABC: US-North Korea Relations-Summit; Kim-Jong - Un Insights; News: US-North Korea Relations- US-North Korea Relat ions-Korean Peninsula; Trump - G7 Allies Relations ; Severe Weather; Trump - Imm igration; Orlando-Hostage Situat ion; Washington State-Cab in Explosion; United Airlines-Secur ity Threat; Anthony Bourdain-Suicide; US-North Korea Relations-Kim Jong-Un Out Late. CBS: US-North Korea Relations-Summ it; Trump-G7 Allies Relations; US-North Korea Relations-Kim-Jong-Un Insights; US-North Korea Relations - Denuclearization; US- North Korea Relations -Trump's Deal Making; Colorado-Wildfires; Orlando-Hostage Bourdain-Suicide; /\MERICAi\ pVERSIGHT Situat ion; Anthony North Korea Defector. EXT-18-248-D-000093 NBC: US- North Korea Relations - Summit; US- North Korea Relat ions - Kim-Jong-Un Insights; US-North Korea Relat ions-Singapore; Korea Relations-South Korea; Trump-G7 Allies Relations; Trump- Immigration; Missing US Official Found; Orlando-Hostage Colorado-Wildfires; Ohio-Explosion Investigation; US-North Situation; US-North Korea Relations - Reactions . Network TV At A Glance: US- North Korea Relations - Summit - 13 minutes, 15 seconds US-North Korea Relations-Kim-Jong-Un Insights - 11 minutes, 0 seconds Trump-G7 Allies Relations - 6 minutes, 5 seconds Orlando-Hostage Situat ion - 2 minutes, 50 seconds Story Lineup From This Morning's Radio News Broadcasts: ABC: US-North Korea Relations-Summit; US-North Korea Relations- Summit - Reactions; Orlando - Hostage Situation; Trump -Immigrat ion. CBS: US-North Korea Relations-Summ it; WH-Kudlow Heart Attack; Trump-Immigrat /\MERICAi\ pVERSIGHT ion; Immigration-Cheating For Green Cards; Crash Test EXT-18-248-D-000094 Results; Wall Street. FOX: US-North Korea Relations-Summit; WH-Kudlow Heart Attack; Supreme Court-Ohio Voter Ruling. NPR: US-North Korea Relations-Summit; US-North Korea Relations- Choreographed Hand Shake; WH-Kudlow Heart Attack; WH-TreasurySanctions Against Russian Businesses; Trump-Immigrat ion . Last Laughs Late Night Political Humor. Jimmy Kimmel: /\MERICAi\ pVERSIGHT EXT-18-248-D-000095 "When he left the G7, Trump said his relationship with the other leaders was a 10. He rated it a 10. And then a few hours later, I guess he didn't like the idea that the Prime Minister of Canada Justin Trudeau did n't do as he was told, and so Trump tweeted, 'PM Justin Trudeau of Canada acted so meek and mild during our G7 meetings, only to give a news conference after I left saying that US tariffs were kind of insulting and he will not be pushed around. Very dishonest and weak. Our tariffs are in response to his of 270 percent on dairy.' Bearing in mind that first of all, our dairy trade with Canada - it's only about $600 million a year, which is about what it costs for him to play golf every week." Jimmy Kimmel: "And he justified these new tariffs in the first place by saying our national security was at stake. Now he's saying it's because of dairy. How does Canadian dairy threaten our national security? Are they planning to churn us to death? Are they going to drop cheese curds on us and turn us into poutine?" Jimmy Kimmel: "And who has a problem with Canada? No one has a problem with Canada. It's like picking a fight with 'Nilla Wafers. No one does it. It's ridiculous." /\MERICAi\ pVERSIGHT EXT-18-248-D-000096 Jimmy Kimmel: "Trump also threatened to cut off all trade with the other six nations at the summit. All our closest allies. We would not trade with them anymore. German Chancellor Angela Merkel said she found his actions at the summit to be sobering and depressing . And when a German finds you to be sobering and depressing - bad news. This is the country that gave us Hitler and David Hasselhoff." Stephen Colbert: "Folks, it is an historic evening because, as we speak, President Trump is meeting with North Korean dictator Kim Jong-un, a scenario that, just a few years ago, would have been unth inkable because it includes the phrase ' President Trump."' Stephen Colbert: "So tens ions are high. The United States is on the precipice of unthinkable international conflict, and that's with Canada." /\MERICAi\ pVERSIGHT EXT-18-248-D-000097 Stephen Colbert: "If you're one of those nerds who values the Western alliance that has safeguarded democracy for 70 years, it was a tough weekend for you because Canada hosted the G7, and it did not go 'the good.' Keep in mind, the G7 are our trading partners, and right before he attended, Donald Trump declared protectionist trade tariffs against all of them. That's like showing up to an AA meeting with Captain Morgan." James Corden: "Tomorrow is the big summit meeting between President Trump and North Korean leader Kim Jong-un. Trump spent the day preparing for the summit, which basically means he wrote on his hands, 'South Korea good, North Korea bad,' so he doesn't get confused." James Corden: "When asked by reporters how he will know if North Korean leader Kim Jong-un is serious about a peace treaty, President Trump said he will use his 'touch and feel.' This may not be a great plan. The last time Trump used his 'touch and feel' method, he had to pay Stormy Daniels $130,000." /\MERICAi\ pVERSIGHT EXT-18-248-D-000098 James Corden: "Honestly, it may work. After three minutes of being touched and felt by Trump, Kim Jong-un is just going to shout, 'Fine, take the nukes! Just stop touching me!"' Jimmy Fallon: "Tonight in Singapore, Trump and North Korean leader Kim Jong-un finally came face to face. Or in Kim 's case, more like face to belly button." Jimmy Fallon: "There's a lot riding on this meeting. Last night, Kim spent hours preparing, while at the same time, Trump was in bed waiting for 'Spongebob' to perform on the Tonys." /\MERICAi\ pVERSIGHT EXT-18-248-D-000099 Seth Meyers: "President Trump and North Korean leader Kim Jong-un met tonight in Singapore after we taped our show. So if you're watching this on TV right now, either it went well, or you have a TV in your fallout shelter." Seth Meyers: "Dennis Rodman arrived in Singapore today for the summit with Kim Jong-un. So at least if Kim launches a nuclear missile, Rodman will be there to grab the rebound." Conan O'Brien: "This past weekend, President Trump told reporters he'll know if the Kim Jong-un meeting is going well by 'touch and feel.' That 's what he said. In other words, Trump's lawyer is going to have to pay Kim Jongun $130,000." Conan O'Brien: "North Korean leader Kim Jong-un brought his own toilet to the summit /\MERICAi\ pVERSIGHT EXT-18-248-D-000100 in Singapore. When he saw the to ilet, President Trump said, 'Oh, so you're planning to tweet, too."' Conan O'Brien: "President Trump said that during the North Korea summit, he will not focus on human rights abuses. Trump said, 'My marriage is no one's business."' Trevor Noah: "White House staffers have reportedly been taping pieces of paper back together a~er President Trump rips them up. They need to tape them back together to comply with the President ial Records Act. According to Politico, the papers include letters and offic ial documents required by law to be preserved and sent to the National Arch ives .... President Trump's tearing up official documents? I mean, let's not act surprised. After all, he spent the last year tearing up the Constitution." Trevor Noah: "I don 't know why Trump rips up all his paper. My guess is to show off /\MERICAi\ pVERSIGHT EXT-18-248-D-000101 how strong he is. 'Would an unhealthy President be able to do this?!'" Trevor Noah: Trump said "he wants Russia to be we lcomed back into the G8. I don't know if Trump colluded with Russia, but if everyone was accusing me of colluding with Russia, I wou ldn't be caught dead mentioning their name. If your girlfriend accused you of cheat ing with Keisha, even if you didn't do it, shut up about Keisha, just shut up ." Trevor Noah: "Trump went into the G7 for a run-of-the-mill check-in with America's allies and came out full-on beefing with Canada, the Ned Flanders of countries ." Trevor Noah: "Emmanuel Macron called Trump incoherent, and Ange la Merkel said it is sober ing and depressing. She is German, so everything is sobering and depressing to her. She was at breakfast saying, 'I find th is pancake both sobering and depressing."' /\MERICAi\ pVERSIGHT EXT-18-248-D-000102 Copyright 2018 by Bulletin Intellig e nce LLC Reproduction or redistribution without permission prohibited. 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Sender: Bullet in Inte lligence Recipient: "HHS@bullet inintell igence.com " Sent Date: 20 18/06/ 12 07:30:10 Delivered Date: 2018/06/12 07:33:07 /\MERICAi\ pVERSIGHT EXT-18-248-D-000103 HHS NEWS BRIEFING PRODUCED BY BU LLETIN INTELLIGENCE WWW.BULLETININTELLIGENCE.COM/HHS TO: THE SECRETARY AND SENIOR STAFF DATE: TUESDAY, JUNE 12, 2018 7:30 AM EDT TODAY'S Leading the News CMS Unveils New Guidance To Help States Fight Opioid Epidemic .. ................................................3 Trump's Decision Not To Defend The ACA Could Be A Boon To Dems During The Midterms . .......4 The Secretary in the News Azar To Testify About Drug Prices Before Senate Panel Today .... ....................................................5 Trump Administration Meeting With Pharmaceutical Companies To Seek Voluntary Price Cuts . ........5 Opinion: Trump Can Use Patent Law To Slash Prices For Naloxone ............................................5 Donna Shalala Expresses Support For Single-Payer System Similar To The One Advocated By Bernie Sanders ................................................... 5 HHS in the News White House Wants HHS To Delay Issuing Final Rule On Religious , Moral Beliefs ........................ 5 Columnists Say Healthcare Will Be The Focus Of The Midterms Given Administration's Decision Not To Defend The ACA. ....................................5 Healthcare Groups Want CMS To Improve Reimbursement For Remote Patient Monitoring ............................................................6 Trump Administration Immigration Policy Examined. 6 Column: Redirecting Family Planning Funds Could Undercut STD Fight. ...........................................6 Whistleblower Lawsuit Against Signature Healthcare Reveals $244 Million Fraud ......... .....6 HHS Seeking Public Comment About How To Set Up A Workgroup To Encourage Innovation, Investment In Healthcare . ...................................6 Many American Toddlers Exceed Recommended Added Sugar Intake For Adults, Study Suggests ...... .......................................................6 CDC Data Reveal Severity Of Latest Flu Season ......? Ebola Vaccines Could Signal Hope In Congo As Outbreak Continues ............................................ 7 EDITION Laser Eye Surgery May Be Riskier Than Many People Think, Research Suggests ..................... 7 Anheuser-Busch Cancels Funding For NIH Alcohol Study ... ................................................................7 House To Vote On 34 Opioid Bills This Week ... ........8 Boston Globe Highlights Work Of Alzheimer 's Disease Researcher Focused On Preclinical Phase . .................................................................8 Northwestern University Researcher Interviewed About Participating In NIH All Of Us Research Program. ..............................................................8 Editorial: NCI Cancer lmmunotherapy Study Has Applications For New Pittsburgh Therapy Center ..................................................................8 House Panel Questions FDA's Efforts To Track Illegal Opioids ............ ............................... ...........8 Experts Describe Federal Efforts To Prevent Food borne Illnesses ............................................8 Federal Court Bars Mississippi Compounding Pharmacy From Making , Distr ibuting Drugs . ......9 Opioid Crisis Naloxone Use To Expand Among Police Departments, School Campuses In San Diego County ................................................................. 9 Former Sen. Bill Frist Highlights Cigna 's Efforts To End Opioid Epidemic ...........................................9 Mental Illness Word Choice May Be Indicative Of Depression , Studies Involving Linguistic Analysis Programs Suggest. .............................................................. 9 Prescription Drug Pricing Drugmaker Reboots Female Libido Drug At Half Price .................................................................... 9 Drug Pricing Advocates Condemn Democrats For Supporting Drug Industry . ...................................9 Health Care & Insurance Reform Dems, Who Once Shied Away From Healthcare, EXT-18-248-D-000104 Are Hoping The Issue Will Propel Them To Victory In The Midterms ..... .................................9 Trump 's Opposition To Parts Of New VA Healthcare Law May Endanger Its Implementation ... ......... 10 Experts Caution Against Use Of Cheaper Outpatient Surgical Centers ............................... ................. 10 Less Than 10% Of American Adults Get Recommended Preventive Healthcare, Study Indicates . .......................................... ................. 10 Cisco , Other Large US Employers Trying To Manage Workers ' Health To Control Costs .. .... 10 Opinion: Supreme Court Leaning In Favor Of ProLife Cause ..... ............ ........................................ 10 Midwest Has Fewest Abortion Clinics Per Woman Than Any Other Region, Study Indicates ..... .... 1O Air Ambulance Companies Leave Patients W ith High Bills ..... ..................................... ................. 11 Commentary Considers Health Reform . ............. ..... 11 Health & Medical News Young Women Get Less Exercise Than Young Men , Study Suggests . ....................................... 14 Research Explores Why People Get "Hangry ." ....... 15 Erectile Dysfunction May Be Linked To Increased Risk Of Heart Disease, Study Suggests ........... 15 Healthy Lifestyle Assoc iated With Improved Memory In O ld Age, Study Indicates . ............................. 15 Millennial Men And Women Invest Differently, PNC Survey Reveals . ................................................ 15 Morningstar Analyst Supports State-Sponsored Auto-Enrollment For Retirement Savings ........ . 15 Tallahassee Targeting Multigenerational Families To Increase Retiree Draw ......................... ........ 15 Ford Works On Self-Driving Delivery Service With Postmates .. ....................................................... 15 Experts Worried About Unproven Tesla Self-Driving Features . .......................................... ................. 16 Uber-Like Flight Hailing Service Skyryde Starts Service In Los Angeles ... .................................. 16 Researchers Create Virtual Reality Platform To Help Children Cope With Doctor's Appointment Anxiety ................................................. .............. 16 Feeding Children Honey After Swallowing A Small Battery Can Prevent Ser ious Injury, Study Suggests .. ........................ ................... .............. 16 Phys ician Advises Parents To Keep Kids Safe While Swimming ................................................ 16 Using Prophylact ic NSAIDs Before And After Cataract Surgery May Reduce Development Of Cystoid Macular Edema In Diabetic Patients, Study Suggests .... ............................... .............. 16 Young Surgeons Face High Debt , Financial Instability, Study Suggests ...... ............ .............. 16 Opinion: Retail Health Clinics Set The Stage For Today 's Mega -Mergers . .................................... 17 Tick Paralysis Strikes Five-Year -Old In Mississippi. 17 Red Cross Blood Drive Campaign Sees Major Brands Dropping A, B, and O From Their Names .................. ........................... .................. 17 KKR To Buy Envision Healthcare For $5.57 Billion . 17 Surgeons Use 3D-Printed Organs To Determine Best Way To Operate . ................ ...................... 17 Legacy Of Racism Hurting Health Of African Americans . .............................. .......................... 17 South Carolina Primary Vote To Gauge "Temperature " Of Electorate ............ ................. 17 Opinion : Phys ician-Ass isted Suicide "Can Never Be Medica l Care ." ......................... ............ ............. . 17 Amer ican Medical Association Votes To Keep Reviewing Its Guidance On Physician -Assisted Suicide ..................................... ............ .............. 17 Cherokee Hospita l Testing 186 Patients For HIV , Hepatitis After Nurse Reused Syringes . ........... 18 Louisiana Regulators Prepare For Expanded Medica l Marijuana Program .............................. 18 Human Services News Experts : Don't Let Social Security Solvency Fears Affect Claiming Decision ... .................. .............. 12 Ryan Making One Last Push To Overhaul TANF, SNAP Before He Retires From Congress . ....... 12 Jefferson County Decision To Forfeit Head Start Funding Resulted In The Loss Of Family Advocate Jobs .................................. ................. 12 CBP Commissioner Discusses Illegal Border Crossings During Interview . .............................. 13 Louisiana Child Care Program Improved Controls, Auditor Says .... ........... .................................. ..... 13 Food & Import Safety Opinion: Labeling Requirements Drive Up Costs For Consumers ... ........................... ............ .............. 13 Tyson To Recall 3, 120 Pounds Of Breaded Chicken Over Plastic Contamination . ............ ................. 13 Tennessee E. Coli Outbreak Leaves Six Children Hosp italized, Two In Serious Condition ... ......... 13 Arizona Family Awarded $1.95 Million In Foster Farms Salmonella Case ...................... .............. 13 Medicaid & CHIP Ohio Decides Not To Implement Five-Percent Cut To Medicaid Reimburse ment For Hospitals ..... 13 Nursing Homes , Ass isted-Living Facilities Suing Montana Over Medicaid Reimbursement Cuts.14 New Hampshire Substance Abuse, Menta l Health Treatment Providers Worried About Proposed Cuts To Medica id Reimbursement. .................. 14 Michigan Governor Signs Bill To Repeal , Replace Tax That Funds Medicaid . ................................ 14 Fate Of Medicaid Expansion In Maine May Depend On Outcome Of November Election For Governor. .......................................................... 14 2 EXT-18-248-D-000105 Physician Offers Advice About Genetic Screening For Pregnant Women ........................................ 18 Guided Nanospears Can Administer Genetic Therapies Targeting Cancer , Researchers Say.18 US Adults With Hyperte nsion Incur Nearly $2 ,000 More In Annual Healthcare Costs , Study Indicates ................................ ............................ 18 Lonelines s May Cause Premature Death By Damaging Heart , Research Suggests . ............. 18 CRISPR-Cas9 May Increase Cancer Risk In Cells , Research Suggests ........................................... 18 Congressional Action On Marijuana Could Potentially Lead To Studies On Benefits Of Medical Marijuana For Cancer Patients ............ 18 Genetic Test For Prostate Cancer Can Identify Individuals Who Have A Higher Risk Of Develop ing The Disease , Researchers Say ..... 19 Rhode Island Nursing Homes Decry State Budget Cut That Would Lead To Layoffs , Closures ...... 19 THCA ~~unds Alarm Over Texas' LTC Staffing Cns,s ................... .............................................. 19 Despite Prevent ion Efforts, South Dakota's STD Rates Rising ..... ................................................. 19 Pennsylvania, Nation Losing Fight Aga inst Lyme Disease ...... ....................................................... 19 Epidemiologists Predict California Will See Another Cycle Of Pertussis Cases ................... .............. 20 Cost Of Kansas City's Measles Outbreaks Exceeded $170,000 ...... ....................................20 Stryker Reportedly Eyeing Boston Scientific For Takeover. ..........................................................20 Juvenescence Takes Stake In Company Generating Cell-Based Therap ies For Age-Related Diseases ............................................................20 Experts Push For "Medicalized Approach" To Suicide Prevention ............................................ 20 Opinion: Ending The Stigma Is The Key To Suicide Prevention ......................................................... 20 Oral Migraine Drug Succeeds In Study , Manufacturer Says . ...........................................20 Layoffs A Symptom Of A Deeper Problem With . IBM's Watson Health, Former Employees Say.20 Children Exposed To Cigarette Smoke Have Higher Risk Of Hearing Loss, Research Indicates ....... 21 Studies Link Abdominal Fat To Increased Rates Of Coronary Heart Disease, Increased Risk For Cancer, And Risk Of Developing Dementia Decades Later ...................................................21 Experts Release Blueprint For Improving End-OfLife Care ............................................................ 21 Global Health Rollout Of HIV Prevention Drug Tied To Reduction In Condom Use Among Men Who Have Sex With Men In Australia, Study Suggests . ...........21 HIV/A IDS Epidemic Getting Worse In Russia .......... 21 " " National News Trump , Kim Pledge "Comp lete Denuclearization " After Historic Summit. .......................................22 Trump To Hold Rally In MN8 Next Week ... ..............24 Trump Hails High Court Ruling Allowing Ohio To Drop Inactive Voters From Rolls ...... .................25 Trump-Recruited GOP Candidate Frustrated By Trump 's "Affinity" For Heitkamp . .......................26 Obama Meeting With Potential 2020 Democratic Presidential Candidates .................................... 26 New D'Souza Film Compares Anti-Trump "Resistance" To Democrats' Opposition To Lincoln ............................................................... 26 Trump Highlights Good Economic News . ................27 Pai: Expiration Of Net Neutrality Means A Return To Clinton-Era Framework ..................................... 27 Pentagon Officials Distance Themselves From LGBT Pride Month Observances ...................... 27 Biden Heckled During Book Tour Stop In Delaware.27 Poll: Scott "Dominating" Nelson Among Florida Voters 50 And Older .......................................... 27 McClatchy Analysis: Sanford Fighting For Political Life In SC1 GOP Primary ..................................27 In AL2 , Rouby Faces Runoff Amid Questions About Her Loyalty To Trump ... ....................................28 Democrats Consulting With Hollywood Ahead Of Midterms ............................................................ 28 Democrats Hope Anti-Trump Sentiment Will Help Unseat Comstock ..............................................28 Female Gubernatorial Candidates Say They Face Resistance To Female Executive Power . .........28 Bill Clinton: Norms Of "What You Can Do To Someone Against Her Will" Have Changed . ....28 Broadway Veterans, Trump Critics Struggle With De Niro's Tony Comments .... .................................29 Twitter CEO Draws Fire For Chick-Fil-A Post During Pride Month ...... .................................................29 Editorial Wrap-Up New York Times .............. .................................. .......29 Washington Post. ......................................................29 Wall Street Journal. .................................................. 29 The Big Picture Headlines From Today 's Front Pages ......................30 Last Laughs Late Night Political Humor ........................................ 31 3 T Rift Valley Fever Kills Five In Kenya , Official Says . .21 British Authorities Seize Mother's Cannabis-Based Medication For Son W ith Epilepsy, Prompting Stand-Off ........................................................... 21 Opinion: Chinese Communist Leaders Must Be Held Accountable For Human Rights Violations ...........................................................21 National Register In Australia Could Curb Financial Abuse Of Elders . ...............................................22 EXT-18-248-D-000106 Health Exec (6/11, Leider) also covers the story. CMS Says States Can Use Federal Funding To Make IT Improvements To Better Address Opioid Crisis. Fierce Healthcare (6/11, Sweeney, 146K) reports, "Federal funding is available to state Medicaid programs to enhance the use of technology to help states manage the opioid crisis, according to new guidance from" CMS. According to the agency, a lot of "funding is already available through existing legislation." CMS is also urging "Medicaid program directors to use telehealth and telepsychiatry to coordinate care for patients with substance abuse disorder." Tim Hill, acting director of the Center for Medicaid and CHIP Services, told Medicaid directors that "CMS doesn't need to approve telehealth coverage changes for opioid treatment unless the state elects to cover telehealth encounters differently than in-person visits." LEADING THE NEWS CMS Unveils New Guidance To Help States Fight Opioid Epidemic. The Hill (6/11, Roubein, 2.71 M) reports that on Monday, CMS unveiled "guidance aimed at helping states leverage Medicaid to combat the opioid epidemic." The article says "the guidance focused on information related to covering services for infants born exposed to opioids and how to enhance federal funding for telemedicine and programs that keep tabs on patients' prescriptions." HHS Secretary Alex Azar stated, "The number of American infants born dependent on opioids each day is heartbreaking .... Today's announcement reflects the Trump Administration and HHS's commitment to helping states use Medicaid to support treatment for this condition and other challenges produced by our country's crisis of opioid addiction ." Fierce Healthcare (6/11, Stankiewicz, 146K) reports that the new guidance "includes summaries of different treatment modalities including hospital and home-based services, a~ well as ways Medicaid can support parents with substance abuse disorder." The agency "said states can create bundled rates for such services instead of the traditional fee-for-service model.' Tim Hill, acting director of the Center for Medicaid and CHIP Services, is quoted as saying, ''Through discussions with states, we have recognized their growing challenge in providing treatment services to the expanding number of infants with NAS [neonatal abstinence syndrome] . ... We have also recognized that states may not be fully aware of available options under Medicaid that can play a critical role in the care of these infants, as well as the limitations on Medicaid coverage." Healthcare Finance News (6/11, Morse, 93K) reports that so far, "CMS has approved substance use disorder related section 1115 demonstration projects in Louisiana, West Virginia, Indiana, New Jersey, Kentucky, Utah, Illinois, and Vermont to improve access to treatment for Medicaid beneficiaries." The article adds that Hill also said "By leveraging and improving the technological capabilities of state Medicaid programs, we are providing Medicaid agencies, providers, and patients with the tools they need to improve health outcomes associated with addiction." Trump's Decision Not To Defend The ACA Could Be A Boon To Dems During The Midterms. On its website CNN (6/8, Merica, 82.6M) reports that the Trump Administration's move to refuse "to defend key provisions of the Affordable Care Act could deal Democrats a sizable win going into the midterm elections, handing a party already prepared to run on health care a cudgel to use against vulnerable Republicans." Several polls show voters consider healthcare the top issue in the midterms, "and Democratic candidates have responded by making it the cornerstone of their attacks on Republicans." The article adds that last week , the Administration "clearly outlined" its stance "on key - and popular - provisions in the Affordable Care Act, telling a court that the law should be invalidated and that the individual mandate is unconstitutional." The Justice Department also argued "in favor of invalidating protections for" people with pre-existing conditions. Fortune (6/ 11, Mukherjee, 3.91M) reports that the Administration's decision "could wind up being a political gift to Democrats in the 2018 mid-term elections, as it targets one of Obamacare's single most popular provisions." The article says the Administration is hoping the "courts will ultimately dismantle these Obamacare tenets ," and its support of this suit against the ACA is an effort to hasten the process . However, "it could prove a 1 ' 4 T " " EXT-18-248-D-000107 political land mine (and boon to Democrats) going into the 2018 mid-term elections, if polling and recent campaigns are any indication." Politico (6/11, Diamond, 3.51 M) reports that over the weekend, Democrats "seized" on the Administration's "move to revive their charge that the GOP can't be trusted to protect Americans' health insurance." Meanwhile, "few congressional Republicans rushed to defend the administration's move, instead emphasizing their support for preserving pre-existing condition protections." The Daily Intelligencer (NY) (6/11, Levitz, 551K) reports that the Administration move is against the GOP's "political interests." The article says "Democratic consultants are cheering" the Administration's decision . The piece adds that Democrats' "No. 1 strategic objective has been to force health care to the front of voters' minds both to exploit the party's advantage on that issue, and to undermine public support for the Trump tax cuts by reminding voters that the GOP always intended to pay for its regressive giveaway with cuts to Medicaid and Obamacare ." Kaiser Health News (6/11, Bartolone) reports that on Friday, California Attorney General Xavier Becerra vowed "to redouble his efforts as the Affordable Care Act's leading defender, saying attacks by the Trump Administration threaten health care for millions of Americans." He argued that the Administration's decision is, "simply put, an attack on the health care that millions of Americans have come to count on, and California, being the most successful state in implementing the Affordable Care Act, stands to lose perhaps more than anyone else." Commentary. Contributor Bruce Japsen writes in a Forbes (6/11, 10.34M) piece that physicians' groups "are once again rallying to the defense of the Affordable Care Act after the U.S. Justice Department filed a brief that doesn't defend the law's popular protections for patients with preexisting conditions." During "the American Medical Association annual meeting this week, doctors are discussing numerous ways to protect patients, updating its lobbying agenda to include ways to support the ACA." Japsen says groups such as the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American Psychiatric Association also criticized the Administration, saying, 'The elimination of these protections could result in millions of people facing limited access to health care coverage and higher cost as a result of insurers being allowed to return to discriminatory coverage and pricing practices." Sarah Kliff writes in a Vox (6/11, 1.66M) piece that President Trump and the GOP are so intent on "killing Obamacare they've decided, just months before the midterm elections, to take aim at the most popular part of the law: coverage for preexisting conditions." Kliff says the suit "is, in some ways, a perplexing move mere months before midterm elections. Polling finds that both Democrats and Republicans think it's a good idea to ensure that sick people have access to health insurance." Yuval Rosenberg writes in the Fiscal Times (6/11, 7K) that the Trump Administration's decision to not defend the ACA is "political dynamite" because polls show the protections for pre-existing conditions are popular and may affect as many as 52 million non-elderly Americans. Rosenberg adds, "Democrats, who have already been hammering a health care message, are pouncing at the new opportunity." THE SECRETARY IN THE NEWS Azar To Testify About Drug Prices Before Senate Panel Today. In a news roundup, Politico (6/11, Pittman, 3.51M) reports HHS Secretary Alex Azar on Tuesday "will defend the Trump administration's plan to lower the cost of medicines" before the Senate Health, Education, Labor, and Pensions Committee. Politico reports lawmakers are expected to "to try to pin down Azar on aspects that were lacking when the administration rolled out its blueprint last month," noting that "Inside Health Policy reported last week the administration would soon announce that drug companies will lower their asking price on insulin." The C-SPAN Video Library (6/12, 28K) posts a feed for Secretary Azar's scheduled testimony before the HELP Committee. Trump Administration Meeting With Pharmaceutical Companies To Seek Voluntary Price Cuts. The Hill (6/11, Sullivan, 2.71 M) reports officials from the Department of Health and Human Services have been meeting with pharmaceutical companies to "seek voluntary cuts in drug prices." The Hill adds, "Voluntary cuts in prices would allow the administration to immediately tout benefits of President Trump's drug pricing plan, which was 5 EXT-18-248-D-000108 announced last month, rather than having to wait for any regulatory actions to be put forward and take effect." An HHS spokesperson said Monday when asked for comment, "We are working with stakeholders across the spectrum including drug companies, [pharmacy benefit managers], distributors, patients, health care professionals, physicians, insurers, etc., to respond to President Trump's call to action and help patients pay less for their prescription drugs." HHS Secretary Alex Az.ar hinted at such talks last month, saying, "We look forward to working with industry to build a better drug-pricing system." HHS IN THE NEWS White House Wants HHS To Delay Issuing Final Rule On Religious, Moral Beliefs. Modern Healthcare (6/11, Dickson, Subscription Publication, 239K) reports that the White House wants HHS to delay issuing a final "rule that will require hospitals and physician practices to create standards and procedures to protect their employees' religious and moral beliefs until it can elaborate how the policy will affect the industry." The department "received more than 72,000 comments on the rulemaking before the March deadline," and it "is still drafting a final version of the rule, but proactively asked the Office of Management and Budget to allow it to confirm that providers were both complying with the rule and notifying staff and patients of their rights." The article says 0MB denied HHS requests because the department "did not provide industry comments on how these changes would affect their business," and it failed to "provide 0MB with adequate estimates of the time it would take providers to implement the rule." Opinion: Trump Can Use Patent Law To Slash Prices For Naloxone. In an oped for the Washington Post (6/11, 15.68M), Public Citizen president Robert Weissman and Baltimore City Health Commissioner Leana Wen write that since President Trump declared the opioid crisis a public health emergency, "he and his administration have yet to take the steps that would help those fighting the epidemic on the front lines." Weissman and Wen call on the President to "use existing legal authority to slash prices for the lifesaving drug naloxone ...and for its easy-touse, patented delivery devices." They note that during the post-Sept. 11 anthrax scare, "amid public debate about employing government-use authority, then-Secretary of Health and Human Services Tommy Thompson demanded that the ciprofloxacin patent holder, Bayer, match the price of generic makers." They argue that the Administration "can choose to lower prices and save lives" or "perpetuate the rationing of lifesaving treatments." Columnists Say Healthcare Will Be The Focus Of The Midterms Given Administration's Decision Not To Defend The ACA. Former Acting CMS Administrator Andy Slavitt and Nicholas Bagley, a law professor at the University of Michigan and a former Justice Department attorney, write in a USA Today (6/11, 11.4M) column that President Trump and the GOP "just put America's health care squarely on the November ballot." Following their failure to repeal the ACA, "the Trump administration, in cahoots with 20 conservative states, has asked the courts to strike down several pillars of the ACA - including its protections for Americans with pre-existing health conditions." Slavitt and Bagley add, "Nothing has defined the domestic agenda over the 18 months like health care. It's only fitting that it will define the election too." Donna Shalala Expresses Support For Single-Payer System Similar To The One Advocated By Bernie Sanders. Colby ltkowitz writes in the Washington Post (6/11, 15.68M) "Power Post" blog that during her tenure as HHS Secretary under President Clinton, "Donna Shalala fended off accusations that she was too liberal for the job . Now, as a candidate for Congress in a competitive Democratic primary, the former secretary must dust off her old progressive bona fides." In the past, Shalala insisted that a single-payer system was not feasible. Now, however, "Shalala says she supports universal health care under a Bernie Sanders-style system that isn't too different than 'Medicare for All."' Healthcare Groups Want CMS To Improve Reimbursement For Remote Patient Monitoring. mHealth Intelligence (6/11, Wicklund) reports that on Monday, nearly 50 healthcare organizations and vendors which "are lobbying the Centers for Medicare & Medicaid Services to improve reimbursement opportunities 6 EXT-18-248-D-000109 for remote patient monitoring" wrote to CMS Administrator Seema Verma. The groups want "CMS to modify and add Current Procedural Terminology (CPT) codes that would enable Medicare reimbursement of mobile health programs that collect patient-generated health data in the home." Column: Redirecting Family Planning Funds Could Undercut STD Fight. Michelle Andrews writes for the Washington Post (6/12, 15.68M) that a Trump Administration effort to shift family planning funding "could cripple other federal efforts to curb an explosion in sexually transmitted diseases (STDs), some public health officials fear." The Department of Health and Human Services has proposed changes to Title X rules that, "if adopted in their current form, would require that Title X services be physically and financially separate from abortion services" and could push some medical practice to "choose not to prescribe birth control pills or other Food and Drug Administration-approved methods of contraception." Trump Administration Immigration Policy Examined. Vox (6/11, Lind, 1.66M) features an article which explains the Trump Administration's immigration policy. Vox examines how the government is separating families at the border, how many families are being separated, the policy behind the separations, and what happens to the children. The piece says that under federal law, "unaccompanied alien children are sent into the custody of the Office of Refugee Resettlement, which is part of the Department of Health and Human Services. The ORR is responsible for identifying and screening the nearest relative or family friend living in the US to whom the child can be released." Opinion: Trump Administration's "Zero Tolerance" Policy Is "Cruel And UnAmerican." Arizona Republic (6/11, 1.21M) columnist EJ Mantini writes that the Trump Administration's "zero tolerance" immigration policy "is cruel and un-American," and discusses the many children being separated from their parents at the border. Mantini says, "After the cruelty of the current policy got some public attention, Homeland Security is said to have established a hotline through which confused, despairing arrested parents might be able to locate their children. Perhaps the department could set up another hotline to help the administration locate its humanity." Opinion: Trump's Immigration Policy Is "Completely Impractical." Dyana Mason, Assistant Professor of Planning, Public Policy and Management at the University of Oregon, writes in the Conversation (US) (6/11, 98K) that many of the immigrant children being "deliberately" separated from their parents at the border "are under the age of 4 and are infants." Mason adds, "When I researched this largely hidden aspect of immigration policy, I found little evidence that this patchwork system can absorb what promises to be an influx of thousands more children. And I have no doubt that forcibly separating kids from their families is completely impractical and bound to make a bad situation worse." Whistleblower Lawsuit Against Signature Healthcare Reveals $244 The Tennessean (6/11, Million Fraud. Kelman, 513K) reports on a whistleblower lawsuit filed against Signature Healthcare in which the provider was accused "of artificially inflating therapy time to maximize profits." The lawsuit "prompted Signature to sign a $30 million settlement to resolve the claims," but federal prosecutors in that settlement "say the total fraud was much larger - about $244 million." The piece quotes HHS Office of Inspector General special agent Derrick L. Jackson as saying, "Signature was charged with illegally boosting profits by providing excessive amounts of therapy to patients whether they needed it or not. ... The decision to provide therapy should never be based on corporate financial considerations rather than a patient's medical needs." HHS Seeking Public Comment About How To Set Up A Workgroup To Encourage Innovation, Investment In In continuing coverage, Healthcare. ExecutiveGov (6/11, Crews) reports that HHS is seeking "comments on how to structure a workgroup to facilitate high-level discussions between HHS leaders and outside parties that support innovation or invest in the healthcare sector." A notice posted in the Federal Register last week said HHS intends "to create a workgroup to explore technological approaches to address healthcare challenges and drive communication activities meant to encourage industry competition." 7 EXT-18-248-D-000110 Republic of Congo are offering a vaccine to impacted and at-risk populations, drawing international attention as onlookers wait "to see if a promising but still experimental vaccine might help stop this terrifying disease faster than traditional measures doctors have tried since Ebola was identified 40 years ago." However, even if it is effective, "there are serious hurdles" including logistical issues and gaining community trust. The article quotes CDC Ebola expert Dr. Pierre Rollin as saying, "People die every day and everywhere but nobody's interested. Suddenly because of Ebola people are interested and that makes you suspicious. ... Why would they trust us?" STAT (6/11, Branswell, 27K) reports some experts "have watched with frustration the snail's pace progress of the efforts to study Ebola drugs during outbreaks," and many "are beginning to wonder if, with the advent of Ebola vaccines, the window for doing this kind of research may be closing for good." The piece says that within the scientific community, "There remain deeply divergent positions...about how to design outbreak trials," noting that "generating the human efficacy data that regulatory agencies like the Food and Drug Administration look for has been almost impossible." Op-Ed: Trump's Reversal On Ebola Funding Cut Is Welcome News For Disease Prevention, Treatment Efforts. K. Riva Levinson, president and CEO of KRL International LLC, writes in The Hill (6/11, 2.71 M) that President Trump has deviated from his 2014 Twitter statements that America "cannot allow EBOLA infected people back" by electing to reinstate the $252 million he had previously rescinded from the International Disaster Assistance account. She says this will help the international community address issues that actors learned from the 2014 Ebola outbreak, during which the National Institute of Health assisted in leading response efforts. Many American Toddlers Exceed Recommended Added Sugar Intake For Adults, Study Suggests. USA Today (6/11, Carrig, 11.4M) reports a study by researchers at the Centers for Disease Control and Prevention suggests toddlers are consuming too much added sugar, with many actually exceeding adult recommendations. Investigators said that consuming foods with added sugar at such an early age can affect food preferences later in life. Lead study author Kirsten Herrick, a nutritional epidemiologist at the CDC , said, "Once kids start eating table food, they're often eating the same types of foods that Mom and Dad have in their diet, and other research has demonstrated that adults exceed recommendations for added sugar too." Newsweek (6/11, 2.18M) reports the study suggests "99% of children aged between 19 to 23 months eat over seven teaspoons of added sugar each day on average." Also, results indicate that non-Hispanic black children aged between 12 to 23 months ate the most sugar, "while white children ate the least." Researchers analyzed "data from more than 800 infants and toddlers, aged between six and 23 months old, who took part in the National Health and Nutrition Examination Survey between 2011 and 2014." The findings were presented "at Nutrition 2018, the annual meeting of the American Society for Nutrition held in Boston." CDC Data Reveal Severity Of Latest Flu Season. The Pittsburgh Post-Gazette (6/11, Daly, 507K) reports new data from the CDC show that this past flu season killed 172 children "one more than the high set in 2012-13." According to the CDC , "about 80 percent of this season's pediatric deaths were in children who had not received a flu shot," the piece says, adding that local health officials experienced high rates of flu cases, hospitalizations, and deaths. The Scientist (6/11, Charuchandra, 153K) reports Daniel Jernigan, head of the CDC's flu division, said the flu season was "bad across the population" and that it "was happening to everyone, and it seemed to be happening everywhere." Laser Eye Surgery May Be Riskier Than Many People Think, Research Suggests. The New York Times (6/11, Rabin, Subscription Publication, 19.33M) reports "roughly 9.5 million Americans have had laser eye surgery, lured by the promise of a quick fix ridding them of nettlesome glasses and contact lenses," but "serious questions remain about both the shortand long-term risks and the complications of this Ebola Vaccines Could Signal Hope In Congo As Outbreak Continues. The AP (6/11, Mednick, Neergaard) reports health workers tackling the Ebola crisis in the Democratic 8 EXT-18-248-D-000111 increasingly common procedure." The article highlights a trial conducted by the Food and Drug Administration, the National Eye Institute, and the Navy Refractive Surgery Center finding that "people who did not have dry eyes or visual aberrations before Lasik were at high risk for developing these problems." Research suggests "28 percent of these participants developed dry eyes after surgery, and 45 percent reported a new visual aberration three months after surgery." Dr. Malvina Eydelman, the study's lead author and the director of the FDA's Center for Devices and Radiological Health's division of ophthalmic and ear, nose and throat devices, "said the researchers had concluded that the multimillion dollar trial was too small to produce meaningful results, and that the purpose of the study had shifted from determining how many patients have problems functioning to developing a questionnaire that might be used in future research." drugs and hinder drug research." National Institute on Drug Abuse Director Nora Volkow testified in April, "We need to have countermeasures, and the only way that we're going to have countermeasures is [by] doing research." CQ reports that the House will vote Thursday on a bill to help prevent the importation of synthetic opioids, but a rival bill in the Senate "would impose stricter requirements on" the US Postal Service and Customs and Border Protection "than the original House bill." The Washington Times (6/11, Howell, 460K) reports that notable bills include Jessie's Law, which "orders the Health and Human Services Department to come up with best practices for hospitals and physicians to share the information" on consenting patient's record of drug addiction before prescribing treatment. Boston Globe Highlights Work Of Alzheimer's Disease Researcher Focused On Preclinical Phase. In an Anheuser-Busch Cancels Funding For NIH Alcohol Study. The Scientist (6/11, over 2,800 word article, the Boston Globe (6/11, Kendall, 945K) highlights the work of Reisa Sperling, "one of the world's foremost researchers of Alzheimer's disease," who leads Brigham and Women's Hospital's Center for Alzheimer's Research and Treatment. Sperling's work focuses on the preclinical phase of Alzheimer's disease with the aim of better understanding the early stages of the disease "before significant memory problems set in." The article mentions that the National Institute on Aging has awarded a fiveyear $70 million grant to Sperling and her colleagues to "build a research infrastructure called the Alzheimer's Clinical Trials Consortium, a network of 35 testing sites at academic medical centers across the country." Laurie Ryan, the leader of dementia research at the National Institute on Aging's Division of Neuroscience, said, "This should be a game changer." Williams, 153K) reports Anheuser-Busch InBev announced on Friday that it no longer plans to assist in funding the National Institutes of Health's "study on the effects of moderate alcohol consumption," withdrawing its $15 million funding commitment. The piece says scientists with the National Institute of Alcohol Abuse , which is leading the $100 million study, "met with industry leaders and 'gave talks strongly suggesting that the study's results would endorse moderate drinking as healthy,"' according to the New York Times. The piece adds that NIH Director Francis Collins "announced that the agency was reviewing the process around funding for the trial and would determine whether it should proceed, and that enrollment had been suspended for the time being." House To Vote On 34 Opioid Bills This Week. Congressional Quarterly (6/11, Raman, Northwestern University Researcher Interviewed About Participating In NIH All Of Us Research Program. The Subscription Publication) reports that on Tuesday the House "will begin a voting marathon on 34 bills designed to address the opioid epidemic," and while most are unlikely contentious, "two bills have previously stirred controversy." One bill set for a Friday vote "would create a new class on the controlled substances schedule for compounds related to fentanyl" and ease related prosecutions, but critics warn it could justify "broad bans on Chicago Tribune (6/11, Schencker , 2.37M) reports on an interview with Northwestern University research assistant professor Joyce Ho, who discussed the university's role in the All of Us Research Program, noting that the Illinois Precision Medicine Consortium - of which the university is a member - "has received $51 million from the National Institutes of Health to gather 9 EXT-18-248-D-000112 data and samples from 93 ,000 volunteers over the next five years." Ho examined prec1s1on medicine's comprehensive approach to analyzing health, how the program will work, and its potential implications for the future of medical treatment. Editorial: NCI Cancer lmmunotherapy Study Has Applications For New Pittsburgh Therapy Center. In an editorial, the Pittsburgh Post-Gazette (6/12 , 507K) applauds the findings of a recent study led by National Cancer Institute researcher Steven A. Rosenberg which showed "success in using a type of immunotherapy to treat metastatic breast cancer in a Florida woman ." The Post-Gazette heralds the findings as the kind "of lifesaving (breakthrough] that could be possible at a new immunotherapy center planned for Pittsburgh" called the UPMC Immune Transplant and Therapy Center. The editorial says NCI researchers identified some of the woman's "immune cells that seemed able to fight the cancer, multiplied them and infused them into her." Rosenberg is quoted as saying, "All cancers have mutations, and that's what we're attacking with this immunotherapy . ... It is ironic that the very mutations that cause the cancer may prove to be the best targets to treat the cancer." foods, explained that with an outbreak, the task of sourcing breakouts is akin to an incomplete puzzle, saying, "the product that was consumed is no longer available to test and that makes it so much more difficult, even if we can trace it back through supply chain." The article notes that the "FDA conducted about 156,000 food-safety inspections across the country between 2010 and 2017, " pointing out labeling gaps and that "insect, bird or vermin contamination was the most common critical deficiency." Federal Court Bars Mississippi Compounding Pharmacy From Making, Distributing Drugs. The Jackson (MS) Clarion Ledger (6/11, 287K) reports that the Justice Department announced that a federal court has barred a compounding pharmacy, Delta Pharma Inc in Ridley, Mississippi, and two of its officers from distributing adulterated drugs under a consent decree . The defendants cannot manufacture, hold, or distribute drugs until the FDA notifies them in writing that "they appear to be in compliance with ...specific remedial measures." Last year, the FDA uncovered "numerous unsanitary conditions" during an inspection, prompting the legal case. The Washingto n Times (6/11 , Mordock, 460K) reports the FDA inspectors "noted numerous unsanitary practices including using tubes that may not have been sterilized to process drugs" and "did not take steps to ensure chemicals or particles from the tubes would contaminate the medicines, according to court documents." House Panel Questions FDA's Efforts To Track Illegal Opioids. Reuters (6/11, Lynch) reports members of the House Energy and Commerce Committee sent a letter to Food and Drug Administrator Scott Gottlieb questioning whether the agency was "doing enough to stop the flow of illegal drugs" into the US as the nation battles the opioid epidemic. Republican Chairman Greg Walden (OR) and ranking Democrat Frank Pallone (NJ) wrote , "We have concerns about whether the FDA is appropriately devoting its resources to prioritize these efforts against unapproved opioids." FDA spokeswoman Lyndsay Meyer confirmed the agency received the letter and planned to respond. OPIOID CRISIS Naloxone Use To Expand Among Police Departments, School Campuses In San Diego County. The San Diego Union-Tribune (6/7, Hernandez, 664K) reports that "almost all police departments in" San Diego County "intend to supply their officers with naloxone, including the police forces for some universities and colleges," amid "efforts to prevent opioid overdose deaths." The article spotlights police departments in San Diego County that have "stocked up on naloxone in the past year," and notes that "the drug is available to school resource officers" at some schools. Experts Describe Federal Efforts To The Prevent Foodborne Illnesses. Poughkeepsie (NY) Journal (6/11, Robinson, 111 K) interviewed federal regulators and foodsafety experts and surveyed public health data in an ongoing investigation of foodborne illness. Dr. Stephen Ostroff, FDA deputy commissioner for 10 EXT-18-248-D-000113 agreement acknowledging the risk of drinking while taking the drug." Former Sen. Bill Frist Highlights Cigna's Efforts To End Opioid Epidemic. In an op-ed in The Tennessean Drug Pricing Advocates Condemn Democrats For Supporting Drug Industry. STAT Plus (6/11, Mershon, (6/11, 513K), Bill Frist, a former Senate majority leader in Middle Tennessee , states that "private sector health insurers ...have a role to play" in ending the opioid epidemic, highlighting Cigna as "a company that is demonstrating real leadership" in this effort. Frist states Cigna "recently announced that it achieved a 25% reduction in opioid use among its customers," and "the gains were achieved through collaboration with 1.1 million prescribing clinicians using an integrated analysis of pharmacy, medical, and mental health benefits to personalize the level of customer care." Frist says that it is also necessary to educate physicians on "non-addictive alternatives to manage pain," change "federal reimbursement rates that incentivize opioid prescribing over nonaddictive alternatives," make it easier for people to access and afford addiction rehabilitation and mental health treatment , and facilitate treatment for people who have active addictions. Subscription Publication, 27K) reports 50 congressional Democrats endorsed a letter which a drug pricing advocacy group, Patients for Affordable Drugs, claims advances the pharmaceutical industry's "talking points." The advocacy group responded by letter Monday to House Speaker Paul Ryan, Minority Leader Nancy Pelosi, and the 50 Democrats "condemning" their support for changing the "financial liability in the so-called 'donut hole,"' which is one of the industry's "chief lobbying priorities." HEALTH CARE REFORM & INSURANCE Dems, Who Once Shied Away From Healthcare, Are Hoping The Issue Will Propel Them To Victory In The Midterms. The Los Angeles Times (6/11, MENTAL ILLNESS Word Choice May Be Indicative Of Depression, Studies Involving Linguistic Analysis Programs Suggest. The Wall Street Journal (6/11, Barabak, 4.03M) reports that for years, Democrats have been shying away from the issue of healthcare "as though it were a heap of flaming rubble, which, politically speaking, it was." They lost control of Congress after the ACA was passed. But new polls indicate support for the ACA is "increasing as it becomes more imperiled, and the result has been a political sea change ." The article says criticism of "GOP repeal efforts has emboldened Democrats, who think they can seize back the House, dramatically expand coverage and turn healthcare from an albatross to an advantage even in red states like Idaho, with the help of Republicans like Christy Perry." Bernstein, Subscription Publication, 6.13M) reports that according to certain linguistic analysis programs, particular words may indicate someone is suffering from depression, based on findings from several studies published in psychological journals . PRESCRIPTION DRUG PRICING Drugmaker Reboots Female Libido Drug At Half Price. Bloomberg News (6/11, Trump's Opposition To Parts Of New VA Healthcare Law May Endanger Its Implementation. Joe Davidson writes in the Koons, 4.46M) reports Sprout Pharmaceuticals is relaunching its drug, Addyi, the "first-ever" FDA "approved drug for low libido in women," at a price point that is half of what it once was. Bloomberg points out that the price cut is "a rare step" in the industry, as "drugs typically go up in price on an annual basis, sometimes even twice a year." The "prescription carries a boxed warning" that requires women taking Addyi "to sign an Washington Post (6/11, 15.68M) "Power Post" blog that President Trump said he was "very happy" to sign the VA Mission Act, which seeks to improve veterans' healthcare. Since then, however, Trump has expressed dissatisfaction with portions of the law, and the Administration has "sent Congress a memo outlining objections 11 EXT-18-248-D-000114 use." The study was published online June 4 in Health Affairs. to proposed funding measures for the new program." According to a top Democrat, these "objections could lead the Department of Veterans Affairs to 'cannibalize itself."' Davidson adds that the new law includes "sweeping, historic changes," as Trump said, yet "how the job gets done is now open to question because of the signing statement Trump issued after his Rose Garden statement and the administration's opposition to certain funding measures." Cisco, Other Large US Employers Trying To Manage Workers' Health To Control Costs. Reuters (6/11, Humer) reports that Cisco Systems, Inc. is among "a handful of large American employers who are getting more deeply involved in managing their workers' health instead of looking to insurers to do it." Last year, the company "began offering its employees a plan it negotiated directly with nearby Stanford Health medical system," and a clinic is located at Cisco's San Jose campus . Reuters adds that other large companies, such as Amazon.com Inc., JPMorgan Chase & Co., and Berkshire Hathaway Inc. are "closely watching" whether these efforts pay off. Experts Caution Against Use Of Cheaper Outpatient Surgical Centers. Dr. Dhruv Khullar and Austin Frakt, director of the Partnered Evidence-Based Policy Resource Center at the VA Boston Healthcare System, write in the New York Times (6/11, Subscription Publication, 19.33M) "The Upshot" blog that while "cost variation across care settings has led policymakers to consider paying more evenly for medical services regardless of where they're delivered, and to shift care from expensive, highintensity settings to cheaper, low-intensity ones," a study of Medicare hospitalizations "found that almost all patients are more likely to survive at teaching hospitals, which tend to be more expensive." Khullar and Frakt explain that "sometimes more is more." Outpatient surgical centers do not always have the resources and staff needed to handle potential complications, and teaching hospitals have more advanced technologies, "subspecialty expertise, more clinicians involved in care, and greater availability of ancillary services." Additionally , "research suggests that hospitals that spend more and do more may have better patient outcomes and lower mortality rates." Opinion: Supreme Court Leaning In Favor Of Pro-Life Cause. Father Frank Pavone, national director of Priests for Life, writes in an analysis for the Washington Examiner (6/11, 340K) that two recent Supreme Court actions "indicate there are winds blowing in favor of the pro-life cause." On May 29, the Court "declined to hear a case that sought to overturn an Arkansas law on chemical abortion" which "requires abortion providers to have contracts with physicians who have hospital admitting privileges." On June 4, "the justices unanimously vacated an order of the U.S. Court of Appeals for the D.C. Circuit that had allowed a pregnant, undocumented minor in federal custody to have an abortion back in October." Midwest Has Fewest Abortion Clinics Per Woman Than Any Other Region, Study Indicates. The Chicago Tribune (6/7, Less Than 10% Of American Adults Get Recommended Preventive Healthcare, Study Indicates. Reuters Lourgas, 2.37M) reports a new study published in the Journal of Medical Internet Research found that the Midwest has fewer abortion clinics than any other region in the United States based on the population of women of child-bearing age. According to the article, "Illinois - often referred to as an oasis for abortion care in the middle of the country - had an estimated 25 clinics, roughly one for every 120,135 women of reproductive age. In neighboring Wisconsin, by comparison, researchers found three facilities providing abortions, about one for every 423,590 women ." (6/11, Lehman) reports that according to a new study surveying nearly 2,800 American adults over age 35, "only 8 percent were getting all of the highly recommended preventive services with the greatest potential for improving health." Reuters explains the survey included questions "about the receipt of 15 high-priority preventive services including blood pressure and cholesterol checks, screening for osteoporosis and several cancers, counseling on tobacco use, obesity, alcohol use and depression, plus vaccinations and aspirin Air Ambulance Companies Leave Patients With High Bills. Bloomberg News 12 EXT-18-248-D-000115 Administration is attempting to have the courts declare that protections for pre-existing conditions are unconstitutional, she argues. Rampell calls all of the Republican lawmakers who are "keeping their heads down" amid these moves "cowards." Jennifer Rubin writes in the Washington Post (6/11, 15.68M) "Right Turn" blog that after failing to repeal the ACA, President Trump and congressional Republicans "have decided to make it worse and help states get rid of it in the courts." She argues, "As a policy matter, their approach will cause hardship to Americans, especially rural Trump voters; as a political matter, it defies logic." Rubin adds that "everything the Trump administration has done with regard to the ACA is designed to raise prices. Republicans' refusal to reverse these steps will surely be fodder for Democrats in the midterms." In an editorial, the Wall Street Journal (6/11, Subscription Publication, 6.13M) analyzes the position Republican candidates find themselves in after failing to repeal the Affordable Care Act and with premiums expected to rise by double-digit percentage points in the run-up to the midterm elections. The Journal argues that despite fingerpointing by Democrats, the problems stem from the structure of the law itself, not the actions of the Trump Administration or the repeal of the individual mandate. Michael Hiltzik writes in his Los Angeles Times (6/11, 4.03M) column that legal experts "who pay attention to the courthouse fortunes of the Affordable Care Act could tell something weird and bad was in the wind last Thursday, when three career attorneys at the Department of Justice abruptly withdrew from the team defending the law against a right-wing attack by Texas and 19 other red states." Hiltzik asks, "Just how indefensible does an argument in a government brief have to be to cause all the career litigators ...to withdraw?" He says while it may not be unusual for the government to refuse to defend a federal law, "it may be unprecedented for virtually the entire legal team representing the government in a case to withdraw en masse." Corey R. Lewandowski, who served as a campaign manager to Donald J. Trump , writes in an op-ed for The Hill (6/11, 2.71M) that President Trump "inherited a mess from his predecessors." The biggest issue "is an entitlement time bomb that is soon to explode the national debt. Thankfully, President Trump is up for the task of entitlement reform." Lewandowski adds that a (6/11, Tozzi, 4.46M) reports on the growing size of the air ambulance fleet in the US and the increasing cost of using an air ambulance for medical emergencies. Air ambulance operators believe that because "US government health programs, including Medicare and Medicaid, don't cover their expenses, they must ask others to pay more - and when health plans balk, patients get stuck with the tab." As a result of "favorable treatment under federal law," air-ambulance companies have "few restrictions on what they can charge for their services" and "states have no power to put in place their own curbs." According to the article, Sen. Jon Tester (D-MT) has "introduced legislation that would roll back the special status of air-ambulance companies." In addition, the FAA reauthorization bill passed by the House in April "would make medical services provided by air ambulances subject to state regulation." Commentary Considers Health Reform. Several outlets offer opinions on health reform. In an editorial, the New York Times (6/11, Subscription Publication, 19.33M) argues that Democrats who hope "to make health care a centerpiece of midterm election campaigns just got a gift from the Trump administration," as the Justice Department has "declined to defend the Affordable Care Act against a lawsuit filed by 20 Republican-led states," and is "arguing for the repeal of enormously popular consumer protections, including coverage of pre-existing conditions." The Times concludes, "Add this latest move to a growing list of similar efforts eliminating the mandate tax penalty to begin with, allowing more short-term plans on the market and it becomes clear where the administration's priorities lie: not in helping more Americans get good health care, not even in supporting the will of the people, but in dismantling what some political opponents built, just for the sake of doing so." Catherine Rampell writes in her column in the Washington Post (6/11, 15.68M) that "if the GOP really thinks gutting protections for people with preexisting health conditions is good policy, they should pass a damn law." Rampell points out that Republicans passed "literally dozens" of bills repealing the ACA while President Obama was in office, but then they "chickened out" last year "because they feared the blowback from voters." Unable to take such action legislatively, the Trump 13 EXT-18-248-D-000116 conservative group has recommended that Congress "raise Social Security and Medicare retirement ages to account for increased life expectancies and work capacities; transition to a flat, anti-poverty benefit for future beneficiaries so that the programs do not pay the highest benefits to those with the least need; and reduce the payroll tax to allow individuals to save more on their own for retirement and disability." The New York Daily News (6/8, 3.71M) says in an editorial after failing to get Congress to repeal the ACA, the Trump Administration now wants "a judge to undo the rest of the law through the courts." The paper argues, 'This is a brazen act of executive overreach. If it succeeds, it will endanger the coverage of thousands of sick Americans." Contributor Sally Pipes writes in a Forbes (6/11, 10.34M) piece that in 2017, "Canada's single-payer healthcare system forced over 1 million patients to wait for necessary medical treatments." This was a new record. Pipes argues that long, costly "delays are the norm in Canada and other single-payer nations, which ration care to keep costs down. Yet more and more Democratic leaders are pushing for a single-payer system - and more and more voters are clamoring for one." Charles Wallner, executive director of the Faith Community Alliance of Greater Cincinnati, writes in a Cincinnati Enquirer (6/11, 246K) op-ed that healthcare access through Medicaid "has been critical in helping Ohioans to enter the workforce and supporting them in their work." The state "should be focused on strengthening residents' connection to the preventive care and treatment that keeps them healthy and connected to the workforce . Instead, Ohio is pursuing a bad idea dressed up as health care reform." The Charleston (WV) Gazette-Mail (6/11) editorializes that in 1992, West Virginia formed a study group to look at allowing anyone to buy into its Public Employees Insurance Agency. The editorial suggests the state should return to the idea once again because it could provide an economical "single-payer health care for everyone." The editorial argues that Republicans in Washington, DC, "aren't interested in fixing this" and the state should address health coverage on its own. HUMAN SERVICES NEWS Experts: Don't Let Social Security Solvency Fears Affect Claiming Decision. CNBC (6/11, 4.81 M) reports the "Social Security Board of Trustees said the trust funds that help support the system will run out of money in 2034," but "experts say you should not let fear about the program's future affect your eventual claiming decision." They say they expect Congress to act to address that issue, and that retirees and near-retirees are unlikely to be affected. Additionally , if nothing is done, it won't be good, but it result in payouts of 75 to 80 cents on the dollar, not a complete stop of payments. Compromise Social Security Reforms Suggested. Robert Pozen, a senior lecturer at the MIT Sloan School of Management, in an oped in The Hill (6/11, 2.71 M), predicts that, "given the intense hostility between the parties, they are not likely to agree on a compromise package of reforms before Social Security is on the brink of insolvency" in 2034. Still, Pozen suggests a "compromise package of reforms" that include "a 2 percent surcharge on all earnings above the maximum earnings subject to the payroll tax without raising benefits"; increasing the "normal retirement age to 68 around 2040," indexing to increases in life expectancy; and "in calculating initial benefits at retirement, phase in a formula based on consumer price index growth over a worker's career for the top third of earners, who have other retirement plans subsidized by taxes and corporations." Social Security Said To Face "Manageable Financing Shortfall." Alicia H. Munnell writes in a column in MarketWatch (6/11, 1.49M), "The 2018 Social Security Trustees Report, released last week, shows that the program faces a 75year deficit of 2.84 percent of taxable payrolls virtually unchanged from last year's projection of 2.83." The deficits are partly due to "a worsening of economic assumptions" and "persistent increases in disability rolls." Munnell concludes, "Social Security faces a manageable financing shortfall over the next 75 years, which should be addressed soon to share the burden more equitably across cohorts, to restore confidence in the nation's major retirement program, and to give people time to adjust to needed changes." Johns Hopkins Lecturer Calls For Social Security Changes. Johns Hopkins University 14 EXT-18-248-D-000117 money and a program that community's most vulnerable kids." School of Advanced International Studies senior lecturer Jason J. Fichtner, in an op-ed in CQ Roll Call {DC) (6/ 11, 117K), writes that the Social Security crisis "is already well upon us." He warns, "To ensure that Social Security remains viable for the most vulnerable in our society, policymakers must soon address its severe and urgent financial challenges." Fichtner calls for "bipartisan policy solutions," recommending reforms suggested by "an expansive project housed at the Bipartisan Policy Center'' that would "improve retirement security and personal savings." serves the CBP Commissioner Discusses Illegal Border Crossings During Interview. The Los Angeles Times (6/11, Hennessy-Fiske, 4.03M) runs an interview with US Customs and Border Protection Commissioner Kevin McAleenan "during his visit to agents in Texas' Rio Grande Valley, the epicenter of migration in recent years." McAleenan tells the Times, "We've had consistent levels of apprehensions and inadmissible crossing since March. March and April were pretty much level at 50,000, both between apprehensions between ports of entry at that 36,000-37,000 level, and inadmissibles arriving at ports of entry between 12,000 and 13,000. So we remain day to day at those levels, which presents a number of challenges operationally." McAleenan adds that "it's too early to say what the increased ability to apply consequences for crossing the border illegally what effect that will have on the traffic coming towards us." Ryan Making One Last Push To Overhaul TANF, SNAP Before He Retires From Congress. Congressional Quarterly (6/11, McPherson, Subscription Publication) reports House Speaker Paul Ryan (R-WI) "has spent his 20-year congressional career primarily focused on two issues, taxes and poverty." He "led a major rewrite of the tax code last year, but when he retires at the end of this term he won't have many accomplishments to tout on poverty." The article says "Ryan is spending his final year in office making one last anti-poverty push." That is why the House is mulling "another overhaul to TANF [Temporary Assistance for Needy Families], as well as major changes to the Supplemental Nutrition Assistance Program (SNAP), otherwise known as food stamps ." Louisiana Child Care Program Improved Controls, Auditor Says. The AP (6/ 12) says a report issued Monday by Louisiana Legislative Auditor Daryl Purpera's office "says the education department has enacted most of the recommendations made by auditors to track spending on the Child Care Assistance Program." A 2012 audit of the program when it was managed by the Department of Children and Family Services identified $46,000 in improper payments, but the education department, "which took control in 2015, trimmed improper payments to about $24,000." Jefferson County Decision To Forfeit Head Start Funding Resulted In The Loss Of Family Advocate Jobs. The Louisville (KY) Courier-Journal (6/11, McLaren, 419K) reports that after the Jefferson County Public School board in Kentucky voted in late May to abandon its "beleaguered" Head Start program, half a dozen young women walked out of the meeting "out of work, no longer contracted by the district to support preschool students and their families," even after Superintendent Marty Pollio said no jobs would be lost. The positions, known as family advocates, are required by the federal Head Start and Early Head Start programs, both of which serve children from low-income households. According to the article, "though the positions will exist if another organization scoops up the Head Start grant forfeited by JCPS, the women's shock illustrated how many in Jefferson County were caught off-guard by the district's decision to forfeit $15 million in federal grant FOOD & IMPORT SAFETY Opinion: Labeling Requirements Drive Richard Up Costs For Consumers. Berman, president of the public relations firm Berman and Co., writes for the Washington Times (6/ 11, 460K) that "the Coalition for Accurate Product Labels reports that in the first half of 2018, 11 states introduced close to three dozen proposals for warning labels or ingredient disclosures that went beyond national standards, and in many cases exceeded the bounds of known evidence." Arguing that labels "have landed us in a regulatory muck of meaningless 15 EXT-18-248-D-000118 warnings and unnecessary added costs to businesses, which are inevitably passed on to consumers," Berman denounces San Francisco's 2015 ordinance on labeling of sugar-sweetened beverages, noting that the FDA recognizes that "added sugars can be a part of a healthy dietary pattern." MEDICAID & CHIP Ohio Decides Not To Implement FivePercent Cut To Medicaid Reimbursement For Hospitals. The 11.4M) reports the "U.S. Department of Agriculture's Food Safety and Inspection Service said Friday Tyson must recall 3, 120 pounds of frozen breaded chicken tenders." The company informed FSIS on Friday that "the breading of the frozen, uncooked chicken tenders may have been contaminated with foreign material in the form of blue and clear soft plastic," the article says. FSIS classified the health risk as "low." Cleveland Plain Dealer (6/11, Hancock, 1.03M) reports that Ohio "has canceled a planned $1.1 billion...Medicaid cut to hospitals, saying an uptick in the economy and reshuffling money in the health care program has prevented the reduction." Officials explained that this was due to the fact that "the number of people enrolled and the amount of money it has cost to cover their health care was lower than state projections." The article says the state had been mulling a five-percent cut to Medicaid reimbursement for hospitals that "treat some 3 million program recipients who qualify based on their incomes, health conditions and disabilities, among other factors." Tennessee E. Coli Outbreak Leaves Six Children Hospitalized, Two In Serious Condition. The Knoxville {TN) Nursing Homes, Assisted-Living Facilities Suing Montana Over Medicaid Reimbursement Cuts. The AP Tyson To Recall 3,120 Pounds Of Breaded Chicken Over Plastic Contamination. USA Today (6/11, Price, (6/11, Volz) reports that on Monday, several nursing homes and assisted-living facilities in Montana "sued the state ...to halt cuts to their reimbursements for providing care to Medicaid patients, cuts that have caused other Medicaid providers to curtail services or close altogether." The article says that in January, the state Department of Public Health and Human Services reduced "the Medicaid provider reimbursement rates...as part of spending reductions across state government aimed at closing a budget shortfall." The state wants to extend the 2.99-percent cut through the next fiscal year which begins in July, but the facilities "are asking a judge to block the cut, reinstate the 2017 rate and to reimburse them for the approximately $3 million that they have lost since January because of the reduction." Montana Public Radio (6/11, Yamanaka) reports the Montana Health Care Association and "some of its members" filed the lawsuit. Executive director of the Montana Health Care Association Rose Hughes "said these cuts mean families are being denied services when they seek help from assisted living facilities." News Sentinel (6/11, Gosnell, 252K) reports that East Tennessee Children's Hospital (ETCH) is still treating six children following a recent E. coli outbreak associated with raw milk and contact with farm animals. "Two of the children are in the pediatric intensive care unit in serious condition ETCH spokeswoman Erica Estep said Monday:'· In a Monday update, the Knox County Health Department said, "While it would be rare, it's possible that our community is experiencing two unrelated E. coli clusters at the same time " ' adding, 'The common link among the majority of those who are ill continues to be consumption of raw milk from a local cow-share dairy, French Broad Farm in Knox County." Arizona Family Awarded $1.95 Million In Foster Farms Salmonella Case. In a 2,700-word feature, the Arizona Republic (6/11, White, 1.21M) reports Arizona couple Amanda and James Craten were awarded $1.95 million in a lawsuit against Foster Farms over the neardeath of toddler Noah, who "was hospitalized in 2013 with an abscess in his brain as a result of a salmonella infection" linked to chicken produced by the farm . The article chronicles the ordeal and describes the likely infection vector. New Hampshire Substance Abuse, Mental Health Treatment Providers Worried About Proposed Cuts To Medicaid Reimbursement. The Concord 16 EXT-18-248-D-000119 NPR (6/11, Watson, 3.55M) "Shots" blog provides coverage of a study by researchers at Duke University suggesting that young women, particularly black women, get less exercise than young men, and that women's "exercise rates drop significantly after high school." Offering possible explanations why young women's exercise rates are lower than young men, one researcher not involved with the study said, "I think our society culturally sends different messages to young girls in terms of their bodies and how they spend their time ... A lot of teen girl socialization is less focused on being physically active together , whether it's teen sports, or pick up games, or even going to the gym." In terms of why black women are affected disproportionately, one study author said, "We know that there is an unequal distribution of things like athletic fields [and] high schools that serve more minority populations are less resourced ...! think that's just compounded when people leave the structured school environment." The findings were published in JAMA Pediatrics. The Washington Times (6/11, Kelly, 460K) reports the study found that "45% of black females age 18 to 24 years reported no physical activity," and that "black females age 25 to 29 reported a little over a half hour of activity per day." Moreover, "White adolescent males were most likely to report any physical activity and younger age, being white, and having a higher income was associated with more time dedicated to exercise." The study authors wrote, 'These data highlight opportunities for targeted physical activity programming and policy efforts to reduce the risk for chronic diseases and improve overall health throughout the lifespan." Additional coverage is provided by The Guardian (UK) (6/11, Davis, 4.03M). (NH) Monitor (6/11, DeWitt, 35K) reports, "Without some action, the state's newly approved Medicaid expansion program could saddle substance abuse and mental health treatment providers with lower payouts that could force cuts to staffing and services around January, when the law takes effect, they say." The article says New Hampshire legislators voted last month to extend Medicaid expansion for another five years. These providers are worried because of "a change that was intended as an improvement." The new deal stipulates that "recipients will receive care through managed care organizations - an insurance alternative designed to reduce health care costs." This means the current "daily rate of $300 to $500 per patient would drop to $162.60 a day." Michigan Governor Signs Bill To Repeal, Replace Tax That Funds Medicaid. The AP (6/11) reports Michigan Gov. Rick Snyder (R) on Monday "signed into law a plan to repeal and replace Michigan's tax on health insurance claims that is used to help fund Medicaid for low-income residents." The measures "require the state to seek a federal waiver to implement the tax change. The waiver is expected to be approved." Fate Of Medicaid Expansion In Maine May Depend On Outcome Of November Election For Governor. Dylan Scott writes in a Vox (6/11, 1.66M) piece that a majority of Maine voters approved "Medicaid expansion last November, but it still hasn't happened yet. And it may just be their vote to choose the next governor that finally finishes the job." Scott says Gov. Paul LePage (R), who will soon leave office, has used every means "at his disposal to stop Maine from expanding Medicaid to 70,000 of Maine's poorest residents," despite voters' expressed wish to expand the program. Scott adds that advocates of Medicaid expansion "are pursuing legal action against LePage to force him into implementing it quickly," however, "if courts don't rule in their favor or if the fight drags out, the fate of Medicaid expansion is very much at stake in the fall election." Research Explores Why People Get "Hangry." USA Today (6/11, Molina, 11.4M) reports that research published in Emotion suggests "environmental cues and a person's emotional awareness can decide whether someone becomes 'hangry."' Newsweek (6/11, Gander, 2.18M) reports that researchers came to this conclusion after conducting "two online experiments on 400 participants." TIME (6/11, Sifferlin, 19.27M) reports that study co-author Kristen Lindquist said, "Despite the colloquial term 'hanger,' we found that this HEALTH & MEDICALNEWS Young Women Get Less Exercise Than Young Men, Study Suggests. The 17 EXT-18-248-D-000120 2018 Millennials & Investing Survey. "Nearly seven out of 10 (67%) female Millennials, for example , said their parents encouraged them to 'save' money, versus just 58% of males," and similarly, "only 29% of females surveyed said their parents 'showed (them) ways to grow wealth."' By contrast, "37% of males said their financial education was focused on wealth-bu ilding, the survey found ." USA Today reports the men surveyed "demonstrated a more aggress ive approach to risk taking than their female peers," with 14 percent saying they "embrace risk," double the percentage of women who said they welcomed risk. effect was not specific to anger." Lindquist added, "People in our studies were more likely to feel intense negativity in general when they were hungry and something bad happened suggesting that feeling hungry can turn up the dial on lots of negative emotions such as anger, stress or disgust." Also covering the story is the NPR (6/ 11, Chen, 3.SSM) "Shots" blog. Erectile Dysfunction May Be Linked To Increased Risk Of Heart Disease, Study Suggests. TIME (6/11, Park, 19.27M) reports that research published in Circulation suggests erectile dysfunction may be linked to a higher risk of heart disease. Investigators found that "among a group of 1,900 men aged 60 to 78, those with erectile dysfunction were twice as likely as men without the condition to have a heart attack, stroke, or die of a heart problem." The New York Post (6/11, Gollayan , 4.46M) reports that Michael Blaha, a co-author of the study, said, "The onset of ED should prompt men to seek comprehensi ve cardiovascular risk evaluation from a preventive cardiologist." Health Day (6/ 11, Mozes, 1OK) reports, "The link between impotence and heart disease appears to be 'a two-way street,' Blaha said , given that men who have had a heart attack appear to face a higher risk for ED." Morningstar Analyst Supports StateSponsored Auto-Enrollment For Retirement Savings. MarketWatch (6/ 11, Vlastelica, 1.49M) reports Aron Szapiro, director of policy research at Morningstar, says that government incentive programs for retirement investing "could dramatically increase the number of Americans who participate in retirement programs , at minimal cost to taxpayers ," and he "stressed that such incentives should be considered , noting the dire state of savings." He adds that auto-enrollment in such plans "is the most powerful tool we 've ever seen," adding that "that this kind of regulation was far more effective in getting individuals to contribute than tax incentives." Healthy Lifestyle Associated With Improved Memory In Old Age, Study Indicates. Xinhua News Agency (CHN) (6/12, Tallahassee Targeting Multigenerational Families To Increase Retiree Draw. The New York Times (6/8, 11K) reports on a Finnish study showing that "a healthy lifestyle, including physical exercises, brain stimulants and healthy diet," has the potential to "improve brain health and prevent lateage memory disorders." The investigation, published Monday , examined 1,262 Finns over the age of 60 with an increased risk for memory disorders. "The control group had nearly 30 percent of the increased risk of deteriorating memory functions , while those who received intensive guidance had improved mental ability and physical performance," Xinhua reports. The research was part of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability. Olson, Subscription Publication, 19.33M) reported Tallahassee , Florida is not seeing the same growth as the rest of the state, and a "key part" of its efforts to "attract new residents" targets retirees with "some unusual tactics - including subsidizing a few people to move there." A new campaign called "Choose Tallahassee" is recruiting "baby boomers who are hitting retirement age and looking to move someplace warmer and more affordable but who may not have thought of Tallahassee " compared to other destinations. Its campaigns are separately targeting boomers who "live elsewhere" and their children who live in Tallahassee , each promoting the benefits of having the other closer : for the boomers, the advantages of tech support and labor provided by nearby adult children; and for residents, the Millennial Men And Women Invest Differently, PNC Survey Reveals. In an exclusive, USA Today (6/ 12, Shell, 11.4M) reports on the insights highlighted in PNC Investments' 18 EXT-18-248-D-000121 benefits of parents in proximity, such as free childcare. Doctor's Appointment Anxiety. u.s. News & World Report (6/11, 1.97M) contributor Jeremy Patterson from the Research Institute at Nationwide Children's Hospital discusses how virtual reality can help children deal with nervousness or anxiety during a doctor's appointment. Patterson explains that researchers at the Institute have created a "first-of-its-kind VR platform called Voxel Bay," which "provides patients with an immersive environment of penguins, pirates and dragons during infusions and other procedures." Additionally, the system's headsets are "built for purpose and are a fun part of the experience." VR games are installed "onto smartphones, so they're wireless, and nurses or families can follow the progress of the games by watching a tablet and adjust if the patient needs more distraction." Ford Works On Self-Driving Delivery Service With Postmates. Fortune (6/11, Corbett, 3.91M) reports that Ford is working on developing a self-driving delivery service program with Postmates. Currently, the pilot program offers delivery options from more than 70 businesses in Miami and Miami Beach, "with the option of having the order delivered in a self-driving research vehicle." The article explains that the vehicles used in the pilot are not autonomous , but instead "are manually driven cars with sensors that are being used to research the first and last mile of the delivery service." Experts Worried About Unproven The Tesla Self-Driving Features. Feeding Children Honey After Swallowing A Small Battery Can Prevent Serious Injury, Study Suggests. The Philadelphia Inquirer (6/ 11, Washington Post (6/ 11, Harwell, 15.68M) reports Tesla CEO Elon Musk tweeted that in August the company's cars will activate "full self-driving features," although a company spokesman said that does not mean full autonomy. Meanwhile, "safety experts worried the grand promises of full self-driving capabilities could lull drivers into a false sense of security for technologies that are still largely unproven on the road." Giordano, 1.07M) reports "a team of pediatric ear, nose, and throat specialists from the Children's Hospital of Philadelphia and Nationwide Children's Hospital has discovered that giving a child honey to eat after he or she has swallowed a small battery can prevent serious injury and possibly even death." Study authors explained, "Our recommendation would be for parents and caregivers to give honey at regular intervals before a child is able to reach a hospital, while clinicians in a hospital can use sucralfate before removing the battery." The findings , which "will be incorporated into the National Capital Poison Center's guidelines for management of button battery ingestions," were published in The Laryngoscope . Science Blog (6/11) also reports. Uber-Like Flight Hailing Service Skyryde Starts Service In Los Angeles. The Washington Post (6/ 11, Kunkle, 15.68M) reports on the launch of Skyryde , an "Uber-like flight-hailing service," in Los Angeles. Skyryde is using small planes that have "four to six seats and instrumentation that allows pilots to fly in everything but the most extreme weather." Skyryde launched its services on April 20 and has been used by 16 passengers since its inception. According to Skyryde Founder Jerome Brenndon Adkins, "a typical Skyryde flight might take a passenger from the University of California at Los Angeles to Long Beach" at a fare of around $300. Adkins "hopes that the same concepts pioneered by Uber ...will lower Skyryde's price from what might seem exorbitant now to something closer to $100." An FAA spokesman said that the agency is aware of the service and "the venture appears to have passed regulatory muster in several respects." Physician Advises Parents To Keep Kids Safe While Swimming. Dr. Perri Klass writes for the New York Times (6/11, Subscription Publication, 19.33M) that "even if kids have had swim lessons, parents must still supervise them in the water." Dr. Klass quotes Dr. Benjamin Hoffman, who is the chairman of the American Academy of Pediatrics Council on Injury, Violence , and Poison Prevention, as saying, "Infant swim is not a drowning prevention exercise," because children are developing water competence in swimming lessons. Dr. Klass notes Researchers Create Virtual Reality Platform To Help Children Cope With 19 EXT-18-248-D-000122 that until 2010 the AAP advised against swimming lessons for children under the age of four due to concerns that "parents whose young children take swimming lessons will be lulled into a false sense of security," but after a 2009 study by researchers at the National Institute of Child Health and Human Development, the AAP recognized "that swimming lessons for young children were not a risk and might be protective - as long as parents continued to be protective as well." Tick Paralysis Strikes Five-Year-Old In Mississippi. The Washington Post (6/11, Wootson, 15.68M) reports on a five-year-old girl in Mississippi who woke up one morning unable to walk. Her mother found a tick on her head and took her to a hospital where she was diagnosed with tick paralysis, a condition that is caused by female ticks on the verge of laying eggs. After the tick eats a blood meal and is engorged, it secretes a neurotoxin into the host. According to the Post, "paralysis begins in the legs, then spreads to the upper extremities. It can manifest as fatigue, numbness and an increasing inability to move," and in the later stages, if no action is taken, "the toxin ultimately makes it impossible for a person to breathe, resulting in respiratory failure." The article says the child quickly recovered after the tick was removed. Using Prophylactic NSAIDs Before And After Cataract Surgery May Reduce Development Of Cystoid Macular Edema In Diabetic Patients, Study Suggests. MD Magazine (6/11, DiSanto) reports researchers found "that using prophylactic non-steroidal anti-inflammatory drugs (NSAIDs) pre- and post-cataract surgery may help reduce the severity and frequency of the development of cystoid macular edema (CME) in the eyes of diabetic patients." The findings were "published in the International Journal of Ophthalmology." Red Cross Blood Drive Campaign Sees Major Brands Dropping A, B, and 0 From Their Names. NBC News (6/11, Fox, 5.76M) reports on its website that major brands are dropping the letters A, B, and O in their logos to support the Red Cross's new blood drive campaign starting Monday. "Without A, B and 0, we can't save anybody," the Red Cross says, adding, "Each year, fewer and fewer people are donating blood." According to the article, "only about 38 percent of the population is even eligible to give blood, and only about 10 percent of those people - that's 3 percent of the population - give blood yearly." Young Surgeons Face High Debt, Financial Instability, Study Suggests. Reuters (6/11, Crist) says a new study published in the American College of Surgeons found that "young surgeons often face debt burdens that make it difficult for them to start their careers and pay off their loans." According to the study, "more than one in three, or 38 percent, reported more than $200,000 in educational debt. When nonstudent loan debt, mortgage liability, vehicle debt, and credit card debt were factored in, the average trainee owed more than $220,000." Overall, the researchers found that 82 percent of respondents had moderate- or high-risk debt-to-asset ratios. KKR To Buy Envision Healthcare For $5.57 Billion. In continuing coverage, Bloomberg News (6/11, Mittelman, 4.46M) reports that KKR & Co. will buy Envision Healthcare Corp. for $46 a share "after an almost yearlong sale process for the medical company." The article says, ''The all-cash deal values Envision at $5.57 billion. Including debt, the acquisition is valued at $9.9 billion." Also reporting are the Associated Press (6/11) and Bloomberg View (6/11, Sutherland, 4.46M) . Opinion: Retail Health Clinics Set The Stage For Today's Mega-Mergers. Hal Rosenbluth and Peter Miller, co-founders of Take Care Health Systems, write in STAT (6/11, 27K) about retail health clinics and say that "the media spotlight is on some of health care's giants as they jockey for position around the themes that retail clinics set in motion." The duo argue that any major mega-merger must focus on aligning incentives, educating consumers on healthcare, and accommodate the social determinants of health. Surgeons Use JD-Printed Organs To Determine Best Way To Operate. The Washington Post (6/8, Blakemore, 15.68M) reports that surgeons are using 3D-printed organs to figure out the best way to operate on patients. Using CT scans that are manipulated via special 20 EXT-18-248-D-000123 software, a team of engineers creates a model that replicates the organ and use computer models predict how blood flow would respond to each patient's unique anatomy. The process helps physicians decide how best to approach the surgery, according to the Post. Physician-Assisted Suicide. The Washington Post (6/11, Bever, 15.68M) reports that delegates at the American Medical Association's annual meeting in Chicago voted Monday to continue reviewing its guidance on physician-assisted suicide. The AMA's House of Delegates "voted by a margin of 56 to 44 percent to have the AMA's Council on Ethical and Judicial Affairs keep studying the current guidance ," according to the article . Modern Healthcare (6/11, Johnson, Subscription Publication, 239K) also covers the story. Legacy Of Racism Hurting Health Of African Americans. In a 7,543-word feature in The Atlantic (6/ 11, 3.08M), Olga Khazan writes about "how African Americans became stuck in profoundly unhealthy neighbo rhoods , and ...how the legacy of racism can literally take years off their lives ." In the US, "black people suffer disproportionately from some of the most devastating health problems," but, excepting a few specific ailments, scientists believe the underlying causes aren't genetic but "social and environmental forces that affect African Americans more than most other groups." Khazan adds, "America 's racist and segregationist history continues to harm black people in the most intimate of ways - seeping into their lungs, their blood, even their DNA." Cherokee Hospital Testing 186 Patients For HIV, Hepatitis After Nurse Reused Syringes. The Tulsa {OK) World (6/11, Overall, 358K) reports that W.W. Hastings Hospital in Tahlequah, Oklahoma , a Cherokee Nation facility, is testing 186 patients for HIV and hepatitis after a nurse allegedly reused syringes to administer medications. According to the article, "the nurse violated protocols by using the same vial of medication and syringe to inject more than one intravenous bag." As of Monday, 64 patients had been screened, and none had tested positive. Hospital CEO Brian Hail said, "Patients were never directly in contact with any needle. Medication was administered into an IV bag or tubing. The likelihood of blood-borne pathogens traveling up the lines into an IV bag or IV tubing to cause cross contamination from using the same syringe is extremely remote." South Carolina Primary Vote To Gauge "Temperature" Of Electorate. The Greenville (SC) News (6/11, Wilkinson, 112K) reports that a nonbinding ballot initiative on the legalization of medical marijuana will be included on the Democratic primary ballot in South Carolina on Tuesday . Bill Nettles, a former US attorney for South Carolina, said the ballot "allows the party to take the temperature of the electorate," on the issue. Louisiana Regulators Prepare For Expanded Medical Marijuana Program. Opinion: Physician-Assisted Suicide "Can Never Be Medical Care." Matt Valliere , executive director of the Patients' Rights Action Fund, writes in The Hill (6/11, 2.71 M) about physician-assisted suicide , and says that "suicide can never be medical care." Valliere argues, "As the med ical community continues to point out its dangers , Congress should summarily reject assisted suicide public policy by passing H.Con. Res.80 - a truly bipartisan bill 'expressing the sense of the Congress that assisted suicide puts everyone, including those most vulnerable , at risk of deadly harm and undermines the integrity of the health care system ."' The Baton Rouge (LA) Advocate (6/11, Thomps on, 141 K) reports that "regulators crafting Louisiana 's medical marijuana policies affecting physicians expressed concern Monday that key rules still need to be revised, while the growing number of state-approved treatable conditions will likely cause the state's nascent program to grow significantly." According to the article , "questions linger about how the drug will be administered, such as determining the appropriate dosage for a 30-day supply, and whether to lift an existing cap on the number of patients that doctors can recommend to be treated using medical marijuana ." American Medical Association Votes To Keep Reviewing Its Guidance On Physician Offers Advice About Genetic Screening For Pregnant 21 EXT-18-248-D-000124 reports that research suggests "loneliness may actually cause premature death by damaging the heart." The study "suggested that feeling loneliness may double a person's risk of dying of cardiovascular disease." The findings were presented at the European Society of Cardiology's annual nursing conference . Women. U.S. News & World Report (6/8, 1.97M) contributor Elaine K. Howley offered guidance on genetic screening for pregnant women. Discussing the elevated risks associated with diagnostic tests such as amniocentesis and CVS, Howley quoted Dr. Deanna Mascho-Cawley, an OB-GYN at Geisinger in Danville, Pennsylvania , as saying, "According to the American College of Obstetricians and Gynecologists, any patient can be offered or should be offered that diagnostic testing as well. We just tailor the counseling based off the patient's risk factors and their desires because of those additional risks that are associated with those procedures." CRISPR-Cas9 May Increase Cancer Risk In Cells, Research Suggests. Reuters (6/11, Kalland) reports that two studies suggests CRISPR-Cas9 , "a gene-editing technology that is being explored by scientists worldwide as a way of removing and replacing gene defects might inadvertently increase cancer risk in cells." STAT (6/11, Begley, 27K) reports that "In the studies ...scientists found that cells whose genomes are successfully edited by CRISPRCas9 have the potential to seed tumors inside a patient," which "could make some CRISPR'd cells ticking time bombs, according to" the investigators. To view the studies , click here and here. Guided Nanospears Can Administer Genetic Therapies Targeting Cancer, Researchers Say. The Daily Beast (6/12, Schultz, 1.69M) reports a recent study in the journal American Chemical Society Nano "describes a method of creating nanospears 5,000 times thinner than human hair that successfully targeted, pierced, and entered a cancer cell within a lab dish." The authors explained in an email, "The capability to guide the nanospears magnetically eliminates the need for potentially harmful chemical propellants that have been used in prior examples of nanorobotic delivery," adding, "A key feature of the nanospears is that we can guide them individually or in groups" to deliver some genetic therapies. Congressional Action On Marijuana Could Potentially Lead To Studies On Benefits Of Medical Marijuana For Cancer Patients. Fox News (6/11, Carlton, 16.38M) reports, "President Trump recently told reporters he will likely support a congressional effort to end the federal ban on marijuana , which could finally help cut through the red tape blocking scientists from conducting large-scale trials on the benefits of medical marijuana in cancer patients." Fox News adds, "According to new research published in the Journal of Clinical Oncology , less than 30 percent of oncologists surveyed felt knowledgeable enough about medical marijuana to make recommendations." Dr. Andrew Epstein, an ASCO patient care expert, told Fox News, 'The amount of information we have is still relatively nascent and evolving and therefore its upon us as a community to re-up our skills in knowing about this aspect of supportive oncology." US Adults With Hypertension Incur Nearly $2,000 More In Annual Healthcare Costs, Study Indicates. Reuters (6/11, Wiener) reports that research indicates "each year, U.S. adults with high blood pressure incur almost $2,000 more in annual healthcare costs." The data indicated that "nationally, healthcare for adults with high blood pressure ...costs an extra $131 billion per year." The findings were published in the Journal of the American Heart Association. Reuters points out that "last year, the American Heart Association, the American College of Cardiology and several other health organizations lowered the threshold for high blood pressure in adults to 130/80 millimeters of mercury." Premature Genetic Test For Prostate Cancer Can Identify Individuals Who Have A Higher Risk Of Developing The Disease, Researchers Say. Forbes (6/11, Death By Damaging Heart, Research Suggests. Newsweek (6/11, Spear, 2.18M) Forster, 10.34M) contributo r Victoria Forster writes that research published in Nature Genetics indicates "a new DNA 'spit test' for prostate Loneliness May Cause 22 T EXT-18-248-D-000125 significant problem that we need to work on and come together to address." He also pointed out that "staffing has always been a challenge, but he has not seen such high turnover rates in the more than 20 years he's worked in the industry." The article lists recommendations from Warren on improving staffing levels. cancer can identify men who have an increased risk of developing the disease." The research was partially funded by the National Cancer Institute. Forster points out that research recently presented at the American Society of Clinical Oncology meeting "showed that only a minority of men with prostate cancer respond to immunotherapy, likely those men whose cancers have defects in genes involved in repairing DNA." HealthDay (6/11, Preidt, 1OK) reports, "According to the new study, the scientists identified 63 new genetic variants associated with increased risk of prostate cancer, and combined them with more than 100 previously identified variants to create the new test." The new "test identifies the 1 percent of men who are at highest risk for prostate cancer." Also covering the story are BBC News Online (UK) (6/ 11, 1.57M) and The Guardian (UK) (6/11, Sample, 4.03M). Despite Prevention Efforts, South Dakota's STD Rates Rising. The Sioux Falls (SD) Argus Leader (6/11, Pfankuch, 175K) reports prevention efforts to combat sexually transmitted diseases in South Dakota "have not reversed a trend of increasing STD rates in rural and urban regions of the state" as cases reach "near-historic infection rates." Health officials worry "that if infection rates continue to rise ...a health crisis could result among sexually active South Dakotans who engage in high-risk behaviors." Their concerns have been compounded by the emergence of "a new antibiotic-resistant form of gonorrhea and cases of congenital syphilis ." Rhode Island Nursing Homes Decry State Budget Cut That Would Lead To The A P (6/11, Layoffs, Closures. Pennsylvania, Nation Losing Fight Against Lyme Disease. The Pittsburgh McGuinness) reports nursing homes in Rhode Island denounced legislators' most recent budget proposal because it would cut their funding and "likely lead to facility closures and layoffs." Rhode Island Health Care Association president Virginia Burke, "Closures. The impact will be closures .. .. Facilities would not be able to keep operating." She also indicated that "the 8.5 percent cut would mean a loss of close to $30 million for the facilities," which "are already financially strapped." Burke also "said nursing homes have not seen any money from the judgment as the state continues its appeal process," and that the cut "would take effect in three weeks." Tribune-Review (6/11, Erdley, 334K) reports on an article in Scientific American indicating that "the battle against Lyme diseases isn't progressing." The piece says Lyme has been particularly bad in Pennsylvania, which "led the country" for the past six years "with the most new cases of Lyme more than 12,000 residents contracted the disease in 2016." The article notes that the pressure to develop a vaccine is growing "ever more pressing as the tick" responsible for its spread "expands its reach across the country." Op-Ed: Rising Number Of Lyme Disease Infections Punctuates Need For Prevention Efforts. Mary Beth Pfeiffer, author of "Lyme: The First Epidemic of Climate Change," writes for Scientific American (6/ 11, 3.12M) that "little has been done to curb the spread of ticks or to control the harm inflicted by the Lyme bacterium," which she argues is "the product of a false image of Lyme disease , embraced by health officials and repeated in reviews of the medical literature, as an illness that is easy to diagnose and readily treatable." She argues that "we must recognize that the power of ticks has been underestimated and our response inadequate." THCA Sounds Alarm Over Texas' LTC Staffing Crisis. The Midland (TX) ReporterTelegram (6/12, McEwen, 42K) reports Texas providers "are ringing alarm bells" about the staffing crisis impacting nursing homes throughout the state. According to the Texas Health Care Association, "the 97 percent turnover rate for certified nurse aides and the 90 percent turnover rate for registered nurses and licensed vocational nurses are affecting nursing homes statewide." THCA president and CEO Kevin Warren explained, "It's a huge concern when you look at the fact we're seeing direct care staff ...have a turnover rate of 90 to 97 percent. ... It's a 23 EXT-18-248-D-000126 the news. The companies have not commented on the alleged deal. Epidemiologists Predict California Will See Another Cycle Of Pertussis Cases. The Orange County (CA) Register Juvenescence Takes Stake In Company Generating Cell-Based Therapies For Age-Related Diseases. (6/11, Walker , 635K) reports on the "cyclical nature" of pertussis, noting that California four years ago "was in the grips of an outbreak" and that "outbreaks tend to occur every three to five years." Epidemiologists have issued warnings that the Southern California region should anticipate "another surge right about now." While "there are no signs as yet of an epidemic, statewide or locally," the piece urges parents to take precautions. MedCity News (6/11, DeArment) reports UKbased Juvenescence Limited, which develops "therapies to slow or reverse the effects of aging," announced Monday it has raised $50 million in a Series A funding round. The company also "made a $5 million equity investment in AgeX Therapeutics, a subsidiary of publicly traded company BioTime focused on developing cellbased therapies for age-related degenerative diseases." AgeX is noted as having previously raised $10.8 million last year, including "a $386,000 grant from the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health." Cost Of Kansas City's Measles Outbreaks Exceeded $170,000. The Kansas City (MO) Star (6/11, Marso, 636K) reports an analysis led by health officials shows "that more than $170,000 in taxpayer resources was spent" in efforts to combat two measles outbreaks in Kansas City that resulted in "35 total cases - 22 in Kansas and 13 in Missouri." Some of the funding came from federal sources, while "some of it came out of redirected state and local resources and none of it includes other costs that are difficult or even impossible to quantify." The article goes on to examine the cost breakdown of treatment and prevention efforts during the outbreaks. Experts Push For "Medicalized Approach" To Suicide Prevention. Modern Healthcare (6/11, Johnson, Subscription Publication, 239K) reports that the recent suicide deaths of designer Kate Spade and TV host Anthony Bourdain "highlight what has become a growing public health issue, as rates of suicide throughout the country have increased sharply over the past two decades." Some experts are calling for a "more medicalized approach toward treating anxiety and depression," much like "early screening for conditions such as diabetes and breast cancer has led to better outcomes and survival rates." The article explains that "such an approach would require changes in the way much of the medical community views mental health disorders" and would require eliminating "lingering stigmas" among both providers and patients, such as "knowing the signs of a potential disorder or when to refer patients to a behavioral healthcare specialist for help." Stryker Reportedly Eyeing Boston Scientific For Takeover. The Wall Street Journal (6/11, Mattioli, Dummett, Cimilluca, Subscription Publication, 6.13M) reports Stryker Corp. recently initiated an attempt to take over competitor Boston Scientific Corp., which would form a medical device behemoth worth more than $110 billion, according to sources. The Journal says it is unknown whether Boston Scientific is amenable toward the offer, which comes amid a jolt of activity in the healthcare sector as companies address industry and regulatory shifts. Reuters (6/11, Banerjee, Berkrot) reports the combination "would give Stryker a strong position in stroke preventing interventional cardiology ." If a deal were to materialize, "Stryker would get Boston Scientific's line of stents, defibrillators and its Watchman atrial device to prevent migration of blood clots." The Minneapolis Star Tribune (6/11, Carlson, 1.16M) reports Boston Scientific shares "shot up nearly 10 percent in midday trading Monday" on 1 ' Alf ll Al\ ,{QVERS~G~T Opinion: Ending The Stigma Is The Key To Suicide Prevention. Petula Dvorak writes in the Washington Post (6/11, 15.68M) that even though 123 people die of suicide every day, "we still don't want to talk about it." Dvorak argues , "The silence , the stigma and the fear keep us from having real conversations and taking action - when it comes to such a determined killer" that is the tenth leading cause of death in the US and the second highest among 24 EXT-18-248-D-000127 teens. The piece concludes that "the key" to suicide prevention is: "Helping others. Breaking the silence. Ending the stigma." And Risk Of Developing Dementia Decades Later. In the New York Times (6/11, Subscription Publication, 19.33M) "Personal Health" column, Jane E. Brody writes that if a person's "waist measures 35 or more inches for women or 40 or more inches for men, chances are you're harboring a potentially dangerous amount of abdominal fat." Brody goes on to detail studies linking visceral fat with increased rates of coronary heart disease, an increased risk for cancer, and even the "risk of developing dementia decades later." Oral Migraine Drug Succeeds In Study, Manufacturer Says. Reuters (6/11, Banerjee) reports Allergan Pie announced Monday that its oral migraine drug, atogepant, met its "main goal across all doses in a study, with a statistically significant reduction in monthly headache days in patients with episodic migraine." The results come after the FDA approved Amgen's calcitonin gene-related peptide (CGRP) treatment last month. Experts Release Blueprint For Improving End-Of-Life Care. NJ Spotlight Layoffs A Symptom Of A Deeper Problem With IBM's Watson Health, Former Employees Say. STAT Plus (6/11, (6/12, Stainton) reports on recommendations released Monday by the nonprofit New Jersey Health Care Quality Institute as "part of a strategic plan for end-of-life care." Targeted investments for improving end of life carer include "developing a statewide database to keep residents' requests and wishes readily accessible" and offering "higher reimbursements for treatment consultations and palliative care." The 15-page report "outlines ways in which state officials can work with hospitals, medical schools, local communities, and other groups to provide more appropriate ...medical treatments and support services to patients nearing the end." Ross, Swetlitz, Subscription Publication, 27K) reports that IBM's Watson Health project is "grappling with a deeper problem - that the company has struggled to turn its new trove of patient data into workable products, and that instead of attracting a wave of new hospital clients, Watson Health is starting to shed business," according to former IBM employees who were recently laid off by the company. The article discusses how IBM has had reported problems with integrating its three acquisitions which brought in "vast stores of patient health data." GLOBAL HEALTH Children Exposed To Cigarette Smoke Have Higher Risk Of Hearing Loss, Newsweek (6/11, Research Indicates. Rollout Of HIV Prevention Drug Tied To Reduction In Condom Use Among Men Who Have Sex With Men In Australia, Study Suggests. The New York Dovey, 2 .18M) reports researchers from Japan have found that "exposure to smoking, both in utero and in the first few months of a child's life, is associated with higher prevalence of hearing impairment," according to a study published in Paediatric and Perinatal Epidemiology. Among the findings, "children exposed to only their mothers' past smoking had a 26 percent increased risk of hearing impairment," and those exposed to only "secondhand smoke at four months had a 30 percent increased risk." In addition, "those whose mothers smoked during their pregnancy had a 68 percent increased risk of hearing impairment." Times (6/11, Baumgaertner, Subscription Publication, 19.33M) reports researchers found that "the rollout of a drug that prevents HIV infection was followed by a reduction in condom use among gay and bisexual men in Australia." The findings were published in Lancet HIV. HIV/AIDS Epidemic Getting Worse In Russia. In an over 2,800 word article, Science Magazine (6/11, Cohen, 441 K) reports that the HIV/A IDS epidemic in Russia is getting worse. The article highlights some of the contributing factors to the problem, including some of the barriers that many patients with HIV face in receiving treatment in Russia. Studies Link Abdominal Fat To Increased Rates Of Coronary Heart Disease, Increased Risk For Cancer, 25 EXT-18-248-D-000128 reports older Australians who are "socially isolated and reliant on others for their care" are "particularly vulnerable to financial abuse ." Last week, "the Australian Banking Association , the Council of the Ageing (COTA Australia) and National Seniors called on the nation's attorneysgeneral to agree to standardise the reporting systems for suspected cases of financial abuse of elders," the article says, adding that such a system "could quickly verify the authority of a power of attorney when they present themselves as acting on behalf of a customer." Rift Valley Fever Kills Five In Kenya, Official Says. Reuters (6/11, Mureithi) says Kenya has reported the deaths of five people in the past week due to the reemergence of Rift Valley Fever disease, marking "the first reports of the disease since an outbreak killed more than 200 people a decade ago." Abdihakim Billow, a health official of the area "where the deaths were reported, said two people died in hospital while the other three died at home," adding that "another two people thought to be ill from the disease had been hospitalized." British Authorities Seize Mother's Cannabis-Based Medication For Son With Epilepsy, Prompting Stand-Off. NATIONAL NEWS Trump, Kim Pledge "Complete Denuclearization" After Historic Summit. At Tuesday's historic summit in Reuters (6/11, Shirbon) reports that the mother of a boy with epilepsy who journeyed to Canada "to buy cannabis-based medication she says is keeping her son alive" had her supplies confiscated by British customs officials upon her return on Monday. The mother says that without the cannabis oil, her 12-year-old son has up to 100 seizures a day, each of which is potentially fatal. According to Reuters, "the case has ignited a debate about the medicinal use of cannabis, a drug which is illegal in Britain and which the British authorities do not recognize as having any medicinal benefits." Singapore, President Trump and North Korean leader Kim Jong-un signed a joint statement committing to the "complete denuclearization of the Korean Peninsula." Details of the agreement were still emerging early Tuesday morning, but initial media reports are critical of its lack of specifics. Reuters (6/12, Kim), for example, says the statement "gave few details," the Wall Street Journal (6/12, Bender, Gordon, Cheng, Subscription Publication, 6.13M) refers to a lack of specific commitments , and Bloomberg News (6/ 12, Wayne, Sink, 4.46M) says the two leaders "laid out goals ...without specifying what immediate steps either side would take." CNN (6/11, Liptak, 82.6M) reports "there was no mentioning the previous US aim of 'complete, verifiable and irreversible denuclearization .' And Kim's commitments did not appear to go beyond what he already pledged to do in April when he met South Korean President Moon Jae-in." According to the A P (6/ 12, Miller, Lucey, Lederman, Klug), the President pledged unspecified "security guarantees" to the North. The two leaders "coupled the summit agreement with lofty promises" by Trump to handle "a very dangerous problem" and Kim's prediction for "major change." The AP says the document "largely amounted to an agreement to continue discussions ," and "did not include an agreement to take steps toward ending the technical state of warfare between the US and North Korea." The New York Times (6/12, Landler, Subscription Publication, 19.33M) reports Trump concluded the meeting saying that denuclearization on the Korean Peninsula would Opinion: Chinese Communist Leaders Must Be Held Accountable For Human Chen Guangcheng, Rights Violations. author of "The Barefoot Lawyer: A Blind Man's Fight for Justice and Freedom in China," writes in the Wash ington Post (6/ 11, 15.68M) that the Chinese Communist Party "is considering abandoning one of its longest-running and most abusive practices: its reproduction planning policy, commonly known as the one-child policy," but says that returning reproductive rights to the people "does not exempt the Communist Party from responsibility for decades of trauma and murder committed under the euphemistic rubric of population planning." Guangcheng "urges the American government to use the tools at its disposal - such as the Global Magnitsky Act - to hold Communist Party leaders accountable and to take a stand for human rights for all." National Register In Australia Could Curb Financial Abuse Of Elders. The Sydney (AUS) Morning Herald (6/8, Collett, 18K) 26 EXT-18-248-D-000129 few concrete steps," Trump called the document "pretty comprehensive" and Kim "a worthy negotiator." Kim, the Washington Times (6/12, Miller, 460K) reports, said the meeting "was the start of a working relationship between the two countries." Fox News (6/12, DeMarche, 16.38M) reports that during a press conference after the talks, Trump "did not refer to the document as a treaty or agreement," and "said Kim agreed to destroy a 'major' missile testing site, but did not offer specific details." The Washington Examiner (6/12, Morrongiello, 340K) reports Kim "departed the summit site at around 2 p.m. Tuesday, just as hundreds of journalists were shuttled over for a late afternoon press conference with Trump." Reuters (6/12) says Kim "is due to leave Singapore at 9 p.m. local time, two sources familiar with the plans said." Trump: US-South Korean Military Exercises On Hold. NBC News (6/11, Allen, 5.76M) reports that after Tuesday's talks, President Trump "confirmed military exercises involving American and South Korea forces would be put on hold for now." The AP (6/12, Miller, Lucey, Lederman, Klug) says Trump "announced that he will be freezing US military 'war games' with ...South Korea while negotiations between the two countries continue." Trump Shows Kim His Presidential Limousine. Breitbart (6/11, Spiering, 1.28M) reports that after Tuesday's talks, Trump "showed Kim the interior of his presidential limousine 'The Beast' as they walked together outside the hotel." Number Of US Journalists Permitted To Cover Talks Limited. According to Politico (6/11, Schwartz, 3.51 M), "the number of American journalists allowed to witness" the ceremony "was limited to seven - a smaller group than would usually be present for such a summit, and one that excluded representatives from the major wire services." The size "appeared designed to match the number of North Korean 'journalists' present, according to a press pool, and led to tension between US media and White House officials on the ground in Singapore." White House Press Secretary Sarah Sanders told Politico, "We have worked very hard to provide access to the media at this event and continually expanded coverage throughout the morning." Trump To Depart Singapore Early. Reuters (6/11, Holland) reports the White House begin "very quickly." In the statement, which Trump called "comprehensive," the President "committed to provide security guarantees" to North Korea, and Kim "reaffirmed his firm and unwavering commitment to complete denuclearization of the Korean Peninsula." According to the Times, the statement "was short on details," but Trump told reporters, "We're starting that process very quickly - very, very quickly - absolutely," referring to denuclearization. The statement said the two nations would hold "follow-on negotiations" led by Secretary of State Pompeo and a high-level North Korean official "at the earliest possible date, to implement the outcomes" of the summit meeting. The AP (6/12) reports that during a "freewheeling press conference before returning to the US," Trump told reporters he thinks "we'll probably need another summit" - or at least a second meeting - with Kim. He also insisted that Kim "understands what the US has been pushing for in the talks." Said Trump , "I think he's going to do these things." During Tuesday's meeting, the Washington Post (6/12, Nakamura, Rucker, Fifield, Gearan, 15.68M) reports, Trump said he had "developed a very special bond" with Kim, but the document "is an outline, with no specifics or deadlines and leaves the details on key issues such as how the United States would verify that North Korea had given up its nuclear program for future talks." Still, Trump "cast his meetings with Kim in the most positive light." The President told reporters, "We are very proud of what took place today. I think our whole relationship with North Korea and the Korean Peninsula is going to be a very much different situation than it has in the past. We both want to do something , we both are going to do something. We have developed a very special bond." USA Today (6/12, Jackson, 11.4M) likewise says Trump "claimed success," saying, "We had a really fantastic meeting" that went "better than anybody could have expected, top of the line, really good." To the Los Angeles Times (6/11, Bierman, 4.03M), the two leaders "appeared to open a new chapter ...in America's long-hostile relations with North Korea." At the signing ceremony, Kim said, "The world will see a major change," adding that he and Trump "decided to leave the past behind." Politico (6/11, Johnson, Toosi, 3.51M) says that while the "text of the agreement contained 27 EXT-18-248-D-000130 denuclearization "is not something that ends badly for them." The Washington Times (6/11, Miller, 460K) likewise says Pompeo said the US "is prepared to offer new security assurance," but "refused to elaborate." To the Los Angeles Times (6/11, Bierman, 4.03M), Pompeo also "publicly downplay[ed] expectations that the nuclear summit will lead to anything beyond future talks," and the Washington Post (6/11, Nakamura, Rucker, 15.68M) says Trump too "has sought to lower expectations for the summit in recent days, suggesting that it would be the start of a lengthy process to get Pyongyang to begin dismantling its nuclear and ballistic missile programs." Kellyanne Conway said on Fox News' Hannity (6/11, 3.26M), "This President knows that sometimes negotiations like this take one, two, three, four, five or more meetings. You can't change 70 years of war and a country that has isolated itself from most of the rest of the world as it becomes nuclear capable. And you can't expect that to turn around in a day or a meeting. Let's remember what's changed from past President attempts . It is the leadership and the vision of President Trump. It's his ability to reframe the way we look at relations around the globe. And I will tell you, this is not an American issue. The denuclearization of the Korean Peninsula is everybody's business." Sean Hannity said on Fox News' Hannity (6/11, 3.26M), "There has been a lot of talk will they be talking beyond denuclearization about human rights? Will he they be talking about possible reunification of North and South Korea somewhere down the line? All of those issues, I'm sure, will be discussed at some point. But as the President was very clear when he left Washington, he was saying this is a process. There will be nothing signed here, he said. He said this might take two, three, four, five meetings or maybe even more. But it is certainly worth it if we can make the world a safer place. But, again, the core argument and mandate of the United States and this is very clear. It is complete, verifiable, irreversible denuclearization of the Korean peninsula." Hannity To Interview Trump After Summit. Axios (6/11, Swan, 2.49M) reports that it has learned Trump's "first sit-down television interview after his historic summit" with Kim is expected to be with Hannity, "his friend and confidant." A Fox said Monday that discussions with North Korea had moved "more quickly than expected" and Trump would leave Singapore on Tuesday night. He had earlier been scheduled to leave on Wednesday. Two US officials told Bloomberg News (6/11, 4.46M) that Kim "set a deadline for ending" the summit , prompting Trump "to set an earlier-than-expected departure time." The officials said Trump "had been willing to stay longer if negotiations were progressing, but since Kim set definite plans for departure, so did Trump." The AP (6/11, Miller, Lucey, Lederman) too says Trump announced on the eve of the meeting "that he will be leaving Singapore early because the nuclear negotiations have moved 'more quickly than expected.' That was before the two had even met, and it was not clear whether it was good news or not." Ahead of Tuesday's summit, Trump tweeted, "Meetings between staffs and representatives are going well and quickly ...but in the end, that doesn't matter. We will all know soon whether or not a real deal, unlike those of the past, can happen!" He continued, "The fact that I am having a meeting is a major loss for the U.S., say the haters & losers. We have our hostages, testing, research and all missle launches have stoped, and these pundits, who have called me wrong from the beginning, have nothing else they can say! We will be fine!" Pompeo: Denuclearization "Ultimate Ahead of today's Objective" Of Summit. summit, Reuters (6/11, Spetalnick, Brunnstrom) reports Secretary of State Pompeo said the "ultimate objective" of the summit had not changed and the US was "eager to see" if North Korea was sincere about denuclearization. Pompeo told reporters Trump was "fully prepared" for the talks, and was optimistic that the outcome would be "successful," while warning that there was still "lots of work left to do." Bloomberg News (6/11, Jacobs, Olorunnipa, Tweed, 4.46M) reports Pompeo also said the US plans to keep sanctions in place until North Korea denuclearizes yet is prepared to offer "unique" guarantees to the regime. In what Bloomberg calls a "stern message to Pyongyang," he also stressed that complete denuclearization "is the only outcome that the United States will accept" from North Korea. Breitbart (6/11, Caplan, 1.28M) reports Pompeo said the US is prepared to take actions to provide North Korea with "sufficient certainty" that 28 EXT-18-248-D-000131 try to reach out and make sure our hands, America's hands always open .... If Trump can pull this off, more power to him." The Gateway Pundit (6/11, Taylor, 201 K) notes that Rodman wore a red Trump "Make America Great Again" hat during his "emotional interview" with CNN. Politico Analysis: "Trump Made Blake Hounshell Diplomacy Great Again. 11 writes for Politico Magazine (6/11, 3.45M) that when "candidate Barack Obama said in a 2007 debate that he'd meet with the leaders of rogue states - including North Korea - without preconditions, critics pounced . ... Flash forward to today, and what are Republicans saying about the current president's willingness - eagerness, even - to cut a nuclear deal with the most roguish leader of them all, North Korean strongman Kim Jong Un?" Not much, according to Hounshell, who notes that Democrats "have largely welcomed Trump's North Korea diplomacy." He argues that "whether he succeeds or fails, to his supporters, is almost beside the point - the president is making diplomacy great again." NYTimes Editorial Board Member Suggests Summit A Distraction From Russia Probe. The Daily Caller (6/11, Nista, 420K) reports New York Times editorial board member Mara Gay suggested Monday on MSN BC that today's summit "exists to distract from the Russia investigation." Said Wallace, 'This is not just a meeting about foreign policy, this is about Donald Trump's political survival. He has said to friends that he plans on taking a win in North Korea to the voters. That's their midterm message; that's all they've got." News spokeswoman "confirmed the interview" will air in full on Fox News' Hannity on Tuesday. WPost Analysis: Trump's Feud With Trudeau "Looks Like A Stunt." Callum Borchers writes for the Washington Post (6/11, 15.68M) 'The Fix" blog that Trump's "rationale for lashing out at Canadian Prime Minister Justin Trudeau does not add up." In a tweet, Trump pointed to "Justin's false statements at his news conference" and "the fact that Canada is charging massive Tariffs." But Borchers notes that Canadian tariffs "were in place long before the summit and did not prevent Trump from initially endorsing the G7 statement on trade." He notes that "what was new was Trudeau' s news conference Saturday, where he said that Canadians 'will not be pushed around."' According to Borchers, "It appears as though Trump is the one performing a stunt, raging at Trudeau in theatrical fashion without a clear reason to be so worked up. In fact, [White House economic adviser Larry] Kudlow suggested in his appearance on CNN that Trump's anger at Trudeau is an act for an audience of one: North Korean leader Kim Jong Un." Kim Takes Late-Night Sightseeing Tour In Singapore. Reuters (6/11, Holland) reports that Kim, "one of the world's most reclusive leaders, made an evening tour of sites on Singapore's waterfront." He was joined by Singapore's foreign minister, Vivian Balakrishnan, "who took a selfie." Reuters says the "rare public appearance of Kim, waving and smiling to onlookers, adds to the more affable image of the young leader that has emerged since his summit in April with South Korean leader Moon Jae-in." Bloomberg News (6/11, Zhai, Lee, 4.46M) similarly says the trip "marked a rare outing in a modern metropolis for a reclusive leader" who has "sought to overhaul his image this year." To the Washington Post (6/11, Fifield, 15.68M), "the Singaporean hosts seemed to be daring Kim to think big, to dream of the kind of glittering future his country could have if it opens up to the outside world, as they took him on the late-evening tour." Dennis Rodman: Kim "Trying To Progress His Country. 11 Dennis Rodman said on CNN's Cuomo Prime Time (6/11, 839K), "If President Trump goes in there with a great heart, with his heart on the table, and lets Kim Jong-un see him, really emotional, as far as speaking to him." Kim, Rodman added , "is trying to progress his country. And Donald Trump is going to do a great job and Trump To Hold Rally In MN8 Next Week. The Minneapolis Star Tribune (6/11, Golden, Van Berkel Star, 1.16M) reports the President "will make his first post-election visit to Minnesota ...on June 20 at the Duluth Entertainment Convention Center." The Duluth (MN) News Tribune (6/11, Olsen, 195K) notes that "Trump, who campaigned in Superior in April 2016, will be the first sitting president to visit Duluth since George W. Bush in 2004." As KSJR-FM Collegeville, MN (6/11, 92K) reports, Duluth is "the battleground for the open and highly competitive 8th Congressional District seat," which Trump won in 2016 even as Rep. Rick Nolan (D-MN) "held onto the seat in a close election and Minnesota chose Hillary Clinton for 29 EXT-18-248-D-000132 that split the conservative and liberal just ices, the court rejected arguments in a case from Ohio that the practice violates a federal law intended to increase the ranks of registered voters." The AP adds "Ohio's contested voter purge stems from an inoffensive requirement in federal law that states have to make an effort to keep their voter rolls in good shape by removing people who have moved or died." Ohio "pursues its goal more aggressively than most, relying on two things: voter inactivity over six years encompassing three federal elections and the failure to return a card ...asking people to confirm that they have not moved and continue to be eligible to vote." CNN (6/11, De Vogue , Vazquez, 82.6M) cautions on its website that "at least six other states have similar laws, and the ruling could embolden others to follow suit and enact what critics say are aggressive purges of voter rolls." The Washington Times (6/11, Dinan, 460K) , in fact, reports "the ruling is already boosting conservative groups pushing to have other states clean up their voter rolls." Politico (6/11, Gerstein, 3.51M) calls the ruling "a victory for the Trump administration ," and NPR (6/11, Totenberg, Montanaro, 3.55M) noted that "the Obama Justice Department had sided with the lead plaintiff in the case, Larry Harmon, a software engineer from the Akron area," but "once [President] Trump was elected, the DOJ did an about-face and switched positions." The Los Angeles Times (6/11, Savage, 4.03M) says "the legal dispute played out against a backdrop where two major parties had opposite views. Republicans spoke of 'voter fraud' and election rolls they said were stocked with ineligible and illegal voters, while Democrats complained of "voter suppression" by GOP states which , they said, made it harder for minorities and the poor to cast ballots." To USA Today (6/11, Wolf, 11.4M), along those lines, "the ruling could be a major victory for Republicans, who tend to benefit from lower voter turnout , and a stinging loss for Democrats, who do best in high-turnout elections." That is "because minorities, young people and those with lower incomes are most likely to be disenfranchised by the state's policy." Newsweek (6/11, Goodkind, 2.18M) also reports "a number of civil rights groups argued that the decision would likely aid Republicans but hurt Democrats and voters of color." The Cleveland Plain Dealer (6/11, Eaton, 1.03M) notes "Ohio Secretary of State Jon Husted president." Nolan "earlier this year announced he would not seek re-election to the district, giving Republicans a key opportunity to flip the seat." While "four Democrats are headed for an August primary at this point," St. Louis County Commissioner Pete Stauber "is the lone Republican in the 8th District race. He's a retired Duluth police officer who's also served on the Hermantown City Council and in younger years played minor league professional hockey." The Washington Examiner (6/11, Quinn, 340K) indicates, moreover, that "both of Minnesota's senators , Democrats Amy Klobuchar and Tina Smith, are on the ballot this November." The Hill (6/11, Samuels, 2.71 M) quotes "Michael Glassner, COO of the Trump campaign," as saying in a statement, "The President will meet with Minnesota patriots to report the latest developments for our surging economy, including record-low unemployment and fair trade reforms, and his historic summit with North Korean leader Kim Jong-un ." The Hill adds that the event "could be viewed as a sign of confidence from Trump on his chances in Minnesota." The President "narrowly lost the state, which has been won by every Democratic candidate for president since 1972." The St. Paul (MN) Pioneer Press (6/11, Woltman, 453K) notes that "in an emailed statement , Jennifer Carnahan, chairwoman of the Republican Party of Minnesota, said she is excited to welcome the president back to the state." Said Carnahan, 'The importance of Minnesota this election cycle - in influencing the balance of power in Washington D.C. for the next two years and ensuring we send the President conservative reinforcements - depends on our ability to Make Minnesota Red. ... We look forward to the momentum and positive energy his visit will bring to Minnesota Republicans and our opportunities this election cycle." Trump Hails High Court Ruling Allowing Ohio To Drop Inactive Voters From Rolls. President Trump took to Twitter yesterday to write, "Just won big Supreme Court decision on Voting! Great News!" Trump was referring to a case involving Ohio, which is receiving widespread print media coverage this morning. The AP (6/11, Sherman) reports that the Supreme Court has ruled that states "can target people who haven't cast ballots in a while in efforts to purge their voting rolls." In a "5-4 vote 30 EXT-18-248-D-000133 called the ruling in the case known as Husted v. A. Philip Randolph Institute 'a victory for election integrity, and a defeat for those who use the federal court system to make election law across the country."' Husted "is Attorney General Mike DeWine's running mate in this year's governor's race." DeWine said yesterday, "I am pleased that the United States Supreme Court agreed that Ohio was following federal law in maintaining accurate voter rolls.. .. I congratulate our attorneys throughout this case for their exceptional work in documenting how this process used by Democrat and Republican secretaries of state is indeed lawful." The Columbus (OH) Dispatch (6/11, Torry, Ludlow, 399K) reports Sen. Sherrod Brown, "a former secretary of state, assailed the ruling, saying 'Ohio should be working to make voting easier, not harder. Instead, today's decision empowers Ohio to further strip away the right to vote for thousands of Ohioans, threatening the integrity of our state's election process."' CQ Roll Call (6/11, Ruger, 117K) reports House Minority Leader Pelosi "called the decision dangerous and 'a grave step backward in our nation's progress to advance a future in which every person can enjoy their full, equal right to be heard at the ballot box."' It was , Reuters (6/ 11, Chung) reports, "a ruling powered by the five conservative justices and denounced by liberal Justice Sonia Sotomayor as an endorsement of the disenfranchisement of minority and low-income Americans." The Columbus (OH) Dispatch (6/11, Torry, Ludlow, 399K) reports that in his ruling, Justice Alito said Ohio's system "does not violate federal laws approved in 1993 and 2002 by Congress." Wrote Alito, "We have no authority to second-guess Congress or to decide whether (the Ohio's law) is the ideal method for keeping its voting rolls up to date. ... The only question before us is whether it violates federal law. It does not." Meanwhile, says the Washington Post (6/11, Barnes, 15.68M), Sotomayor wrote in her dissent, "Communities that are disproportionately affected by unnecessarily harsh registration laws should not tolerate efforts to marginalize their influence in the political process, nor should allies who recognize blatant unfairness stand idly by." Alito retorted, "Justice Sotomayor's dissent says nothing about what is relevant in this case namely, the language of the" National Voter Registration Act, and "has not pointed to any evidence in the record that Ohio instituted or has carried out its program with discriminatory intent." NPR (6/11, Totenberg, Montanaro, 3.55M) reported "the first line of the opinion lays out evidence for why Alito sees the need to clean up voter rolls." Wrote Alito, "It has been estimated that 24 million voter registrations in the United States - about one in eight - are either invalid or significantly inaccurate," and "about 2.75 million people are said to be registered to vote in more than one State." Alito was referencing "a Pew Center on the States" report, "the same study that incoming Trump White House officials cited misleadingly - to make the case that voter fraud was occurring and immigrants in the US illegally were voting ." Fox News (6/11, Mears, 16.38M) reports on its website that "Alito, in his opinion, clarified that states could not use the failure to vote as the sole reason for removal from the register." Officials "would be required to show someone had changed their residence, was incarcerated or met other criteria." The New York Times (6/11, Liptak, Subscription Publication, 19.33M) indicates, however, that "the central question in the case was whether a failure to vote could be the reason to send out the notice." Politico (6/11, Gerstein, 3.51M) reports that "Stuart Naifeh, senior counsel at Demos, which led the legal team challenging the state's practices," said yesterday that the ruling "threatens the ability of voters to have their voices heard in our elections." The Wall Street Journal (6/ 11, Kendall, Bravin, Subscription Publication, 6.13M), Was hington Examiner (6/ 11, Quinn, 340K) and The Hill (6/11, Wheeler , 2.71 M), among other news outlets, run similar reports on the ruling. More Commentary . The Washington Post (6/11, 15.68M) editorializes that "though the court majority determined that" Ohio's approach to purging the voter rolls "is legal, it is not wise," as "states should be encouraging more cIvIc participation, not less." The Post adds that in the US, "political legitimacy flows from popular approval ," and "systematically discouraging sections of the populace from voting is cynical and detrimental to the democracy." USA Today (6/11, 11.4M) offers similar arguments in an editorial titled "Supreme Court Upholds Ohio's Vote Suppression Scheme." In an editorial, the Wall Street Journal (6/11, Subscription Publication, 6.13M) defends the 31 EXT-18-248-D-000134 with the plan," but "he is eager to be a sounding board and counselor." ruling, hailing it as a step toward more accurate voter rolls. Pete Hutchison, president of Landmark Legal Foundation, writes in USA Today (6/11, 11.4M) that "the dissenting justices object to the Ohio Legislature's policy decisions," but "the job of judging is to apply the law as written and not to second-guess the people's representatives. Monday's decision is a victory for ballot integrity." New D'Souza Film Compares AntiTrump "Resistance" To Democrats' Opposition To Lincoln. The Hill (6/11, Concha, 2.71M) reports "conservative filmmaker Dinesh D'Souza, who was recently pardoned by President Trump, is making comparisons for his next film between the Democratic resistance to Trump and how Democrats didn't accept President Lincoln's reelection during the Civil War." The Twitter "account for D'Souza's next film, 'Death of a Nation,"' stated yesterday, "Not since 1865 have #Democrats so dramatically refused to accept the outcome of a presidential election." D'Souza also weighed in on Twitter, asking, "Lincoln united his party and saved America from the Democrats for the first time. Can Trump - and wen-- come together and save America for the second time?" Trump-Recruited GOP Candidate Frustrated By Trump's "Affinity" For Heitkamp. The Washington Post (6/11, Sullivan, 15.68M) reports, "President Trump is aggressively campaigning for Republican Senate candidates around the country and belittling their Democratic rivals, with one notable exception Sen. Heidi Heitkamp of North Dakota." The President's "affinity for Heitkamp, who got a shoutout and a handshake at a recent White House bill signing, has frustrated top Republicans who see winning her Democratic seat as crucial to holding onto their fragile 51-to-49 majority." Rep. Kevin Cramer (R-ND), "whom Trump personally recruited to run against Heitkamp," has contacted Chief of Staff Kelly "to appeal for political help" and has "traded warning shots with Trump's legislative affairs director, Marc Short." Trump Highlights Good Economic News. In a tweet Monday afternoon, Trump touted his economic record, writing, "Stock Market up almost 40% since the Election, with 7 Trillion Dollars of U.S. value built throughout the economy. Lowest unemployment rate in many decades, with Black & Hispanic unemployment lowest in History, and Female unemployment lowest in 21 years. Highest confidence ever!" Stocks Rise Slightly. Trump's tweet came on a day that stocks posted slight gains. Reuters (6/11, Brown) reports that the Dow climbed 5.78 points to 25,322.31, the S&P 500 added 2.97 points to close at 2,782, and the Nasdaq ended the day 14.41 points higher at 7,659.93. Fed weighs Historically Low Unemployment In Considering Rate Decision. The Wall Street Journal (6/11, Timiraos, Subscription Publication, 6.13M) reports that as the Federal Reserve prepares to announce whether it will raise the benchmark short-term interest rate on Wednesday, it is considering how far unemployment may fall without stoking inflation. The Journal adds that the US unemployment rate has only his its current level of 3.8% twice before in the past 50 years, one of which , in the 1960s, spurred high inflation. The article adds that the Fed is projected to increase its short-term rate to between 1.75% and two percent, adding that Fed Chairman Jerome Powell's view of the near-term future of US Obama Meeting With Potential 2020 Democratic Presidential Candidates. CNN (6/11, Merica, 82.6M) reports on its website, "Barack Obama has met with several Democrats considering running for president in 2020, a Democrat close to the former president tells CNN, offering them advice on running in the Trump era and discussing how to position the party going forward." CNN adds that "to date , according to the Democrat, Obama has met with Vermont Sen. Bernie Sanders; Massachusetts Sen. Elizabeth Warren; former Vice President Joe Biden; former Massachusetts Gov. Deval Patrick; New Jersey Sen. Cory Booker; former New Orleans Mayor Mitch Landrieu; Los Angeles Mayor Eric Garcetti; South Bend, Indiana, Mayor Peter Buttigieg; former Missouri Secretary of State Jason Kander; and former Attorney General Eric Holder." Politico (6/11, Dovere, 3.51 M) says "Obama is concerned about how his own party is responding" to President Trump, "and how it can be best positioned to win in the midterms and in the next presidential cycle to beat back the president and his politics." Obama, adds Politico, "doesn't see himself as the person to come up 32 EXT-18-248-D-000135 Journal (6/11, Price, 304K) reports that former Vice President Joe Biden was heckled during a book tour stop in his hometown of Wilmington, Delaware on Sunday. As Biden "was talking about sexual assault," the heckler asked, "What about the girls you molested on C-SPAN at the Senate swearing in?" The taunt drew boos and shouting from the audience, but Biden "quieted the crowd enough to respond: This is not Trump world,' which drew a deluge of applause and cheers, even as catcalls and boos aimed at the heckler continued." unemployment will drive Fed interest rate decisions. Maher Hopes For Recession So We Can "Get Rid Of Trump." Writing on Townhall (6/11, 209K), Matt Vespa cites a RealClear Politics report which said that comedian Bill Maher said Friday that he is hoping for a recession so we can "get rid of Trump." On his HBO show Real Time, Maher said, "Can I ask about the economy because this economy is going pretty well? I feel like the bottom has to fall out at some point. And by the way, I'm hoping for it. Because I think one way you get rid of Trump is a crashing economy. So, please, bring on the recession. Sorry if that hurts people, but it's either root for a recession or you lose your democracy ." Poll: Scott "Dominating" Nelson Among Florida Voters 50 And Older. Politico (6/11, Caputo, 3.51 M) reports that a forthcoming Politico/AARP poll shows that Gov. Rick Scott "is virtually tied" with Sen. Bill Nelson in the Florida Senate race, and is "dominating" Nelson "by 9 points among those nearing or at retirement age - a group that casts the majority of Florida's votes." Overall, "Scott leads Nelson overall by 40 percent to 39 percent, but Scott's support grows to 44 percent while Nelson's shrinks to 35 percent with those 50 and older." Pai: Expiration Of Net Neutrality Means A Return To Clinton-Era Framework. The Washington Times (6/11, Munoz, 460K) reports that as net neutrality regulations ended Monday, FCC Chairman Ajit Pai "touted a return to past policies," saying the "new approach is actually more like the policy set in place by former President Bill Clinton." Pai told CBS This Morning, "President Clinton's framework, it served us well from '96 until 2015, and I'm confident going forward ." Reuters (6/11, Shepardson) says that while the net neutrality rules expired Monday, "a court battle remains ahead." McClatchy Analysis: Sanford Fighting For Political Life In SC1 GOP Primary. McClatchy (6/11, Douglas, Dumain, 81 K) reports that Rep. Mark Sanford (R-SC) is fighting for his political life in his Tuesday primary "thanks to his disagreements with President Donald Trump ." Recent polling shows Sanford and State Rep. Katie Arrington "in a statistical tie" in SC1. Pentagon Officials Distance Themselves From LGBT Pride Month Observances. The Washington Post (6/11, In AL2, Rouby Faces Runoff Amid Questions About Her Loyalty To Trump. The New York Times (6/11, Blinder, Sonne, 15.68M) reports that for the first time since the practice became routine in the wake of President Obama's repeal of the military's ban on homosexuals serving openly, senior Pentagon officials "are distancing themselves from the Defense Department's annual LGBT Pride Month celebrations." While an official Pentagon memo is typically distributed at the beginning of LGBT Pride Month in June , the absence of the memo this year "has raised questions among service members and Defense Department civilian employees who remain troubled by President Trump's surprise proclamation last July that he would ban transgender individuals from serving in the military." Martin, Subscription Publication, 19.33M) reports that President Trump "has become a one-man litmus test in some of his party's primaries, imperiling incumbents in races where policy issues seem to matter less to voters than personal loyalty to the president." In AL2, Republican voters "face a peculiar choice in a runoff' - Rep. Martha Roby (R-AL), "who condemned Mr. Trump but has since voted nearly in lock step with him," or Bobby Bright, "who was once a Democrat who supported Nancy Pelosi, but now sounds much like the president." That Rouby was "forced into a runoff by questions of personal fealty illustrates the potency of the issue in this year's Republican primaries." Biden Heckled During Book Tour Stop In Delaware. The Wilmington (DE) News 33 EXT-18-248-D-000136 Democrats Consulting With Hollywood Ahead Of Midterms. Politico violent gangs in the region as she tries to shore up the pro-Trump elements of her party." (6/11, Siders, 3.51 M) reports that the DNC and Democratic lawmakers are "quietly consulting" with Hollywood actors, writers, and producers for "help with voter turnout and messaging ahead of the midterm elections and 2020 presidential campaign." DNC Chairman Tom Perez, several House members, and others have met with a group "formed by members of the entertainment industry in the wake of the 2016 election," to discuss "targeted voter-registration programs with visiting Democrats, as well as the party's framing of issues ranging from abortion rights to gun control." AP Analysis: Democratic House Candidates Pushing Liberal Messages. The AP (6/11, Barrow, Beaumont) reports that Democrats' midterm House candidates are "shaping up to test what liberal messages the party can sell to the moderate and GOP-leaning voters who will help determine control of the House after the November election." According to the AP, "the crop of nominees is trending more liberal than many of the 'Blue Dog' Democrats swept away in Republicans' 2010 midterm romp." As a result, "voters now represented by a Republican will be asked to consider some or all of the mainstream Democratic priorities that may have been considered 'too liberal' in the past: more government involvement in health insurance, tighter gun laws, a path to citizenship for people in the country illegally, reversing parts of the GOP tax law, support for LGBTQ rights." The question is whether that will result in "Democrats gaining the 23 new seats they need for a majority." Female Gubernatorial Candidates Say They Face Resistance To Female Executive Power. The New York Times (6/11, Martin, Burns, Subscription Publication, 19.33M) reports that while women "have emerged as the animating force behind the backlash to President Trump , with many storming to victory in congressional primaries, several are finding governor's races to be more challenging as they struggle to build as much political and financial support as their male rivals." From today through September, "female candidates for governor will be on the ballot in Democratic primaries across 17 states, including pivotal battlegrounds such as Florida, Wisconsin and Colorado," but "several said they are facing entrenched resistance to female power at the executive level, and male opponents with deeper campaign coffers and, in some cases, far less political experience." Bill Clinton: Norms Of "What You Can Do To Someone Against Her Will" Have Changed. The Daily Caller (6/11, Athey , 420K) reports that in an interview with PBS on Friday, former President Bill Clinton "made a disturbing statement about sexual consent." Asked about the resignation of Sen. Al Franken and what that says about changing norms, Clinton said, "I think it's a good thing that we should all have higher standards," Clinton said. "I think the norms have really changed in terms of, what you can do to somebody against their will, how much you can crowd their space, make them miserable at work ." USA Today (6/11, Cummings, 11.4M) reports that Clinton "said that Franken was 'a difficult case' for him because while there may be facts he doesn't know about the allegations , many of Franken's past female colleagues came to his defense." Clinton said, "Maybe I'm just an oldfashioned person ... but it seemed to me that there were 29 women on 'Saturday Night Live' that put out a statement for him, and that the first and most fantastic story was called, I believe, into question." Referring to Franken's resignation, he added that it is "a grievous thing to take away from the people a decision they have made .... But it's done now." Poll: 53% See Clinton As A Sexual Predator. Katie Pavlich writes on Townhall (6/11, 209K) that the latest Rasmussen Reports poll Democrats Hope Anti-Trump Sentiment Will Help Unseat Comstock. The Washington Times (6/11, Sherfinski, 460K) reports that Democrats "are counting on an antiTrump backlash, a desire to overturn the Republican-led Congress and a surge of interest in gun control to unseat suburban Republicans" like Rep. Barbara Comstock (R-VA) in VA10. But Comstock "said she has been a top target in her past two elections yet emerged with a 16percentage-point victory in 2014 and won reelection by 6 points in 2016, even as Hillary Clinton carried the district by close to double digits." Comstock "is highlighting her vote for Republican tax cuts and her work combating 34 EXT-18-248-D-000137 reports that Sen. Marco Rubio "stood up for Chickfil-A" in a series of tweets. Rubio "questioned the prudence of boycotting a company for holding a mainstream Christian view on marriage." He wrote, "This lunacy has gone too far. The CEO of @Twitter bullied into apology for patronizing @ChickfilA because owners support "biblical definition of marriage. Holding a personal view taught by mainstream Christianity is now boycott worthy." Rubio followed that with another, saying, "@ChickfilA isn't denying service to anyone. But if you eat there you must be attacked by the twitter mob b/c owner agrees with what his church teaches about marriage? Why would twitter mob stop at biz owned by Christians? Who is next? Christian schools? Christian charities?" In a final tweet, Rubio wrote, "The message from latest @ChickfilA incident is this: "Your church can still teach traditional marriage (which by the way we will still label as a bigoted belief) but don't you dare repeat it outside of church or we will come after you, your business and/or your job." found that "just 24% of Likely U.S. Voters consider Clinton a victim of his political opponents. Fiftythree percent (53%) describe the ex-president as a sexual predator instead. Another 24% are undecided." Broadway Veterans, Trump Critics Struggle With De Niro's Tony Comments. The Washington Post (6/11, Zeitchik, 15.68M) reports that actor Robert De Niro's speech at the Tony Awards, in which he said, "F---Trump. ... It's no longer down with Trump ...but F--- Trump ," made "a Broadway extravaganza and a beloved American actor ...a lighting-rod referendum on Trumpism." The Post adds that a post-ceremony parties, "the Trump moment was on many Broadway veterans' minds. They just couldn't figure out what to make of it or whether what he did was a good thing." The Washington Times (6/11, Chasmar, 460K) reports that MSNBC host Joe Scarborough said De Niro and those who applauded his comments are unwittingly aiding the President's re-election. Scarborough said, "If people that applauded De Niro's statement last night don't understand that they are helping Donald Trump's re-election every time they do something like that, they don't understand." EDITORIAL WRAP-UP New York Times. "The Healthcare The New York Times (6/11, Stalkers." Subscription Publication, 19.33M) similarly argues in an editorial that Democrats who hope "to make health care a centerpiece of midterm election campaigns just got a gift from the Trump administration," as the Justice Department has "declined to defend the Affordable Care Act against a lawsuit filed by 20 Republican-led states," and is "arguing for the repeal of enormously popular consumer protections, including coverage of pre-existing conditions." "America Isolated." The New York Times (6/11, Subscription Publication, 19.33M) writes on its editorial page that last weekend's G7 summit was "a confirmation that so long as Mr. Trump is in the White House, and maybe beyond that, something fundamental in the community of Western democracies will be missing. America, the leader of the free world and the architect of so much of the modern world order, had decided to go its own way ." The Times argues that "it's past time to recognize that this president has transformed 'America First' into 'America Alone,' and that this is the last place a great and powerful nation wants to be." Twitter CEO Draws Fire For Chick-FilA Post During Pride Month. USA Today (6/11, Carrig, 11.4M) reports that Twitter CEO Jack Dorsey apologized after a tweet in which he said he ordered food from Chick-fil-A drew criticism on social media. Dorsey was criticized "for supporting Chick-fil-A during" June, which is LGBTQ Pride Month. In 2012, Chick-fil-A "came under fire from gay rights supporters ...because of comments made by the fast food chicken chain's CEO, Dan Cathy, expressing opposition to samesex marriage" and the company's donations to anti-gay groups. Amid the backlash from his original tweet, Dorsey wrote, "You're right. Completely forgot about their background." Under the headline "Jack Dorsey Chickens Out," a Wall Street Journal (6/11, Subscription Publication, 6.13M) editorial takes issue with the criticism of Dorsey and argues the Chick-fil-A restaurants serves everyone and Cathy was expressing his personal beliefs when he voiced opposition to gay marriage. Rubio Defends Chick-Fil-A. The Washington Times (6/11, Richardson, 460K) 35 EXT-18-248-D-000138 Washington Post. "Why Are Republicans WALL STREET JOURNAL: So Determined To Discourage People From Voting?" The Washington Post (6/11, 15.68M) editorializes that "though the [Supreme Court] majority determined that" Ohio's approach to purging the voter rolls "is legal, it is not wise," as "states should be encouraging more cIvIc participation, not less." The Post adds that in the US, "political legitimacy flows from popular approval," and "systematically discouraging sections of the populace from voting is cynical and detrimental to the democracy." "Canada Has Every Right To Be Insulted." The Washington Post editorializes that Canada "has every right to be insulted that Mr. Trump would invoke national security in their trade dispute. Canada has stood with the United States in every modern war and crisis. There is no doubt that the United States could rely on Canadian steel and aluminum if another crisis developed, obviating the stated rationale for imposing the tariffs." Trump's "trade offensive," it argues, "is an insult." Trump Greets Kim To Kick Off Summit The Fed's Biggest Dilemma: Is The Booming Job Market A Problem? Stryker Makes Takeover Approach To Boston Scientific Buyer Beware When A Stock Joins The S&P 500 NEW YORK TIMES: Trump, After Talks With Kim, Says Denuclearization Will Begin 'Quickly' Sessions Says Domestic And Gang Violence Are Not Grounds For Asylum Supreme Court Upholds Ohio's Purge Of Voting Rolls New York City Housing Authority, Accused Of Endangering Residents, Agrees To Oversight Democratic Women Are Running For Governor. Men And Money Stand In Their Way. The Nine Steps Required To Really Disarm North Korea WASHINGTON POST: Trump And North Korea's Kim Meet For Historic Summit Justices Uphold Ohio's System For Purging Rolls Of Nonvoters President Increasingly Relies On Unilateral Action To Wield Power Smiles And Handshakes Could Mask Divide Over Nuclear Arms Is MS-13 Overtaking A Middle School In MD.? Wall Street Journal. "The Autumn Of Obamacare." A Wall Street Journal (6/11, Subscription Publication, 6.13M) editorial says that while Democrats are blaming Republicans for double-digit healthcare premium increases, the problem is the structure of the ACA. As the election approaches, the Journal adds, Republicans will have to refute the Democrats' false claims. "Jack Dorsey Chickens Out." A Wall Street Journal (6/ 11, Subscription Publication, 6.13M) editorial takes issue with criticism of Twitter CEO Jack Dorsey over a tweet in which he said he ordered food from Chick-fil-A. The Journal argues the Chick-fil-A restaurants serves everyone and that Chick-fil-A CEO Dan Cathy was expressing his personal beliefs when he voiced opposition to gay marriage. "A Victory For Voting Law." In an editorial, the Wall Street Journal (6/11, Subscription Publication, 6.13M) defends the Supreme Court ruling on states purging voter rolls, hailing it as a step toward more accurate voter rolls. FINANCIAL TIMES: Citi Issues Stark Warning On Automation Of Bank Jobs Martin Sorrell's Downfall: Why The Ad King Left WPP Duque Readies To Become Colombia's Youngest President Spain To Take In 629 Migrants Stranded At Sea After Italy Refuses WASHINGTON TIMES: Trump, Kim Jong-Un Sign Document, Pledge To Work Together For Peace Jeff Sessions Sets Higher Bar For Asylum Claims USS Pueblo Still Held Hostage By North Korea As Trump, Kim Meet Va. Democrats Banking On Anti-Trump Backlash In Bid To Unseat Rep. Barbara Comstock Redskins Replacement Players From 1987 To Get Super Bowl Rings THE BIG PICTURE Headlines From Today's Front Pages. 36 EXT-18-248-D-000139 Murky U.S. Drone-Strike Policy Threatens To Backfire As Other Nations Acquire Technology Sanctions Against Russian Businesses; TrumpImmigration. STORY LINEUP FROM LAST NIGHT'S NETWORK NEWS: LAST LAUGHS US-North Korea Relations-Summit; USNorth Korea Relations-Kim-Jong-Un Insights; USNorth Korea Relations-Korean Peninsula; TrumpG7 Allies Relations; Severe Weather; TrumpImmigration; Orlando-Hostage Situation; Washington State-Cabin Explosion; United Airlines-Security Threat; Anthony BourdainSuicide; US-North Korea Relations-Kim Jong-Un Out Late. CBS: US-North Korea Relations-Summit; TrumpG7 Allies Relations; US-North Korea RelationsKim-Jong-Un Insights; US-North Korea RelationsDenuclearization; US-North Korea RelationsTrump's Deal Making; Colorado-Wildfires; Orlando-Hostage Situation; Anthony BourdainSuicide; North Korea Defector. NBC: US-North Korea Relations-Summit; USNorth Korea Relations-Kim-Jong-Un Insights; USNorth Korea Relations-Singapore; US-North Korea Relations-South Korea; Trump-G7 Allies Relations; Trump-Immigration ; Missing US Official Found; Orlando-Hostage Situation; ColoradoWildfires; Ohio-Explosion Investigation; US-North Korea Relations-Reactions. ABC: Late Night Political Humor. Jimmy Kimmel: "When he left the G7, Trump said his relationship with the other leaders was a 10. He rated it a 10. And then a few hours later, I guess he didn't like the idea that the Prime Minister of Canada Justin Trudeau didn't do as he was told, and so Trump tweeted, 'PM Justin Trudeau of Canada acted so meek and mild during our G7 meetings, only to give a news conference after I left saying that US tariffs were kind of insulting and he will not be pushed around. Very dishonest and weak . Our tariffs are in response to his of 270 percent on dairy .' Bearing in mind that first of all, our dairy trade with Canada - it's only about $600 million a year, which is about what it costs for him to play golf every week." Jimmy Kimmel: "And he justified these new tariffs in the first place by saying our national security was at stake. Now he's saying it's because of dairy. How does Canadian dairy threaten our national security? Are they planning to churn us to death? Are they going to drop cheese curds on us and turn us into poutine?" NETWORK TV AT A GLANCE: US-North Korea Relations-Summit - 13 minutes, 15 seconds US-North Korea Relations-Kim-Jong-Un Insights 11 minutes, O seconds Trump-G7 Allies Relations - 6 minutes, 5 seconds Orlando-Hostage Situation - 2 minutes, 50 seconds Jimmy Kimmel: "And who has a problem with Canada? No one has a problem with Canada. It's like picking a fight with 'Nilla Wafers. No one does it. It's ridiculous.'' Jimmy Kimmel: 'Trump also threatened to cut off all trade with the other six nations at the summit. All our closest allies. We would not trade with them anymore. German Chancellor Angela Merkel said she found his actions at the summit to be sobering and depressing . And when a German finds you to be sobering and depressing - bad news. This is the country that gave us Hitler and David Hasselhoff." STORY LINEUP FROM THIS MORNING 'S RADIO NEWS BROADCASTS: US-North Korea Relations-Summit; USNorth Korea Relations-Summit-Reactions; Orlando-Hostage Situation; Trump-Immigration. CBS: US-North Korea Relations-Summit; WHKudlow Heart Attack; Trump-Immigration; Immigration-Cheating For Green Cards; Crash Test Results; Wall Street. FOX: US-North Korea Relations-Summit; WHKudlow Heart Attack; Supreme Court-Ohio Voter Ruling. NPR: US-North Korea Relations-Summit; USNorth Korea Relations-Choreographed Hand Shake; WH-Kudlow Heart Attack ; WH-Treasury- ABC: Stephen Colbert: "Folks, it is an historic evening because, as we speak, President Trump is meeting with North Korean dictator Kim Jong-un, a scenario that, just a few years ago, would have been unthinkable because it includes the phrase 'President Trump."' Stephen Colbert: 37 "So tensions are high. The EXT-18-248-D-000140 United States is on the precipice of unthinkable international conflict, and that's with Canada." meeting is going well by 'touch and feel.' That's what he said. In other words , Trump's lawyer is going to have to pay Kim Jong-un $130,000." Stephen Colbert: "If you're one of those nerds who values the Western alliance that has safeguarded democracy for 70 years, it was a tough weekend for you because Canada hosted the G7, and it did not go 'the good.' Keep in mind, the G7 are our trading partners, and right before he attended, Donald Trump declared protectionist trade tariffs against all of them. That's like showing up to an AA meeting with Captain Morgan." Conan O'Brien : "North Korean leader Kim Jongun brought his own toilet to the summit in Singapore. When he saw the toilet, President Trump said, 'Oh, so you're planning to tweet, too."' Conan O'Brien: "President Trump said that during the North Korea summit, he will not focus on human rights abuses . Trump said, 'My marriage is no one's business."' Trevor Noah: "White House staffers have reportedly been taping pieces of paper back together after President Trump rips them up. They need to tape them back together to comply with the Presidential Records Act. According to Politico, the papers include letters and official documents required by law to be preserved and sent to the National Archives. ... President Trump's tearing up official documents? I mean, let's not act surprised. After all, he spent the last year tearing up the Constitution.'' James Corden: "Tomorrow is the big summit meeting between President Trump and North Korean leader Kim Jong-un. Trump spent the day preparing for the summit, which basically means he wrote on his hands, 'South Korea good, North Korea bad,' so he doesn't get confused." James Corden: "When asked by reporters how he will know if North Korean leader Kim Jong-un is serious about a peace treaty, President Trump said he will use his 'touch and feel.' This may not be a great plan. The last time Trump used his 'touch and feel' method, he had to pay Stormy Daniels $130,000." Trevor Noah: "I don't know why Trump rips up all his paper. My guess is to show off how strong he is. 'Would an unhealthy President be able to do this?!"' James Corden: "Honestly, it may work. After three minutes of being touched and felt by Trump, Kim Jong-un is just going to shout, 'Fine, take the nukes! Just stop touching me!'" Trevor Noah: Trump said "he wants Russia to be welcomed back into the GB. I don't know if Trump colluded with Russia, but if everyone was accusing me of colluding with Russia, I wouldn't be caught dead mentioning their name. If your girlfriend accused you of cheating with Keisha, even if you didn't do it, shut up about Keisha, just shut up." Jimmy Fallon: "Tonight in Singapore, Trump and North Korean leader Kim Jong-un finally came face to face. Or in Kim's case, more like face to belly button." Jimmy Fallon: "There's a lot riding on this meeting. Last night, Kim spent hours preparing, while at the same time, Trump was in bed waiting for 'Spongebob' to perform on the Tonys." Trevor Noah: "Trump went into the G7 for a runof-the-mill check-in with America's allies and came out full-on beefing with Canada, the Ned Flanders of countries." Seth Meyers: "President Trump and North Korean leader Kim Jong-un met tonight in Singapore after we taped our show. So if you're watching this on TV right now, either it went well, or you have a TV in your fallout shelter." Trevor Noah: "Emmanuel Macron called Trump incoherent, and Angela Merkel said it is sobering and depressing. She is German, so everything is sobering and depressing to her. She was at breakfast saying, 'I find this pancake both sobering and depressing."' Seth Meyers: "Dennis Rodman arrived in Singapore today for the summit with Kim Jong-un. So at least if Kim launches a nuclear missile, Rodman will be there to grab the rebound." Conan O'Brien: "This past weekend , President Trump told reporters he'll know if the Kim Jong-un 38 EXT-18-248-D-000141 Copyright 2018 by Bulletin Intelligence LLC Reproduction or redistribution without permission prohibited. Content is drawn from thousands of newspapers, national magazines, national and local television programs, radio broadcasts, social-media platforms and additional forms of open-source data. 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We can be found on the Web at Bulletinlntelligence.com, or called at (703) 4836100 . 39 EXT-18-248-D-000142 HHS NEWS BRIEFING PRODUCED BY BU LLETIN INTELLIGENCE WWW.BULLETININTELLIGENCE.COM/HHS TO: THE SECRETARY AND SENIOR STAFF DATE: MONDAY, JUNE 25, 2018 7:30 AM EDT TODAY'S Leading the News Administration Says It Has Devised A Plan To Reunite Some 2,000 Separated Children With Parents ...... ..........................................................4 The Secretary in the News Planned Parenthood Affiliates Sue HHS For Abstinence-Only Efforts On Teen Pregnancy Prevention Program ...... .................................... 13 CMS Delays Update To Hospital Star Rating System . ............................................................. 14 Unaccompanied Alien Children ORR Director Mum On Administration's Immigration Policy . ................................................................ 14 Tim Kaine Visits Virginia Facility Housing Separated Immigrant Children ...... ......................... ............. 14 California Facility Housing About 100 Separated Immigrant Children ............................................ 14 Immigrant From El Salvador Deported Without SixYear-O ld Daughter . ........................................... 14 23andMe Offers To Provide Kits, Resources To Conduct DNA Testing , Help Reunite Separated Immigrant Families ............................................ 14 Trump 's Executive Order Helped To Reduce Criticism Over Immigrant Policy , But May Have Created New Issues For Administration . .......... 15 Latino Nonprofit In Texas Providing Housing For Thousands Of Unaccompan ied Immigrant Minors ................................................................ 15 State Legislators , Advocates Worried About Welfare Of Separated Immigrant Children In Kansas .... 15 Sen. Johnson Discusses Government's Ability To Reunite Families ............................................... 15 HHS in the News CNN Says Official Who Was Disciplined Over Conspiracy Website , Anti-Islam Show Included That Information On Her Resume When She Applied To HHS ...... .......................................... 15 CMS Launches Data Element Library Advances ..... 15 EDITION Study: 1 in 5 Americans Lives With Mental Disease .15 Sardella: "Enormous ly Disruptive " Actions By Trump Administration Going Unnoticed ...... ................. 16 CDC Determines Belmont Park Worker's Death Caused By Bacterial Sepsis, Not Hantavi rus ... 16 Lyme Disease Cases Significantly Underre ported, CDC Says .. ......................................... .............. 16 FDA Warns That Recalled Flonase Spray May Contain Glass Particles ..................................... 16 Op-Ed : FDA's Restrictions On Mifepristone Could Harm Women Experienc ing Miscarriages .... .... 16 NIH Cancels Alcohol Study Which Received Industry Funding ............................................... 16 Op-Ed Critical Of NIH Over Its Now-Canceled Alcohol Study .................................................... 17 Marijuana Addiction Poses Real Threat That Many Do Not Recognize, Experts Warn .... ................. 17 NIDA Director Discusses Factors That Have Led To Opio id Crisis ...................................................... 17 Cancer Experts Discuss Ways To Reduce Risk Of Death Due To Prostate Cancer ........................ 17 Oncologist Who Uses Twitter To Decry Precision Medicine "Hype" Profiled ................................... 17 Opioid Crisis House Passes "Sweeping Package" To Fight Opioid Crisis .......... ....................................................... 18 Government-Funded Study Says Medicare, Medica id, Private Health Insurance Fueled Opioid Epidemic .. .............................................. 19 Study: Online Black-Market Opioid Sales More Than Doubled After Reclassification ................. 19 Dartmouth Getting $5.3 Million To Study Opioid Treat ment For Pregnant Women ...................... 19 Study Says Counties With Highest Opioid Prescription Rates In 2015 Were More Likely To Vote For Trump ............................................ 19 Rhode Island Gets More Federal Funding To Combat Opioid Addiction .................................. 20 Portman Says STOP Act Will Help Combat Rise Of Fentanyl. ............................................................20 EXT-18-248-D-000143 Three Insurers That Offered Exchange Plans In South Florida In 2018 Have Refiled To Offer Plans In 2019 ... .................................................23 Indiana Exchange Plan Premiums To Increase 5.2% On Average ..............................................23 Ohio Exchange Plan Premiums To Increase 8.2% On Average ....................................................... 23 Administrative Costs For Blue Cross And Blue Shield Plans Grew In 2017 To Highest Levels Since 2013, Report Says . ................................. 23 Commentary Considers Health Reform .. .................23 Humana Buying Two Hospice Chains ......................24 Cuomo Says Health Insurance Companies Cannot Discriminate Against Transgender New Yorkers .. ............................................................24 Massachusetts State Legislature Trying To Reconcile Differences Among Healthcare Bills.24 Michigan 2019 Budget Keeps Title X Funding For Planned Parenthood ......................................... 24 Rhode Island House Approves Bill To Expand Mastectomy Coverage .. .................................... 24 Rep. Rodgers Highlights Work On Combating Opioid Crisis ...................................................... 20 Ridge: House Vote Brings Nation One Step Closer To Beating Opioid Crisis ................................... 20 Study: Combination Of Opioids With Common Drug Risky In First 90 Days ... ....................................20 Purdue Pharma Fires 350 Employees As Opioid Lawsuits Mount. ................................................20 Ontario Promoting Free Use Of Opioid Antidote Naloxone . .......................................................... 20 Ch ina Says US Should Do More To Cut Demand For Opioids ........................................................21 Experts Discuss Government's Role In Physician's Ability To Treat Patients With Opioids ... ...........21 Gutman : PA Bills Threaten To Push State "Backward On Opioids ." ....................... ............. 21 Lopez: Needle Exchanges Help Combat Opioid Addiction ............................................................ 21 Mental Illness Jails, Prisons Are Places Of Punishmen t Unsuitab le For People With Mental Illness Or Intellectual Disabilities , Psychiatrist Says .... .......................21 Colorado Schools To Receive Small Grants To Pay For Suicide-Prevention Training .......... .............21 Human Services News Proposed Rules For Assisted Living Facilities In DC "Spark Outcry" From Groups Including AARP ..24 Wisconsin Foster Care Task Force Issues Report With Recom mended Changes , lmprovements .24 Mother Offers Tips For Getting Good Healthcare For Children With Disabilities ............................24 Report Shows Parent Drug Abuse A Factor In Many Child Welfare Cases In Indiana ........................ 25 Family Separation Is A Problem For US Citizens, Too ... .................................................................25 US Policies Do Not Support American Families ..... .25 Adoption Rates In Minnesota Experience "Sharp Decline." ............................................................25 Indiana Child Support Seeks Comments On State Guidelines .. .......................................................25 Healthcare Fraud Texas Supreme Court Says Xerox Responsible For Fraudulent Medicaid Dental Payments ............. 21 Former Physician Found Guilty In $13 Million Healthcare Fraud .............................................. 21 Prescription Drug Pricing New York State Demands Drug Maker Lower Cost Of $272,000 Cystic Fibrosis Treatment. ...........22 Hatch: To Reduce Prescript ion Drug Costs, Increase Competition .... ....................................22 Health Care & Insurance Reform Experts Discuss Whether States Should Allow Insurers To Offer Health Plans With Fewer Mandated Benefits .. ..........................................22 Two-Thirds Of Americans Disapprove Of DOJ's Decision To Support Lawsuit That Would Challenge Affordable Care Act's Protections For People With Preexisting Conditions , Poll Says . .................................................................22 Increases In Exchange Plan Premiums May Hurt Republicans In This Year's Midterm Elections . 22 Healthcare Likely To Be Key Issue In Minnesota 's Congressional Races . .......................................22 Florida Attorney General Confronted By Protesters At Movie Showing ............................................. 22 Texas Medical Association "Vehe mently" Objects To AMA Opposing State 's Lawsuit Challenging The Affordable Care Act. ..................................22 Emergency Response and Pandemic Preparedness Op-Ed Considers Analysis Of US' Pandemic Preparedness ....................................................25 US Unprepa red To Manage Epidemic Of Diseases Borne By Ticks, Insects , Experts Say ............... 25 Obama "Ebola Czar" Worries That Trump Administration May Not Address A Pandemic Effectively .......................................................... 25 Medicare Medicare To Provide More Benefits For Chronically lll ........ ................................................................26 State Officials Say "More Than 300,000'' Minnesota Residents To Change Medicare Health Plan Next Year ..................................................... .....26 Lab Charges Spike At Rural Hospitals . ....................26 2 EXT-18-248-D-000144 California Says 374 Terminally Ill Residents Committed Medically Assisted Suicide In 2017 .29 Trump Administration Resumes Approving Young Physician V isas . .............. .................................. 29 Another US Embassy Worker Confirmed Hurt By Mystery Cuba Incidents .. ..................................29 Researchers Using Al To Pred ict Fatal Conditions .. 30 Minnesota Patients Sedated By Ketamine Were Enrolled In Hennepin Healthcare Study Without Consent. ............................................................30 Walmart Secures Patent For Blockchain-Based Health Records . ................................................30 Opinion: Give Women Access To Birth Control To Help Stop Unwanted Pregnancies ....................30 Opinion: Lawmakers Should Begin Investigating CTE In Hockey .................................................. 30 Experts Debate Whether Physicians Should Ask Patients About Gun Use ..... .............................. 30 More Hospitals Launching Online Price Estimators To Improve Transparency .................................30 Sleep Apnea Treatment May Be Associated With Improved Sex Life, Study Suggests .................. 31 Analysis: Americans Entering Retirement In Worse Financial Shape Than Previous Generation ..... 31 Nursing Home Surveillance Cameras Prompt Divisions Among Providers, Advocates ............31 People Fearing Onset Of A lzheimer's Turn To Lifestyle Changes After Drug Candidates Fail. .31 Roche Touts Tr ial Showing Tecentriq Cockta il Improved Survival In Small Cell Lung Cancer .. 31 Cruise Ship With Norovirus Outbreak Stops In Alaska ................................................................ 31 Ohio Declares Statewide Hepatitis A Outbreak ... ....31 Florida Teen Becomes First Human Case Of Keystone Virus .................................................. 31 HIV-Posit ive Community Celebrates CDC's Acknowledgment That Treatment Can Nearly Eliminate Risk Of Transmission ................... ..... 31 New Jersey Health Officials Warn About Measles Exposure .... .......................................................32 Maine, New Hampshi re Beset By Whooping Cough Outbreaks ..........................................................32 Op-Ed : Too Few Older Cancer Patients Included In lmmunotherapy Studies .................................... 32 Debate Continues On Whether Robotic Prostate Surgery Is Better Than Traditional Surgery . .....32 Opinion: Iowa Attorney General Is "Complete ly Right" About Youth Smoking , E-Cig Use ...... ....32 One In Five Parents Don't Talk To Kids About Safety Issues At Amusement Parks, Poll Finds.32 Exposure To Medical Marijuana Advertising May Contribute To Increased Use Through Adolescence , Behavioral Scientist Says ...........32 ACOG Releases Immunization Guide For Pregnant Women ...... ............ ....................................... ..... 32 Medicaid & CHIP Experts Debate Medicaid Work Requirements . .......26 Michigan Governor Signs Medicaid Work Requirement Bill . ...............................................26 Kansas Health Department Awards Contracts To Three Insurers To Manage State's Medicaid Program .............................................................26 Montana Advocates Move Closer To Vote Extending Medicaid Expansion ......................... 27 Baylor St. Luke's Medical Center Could Lose Medicaid Funding ..............................................27 Kenosha Boy To Visit Capitol Hill To Support Children 's Health ...............................................27 Ch ild Advocates Oppose South Carolina Medicaid Agency Push To Add Work Requirements ....... 27 Health & Medical News One-Third Of Older Patients Die In Hospital After They Are Put On Ventilators , Study Indicates .. 27 Robot-Assisted Radical Cystectomy For Invasive Bladder Cancer Linked To Short-Term Oncologic Outcomes Comparable To That Seen With Open RC, Research Indicates . .......27 Advances In Cancer Treatment Do Not Mean An End To Chemotherapy, According To Cancer Experts ....... .......................................................27 Researchers Discover Compound That Could Stop Cancer Cells From Spreading ... .......................27 "Older , Grayer'' Workforce Offers Benefits To Employers ......................................................... 27 Men's Shed Offers Older Men Community, Activity. 28 Column: Loneliness Affects All Ages But Is Preventable ....................................................... 28 Report Finds Working Longer Can Help Retirement Savers Make Up Savings Shortfalls ................. 28 San Francisco Is "Worst" US City For Retires .......... 28 Substance Abuse A Rising Problem Among Older Adults ....... ........................................................ .28 AARP CEO Column: Millennials Helping With Caregiving .. .......................................................28 Adolescents With Eczema May Not Use Topical Corticosteroids As Directed , Study Suggests ... 29 Patients Receiv ing Treatment For Neovascular AgeRelated Macular Degeneration May Be At Increased Risk Of Vision Loss In Connection With Cataract Surgery, Study Suggests ....... ....29 US District Court Rules In Favor Of Eli Lilly's Drug Patent. ...............................................................29 Researchers Growing Plants In Space As Potential Source Of New Drugs ....................................... 29 FDA May Approve First Cannabis-Derived Drug For Two Forms Of Epilepsy ..................................... 29 The Scripps Research Institute Is Now Conducting Clinical Trials .... .................................................29 Oklahoma Conservatives' Views On Medical Marijuana Are Changing ................................... 29 3 EXT-18-248-D-000145 Bossie Apologizes For Saying Black Panelist Is Out Of His "Cotton-Picking Mind." ........................... 36 Bill Clinton Downplays Tarmac Meeting With Lynch .37 Wolfe-Watkins Affair Has "Rattled" Washington Journalists .. .......................................................37 Barr Says Her Controversial Tweet Was "Misinterpreted ." ................................................37 Boardroom Table From "The Apprentice" Sold At Auction For $32,000 ..........................................37 Raju: Trump Drives Up Democrats' Negatives, But Fires Up Democratic Voters ..............................37 Romney Says He'll Back Good Trump Policies, Criticize Bad Ones ..... ....................................... 37 Donovan Says NY11 Primary Battle With Grimm Has "Gotten Personal." .....................................37 Michigan Democrats Fear Thanedar Is A "BizarroWorld Trump. " ...................................................38 Maryland Gubernatorial Race A Test Of Sanders Backers' Ability To Win Primaries ........ .............38 District Of Columbia Council To Consider Lowering Voting Age To 16....... ....................................... 38 WPost: Congress Must Devise Permanent Fix To FHFA's ''Temporary " Housing Finance Takeover . ..........................................................38 White: Kagan, Kennedy Opinions Should Encourage Reform Of Administrative State ......38 Gramm, Ekelund: Income Inequality Helped Elect Trump . ...............................................................38 Scientists Developing Process To Form Blood Vessels To Simulate Heart Disease, Test Drugs .... .............................................................32 Venture Capitalist Explains Investments In Artificial Intelligence . .......................................................33 Senators Ask FTC To Examine Pay-To-Delay Agreements On Biosimilars .............................. 33 Global Health Algeria Abandons 13,000 Migrants In The Sahara .. 33 Non-Invasive Malaria Test Wins Africa Prize For Engineering Innovation ... ..................................33 Ebola Vaccines Help Foster Improvements To Outbreak Response Efforts ...............................33 Op-Ed : Hong Kong Should Pass Official Policy Encouraging Older Workers ..............................33 Older Chinese Villagers Benefit From Yoga Pursuits ...... .......................................................33 National News GOP Lawmakers Say DOJ Less Than Cooperative With House Russia Investigation ..... .................34 Warner: "Buckle Up" For More Revelations From Mueller ...............................................................34 Trump To Campaign For McMaster In South Carolina Today ..... .............................................34 Trump Mistakenly Endorses Wrong Clay Higgins On Twitter ................................................................34 Trump Criticizes Fallon For Not Being "A Man" After Interview .. ..........................................................35 Virginia Restaurant Owner Does Not Regret Ejecting Sanders ............................................... 35 Protesters Confront Bondi Outside Mr. Rogers Documentary .....................................................36 Flake: Senate Shouldn't Vote On Trump Judges Until There Is A Vote On Tariffs .. ......................36 Ethics Watchdogs Warn Administration Over Politicizing Presidential Coins ...... .....................36 Editorial Wrap-Up New York Times .... ................................................... 39 Washington Post. ......................................................39 Wall Street Journal. ..................................................39 The Big Picture Headlines From Today 's Front Pages ......................39 Last Laughs Late Night Political Humor .... ................................... .40 and that it has already released 522 immigrant children to family members. The government stated, 'The United States government knows the location of all children in its custody and is working to reunite them with their families .... This process is well coordinated." The article adds that on Sunday , an Administration official said "the number of children returned to their families to date may be 'slightly higher ' than 522 because the Department of Health and Human Services has released some minors to the custody of other sponsors, typically close relatives ." The CBS Weekend News (6/24 , lead story, 2:40, Quijano , 5.32M) reported in its lead story, "Officials said Saturday night more than 2 ,000 LEADING THE NEWS Administration Says It Has Devised A Plan To Reunite Some 2,000 Separated Children With Parents. The Washington Post (6/24, Miroff, Sacchetti , 15.68M) reports that late Saturday , the Trump Administration indicated "it is taking steps to reunify hundreds of Central American parents separated from their children during the recent border crackdown, with plans to then deport them from a remote detention facility in South Texas." The Administration said it has in its custody 2,053 children who were separated from their parents, 4 EXT-18-248-D-000146 separated minors remained in government facilities. ... But it's not known how long the process to reunite families will take." The New York Times (6/24, Jett, Zaveri, Subscription Publication, 19.33M) reports that the Administration's "efforts to match separated migrant children with their guardians face considerable obstacles." In addition, "the process of reuniting families as well as the indefinite detention they face once they're back together could have psychological consequences for parents and children alike, experts said." The article says government workers, "some of whom were conflicted about Mr. Trump's policy, have been working overtime in an effort to reunite the thousands of children and parents who were separated at the border over a period of several weeks this spring." The piece mentions that HHS' Office of Refugee Resettlement "has a toll-free number set up for parents looking for their children." ABC World News Tonight (6/24, story 6, 2:15, Johnson, 14.63M) reported that "there's chaos at the border" as the Trump Administration is "releasing a plan to reunite the migrant families." The CBS Weekend News (6/24, story 2, 1:05, Quijano, 5.32M) reported, "We have also learned that Immigration And Customs Enforcement have dedicated the Port Isabel detention center as the primary family reunification center for adults in their custody." On its front page, the Wall Street Journal (6/24, A 1, Radnofsky, Subscription Publication, 6.13M) reports Administration officials indicated that they want to deport reunited families, not keep them in the US. The article says HHS has been caring for the children who were separated from their parents as a result of the Administration's zero tolerance policy, as well as for unaccompanied immigrant teens. The department has more than 2,000 of the former, and about 10,000 of the latter. The AP (6/24, Long) reports that the Department of Homeland Security and other departments unveiled a "zero-tolerance prosecution and family reunification" fact sheet on Saturday. The fact sheet does not indicate how long it may take to reunite families , but it does say parents must ask that their children be deported with them. The article adds that precisely how the Administration "would reunite families has been unclear because the families are first stopped by Customs and Border Patrol, with children taken into custody by HHS and adults detained through Immigration and Customs Enforcement." Reuters (6/24, Torbati) reports that the Administration released the information about its plan following "criticism from lawyers for parents and children who have said they have seen little evidence of an organized system." The article adds that the fact sheet says "children are given the chance to speak with a 'vetted parent, guardian or relative' within 24 hours of arriving at a facility run by Department of Health and Human Services (HHS)." The Los Ange les Times (6/24, King, 4.03M) reports that Democrats "responded skeptically Sunday to the Trump administration's assertion that it has a process in place to reunite more than 2,000 'separated minors' with their parents." In a separate article, the Washington Post (6/24, Sacchetti, Miller, Moore, 15.68M) reports Sen. Elizabeth Warren (D-MA) said, "It's clear" that "they're not running a reunification process here." Also covering the story were NBC Nightly News (6/24, story 2, 2:00, Snow, 8.26M), CNN (6/23, Kopan, 82.6M), the Los Angeles Times (6/23, Dolan, 4.03M), NBC News , (6/24, Gambos, 5.76M) NPR (6/24, Van Sant, 3.55M), Boston Globe (6/24, Goodwin, 945K), the Arizona Republic (6/23, Nanez, Wang, 1.21 M), the New York Post (6/24, Moore, 4.46M) , and Vox (6/23, Kirby, 1.66M). HHS Establishes Task Force To Reunite HHS has Separated Immigrant Families. established an "'unaccompan ied children reunification task force,' a first step toward reunifying thousands of migrant children in the agency's custody with their families, according to an internal document obtained by" Politico (6/22, Diamond, 3.51M), which added that "the task force was established by the assistant secretary for preparedness and response - the arm of the agency that responds to public health disasters, and an indication that the challenge of reunifying thousands of families is likely beyond the capabilities of the refugee office." The order read, 'The Secretary of Health and Human Services has directed the Assistant Secretary of Preparedness and Response assist the ACF Office of Refugee Resettlement with Unaccompanied Children Reunification." HHS spokesperson Evelyn Stauffer said HHS Secretary Alex Azar "is bringing to bear all the relevant resources of the department in order to 5 EXT-18-248-D-000147 assist in the reunification or placement of unaccompanied alien children and teenagers with a parent or appropriate sponsor." In the NBC Nightly News (6/22, lead story, 2:35, Holt, 6.6M) lead segment, Gabe Gutierrez reported HHS has "a network of about 100 shelters ...in 17 states" and "says the average stay of a child at its shelters is 57 days." According to HHS spokesman Mark Weber, "We are working as fast as we possibly can to find safe homes for these children." Although the AP (6/22, Merchant, Bryan, Long) reported that a senior Administration official on Thursday said "about 500 of the more than 2,300 children separated from their families at the U.S.-Mexico border have been reunited since May," and Mireya Villarreal reported on the lead CBS Evening News (6/22, lead story, 2:35, Glor, 5.03M) segment that a senior Administration official announced "the rest of the 1,800 that still remain separated will be reunited by Sunday," the Los Angeles Times (6/22, Ulloa, 4.03M) said federal officials nonetheless warned on Friday that "the process of reunifying families who have been separated at the border could take months." Meanwhile, Reuters (6/22, Hals) reported that US District Court Judge Dana Sabraw "said on Friday he could rule as soon as the middle of next week on a request to order the U.S. government to reunite thousands of immigrant children who were separated from their parents after illegally crossing the Mexico-U.S. border." The article added that Sabraw "peppered a government lawyer with questions," but he "declined to rule at the hearing without further briefing and suggested the ACLU provide details for procedures for reuniting parents and children." Politico (6/22, Gerstein, 3.51 M) reported that Sabraw said, "What's happened in this case is unusual in that the case has developed in the media." He added that if he issues an injunction, "there has to be some evidentiary basis for it other than newspaper and television and radio accounts." However, on ABC's Good Morning America (6/22, 4.2M), David Muir reported that "some of the first of the parents and children [are] reuniting after being separated at the border, but there's still so many at more than a dozen shelters around the country, including babies and young children." Jon Karl added that "for most of the children taken away from their parents because of President Trump's 'zero tolerance' policy, it is unclear...how or when they'll be reunited with their families." On CBS This Morning (6/22, 2.91 M), David Begnaud reported from McAllen, Texas that, in regards to the 2,000 children separated from their families, the key question now is "how and when are they going to be reunited?" At the opening of CNN's New Day (6/22, 424K) , Alisyn Camerota said, "There's so much confusion this morning, particularly for the parents of these kids, and heartbreak. Can you imagine not knowing at this hour where your child is, what state, what condition that child is in? It's two days since President Trump signed the order halting those family separations, but children are still not reunited with their parents, and those parents don't know where their kids are." USA Today (6/22, Hughes, 11.4M) similarly said the executive order "sowed more confusion into what was already a complicated system of law enforcement, courts, warehouse-like detention buildings and re-purposed daycare centers," while AFP (6/22, Macor, Handley, Handley) added that "the fate of 2,300 children wrested from their parents at the US border with Mexico remained unclear Friday" as "conflicting messages were contributing to a sense of chaos in the handling of the crisis." On MSNBC's Morning Joe (6/22, 1.02M), Mika Brzezinski said in the that wake of Trump's executive order, "now we have ...chaos," and "the mystery behind where some of these children are. Where some of these babies are. Where the girls are. Who's with them. What's happening to them? Will some never see their parents again? I think there's some distinct possibilities that that's possible. They may never see their families again." The Chicago Tribune (6/22, Briscoe, 2.37M) reported that the Heartland Alliance, a Chicago nonprofit, "said Friday it is housing 66 [im]migrant children who have been separated from their parents in the past six weeks," and "after days of staying out of the political controversy surrounding ...Trump's immigration policy, Heartland officials directly condemned the practice of separating children from their parents at the United States' southern border while asking for support from the community while they look after the minors in their care." Heartland Alliance President Evelyn Diaz warned that reuniting the children with their families is "like [going] on a scavenger hunt." The AP (6/22, Fox) and Miami Herald (6/22, Sweet, Medina, 1.07M) described a visit to the 6 EXT-18-248-D-000148 Homestead Temporary Shelter for Unaccompanied Children. The Herald said that the facility is "under such tight control that Sen. Bill Nelson, Rep. Debbie Wasserman Schultz and other government officials were turned away on Tuesday," but "Friday's guided, one-hour tour seemed to be an attempt to dispel this idea." The Herald added that "cellphones and audio or video recording equipment were prohibited," and HHS spokesman Mark Weber said that this policy is a matter of protecting the privacy of minors in the shelters. Also covering the story were an ABC World News Tonight (6/22, story 2, 3:10, Muir, 7.47M) segment, the Wall Street Journal (6/22, Calvert, Levitz, Subscription Publication, 6.13M), the AP, (6/24, Thomas , Superville) the Washington Post (6/21, Hsu, 15.68M), The Hill (6/22, Bowden, 2.71 M), Newsweek (6/23, Zhao, 2.18M), the Boston Globe (6/22, Johnson, 945K), AFP (6/23), the Daily Caller (6/23, Cohen, 420K), and Axios (6/22, Britzky, 2.49M). Trump Says Undocumented Immigrants Should Not Be Allowed Due-Process Rights. In a front-page article, the Washington Post (6/24, A1, Rucker, Weigel, 15.68M) reports that on Sunday, President Trump "explicitly advocated depriving undocumented immigrants of their dueprocess rights, arguing that people who cross the border into the United States illegally must immediately be deported without trial - and sowing more confusion among Republicans ahead of a planned immigration vote this week." He tweeted, "We cannot allow all of these people to invade our Country," adding, "When somebody comes in, we must immediately, with no Judges or Court Cases, bring them back from where they came. Our system is a mockery to good immigration policy and Law and Order. Most children come without parents." NBC Nightly News (6/24, lead story, 2:40, Snow, 8.26M) reported in its lead story , "Since the day he announced his candidacy, President Trump promised a tough line on immigration and border security," and "this morning on Twitter, he took it to a new level" by "deriding current US immigration policy as, quote, laughed at all over the world. And calling for people who enter the US illegally to be immediately sent back without seeing a judge." The segment adds, "The President's edict fails to recognize constitutional due process" and "long established case law that grants that protection to non-citizens." USA Today (6/24, Bacon, 11.4M) reports Sen. Elizabeth Warren (D-MA) responded to the comments, saying, "That's not what our country stands for .... We do have a system of laws." On its front page, the New York Times (6/24, A1, Rogers, Stolberg, Subscription Publication, 19.33M) reports that the president's "aggressive attack" was "another twist in a head-spinning series of developments on immigration since the administration announced a 'zero tolerance' policy two months ago." Bloomberg News (6/24, Epstein, 4.46M) reports that this "stepped-up rhetoric came after the administration announced a series of steps to reunite families that had been separated at the border under a now-abandoned policy, and drew a sharp retort from the American Civil Liberties Union." Omar Jadwat, director of the ACLU's Immigrants Rights Project, stated, "What President Trump has suggested here is both illegal and unconstitutional. ... Any official who has sworn an oath to uphold the Constitution and laws should disavow it unequivocally ." On Sunday, Rep. Luis Gutierrez (D-IL) said Trump's "choice of words was being used to gin up his supporters for the mid-terms." Reuters (6/24, Chiacu, Lynch) reports that since the President backed away from his policy of separating immigrant children from their parents, he "has redoubled his criticism of U.S. immigration laws on Twitter and in speeches where he likened illegal immigrants to invaders trying to 'break into' the country." The Newark (NJ) Star-Ledger (6/24, Salant, 1.58M) reports Sen. Angus King (I-ME) made the point on NBC's "Meet the Press" that "people coming to claim asylum are not illegal immigrants," rather, "under the law, they have a right to establish their claim of asylum, that they're in a legitimate fear for their life, that they're fleeing persecution in their home country." Also covering the story are the AP (6/24 ), another article in the AP (6/24, Superville), NBC News (6/24, Silva, 5.76M), Politico (6/24, Griffiths, 3.51 M), The Hill (6/24, Thomsen, 2.71M), the Miami Herald (6/24, Madan, 1.07M), TIME (6/24, Abramson, 19.27M), and the Washington Examiner (6/24, Williams, 340K). GOP Leaders Worried Trump's Tweets Will Derail Efforts To Pass Immigration Bill. The AP (6/24, Fram) reports that Republican apprehension over President Trump's "next tweet and fear of riling conservative voters are 7 EXT-18-248-D-000149 undermining GOP leaders' election-year struggle to shove an immigration bill through the House this week , leaving their prospects dubious." Republican leaders are "trying to finally secure the votes they need for their wide-ranging bill with tweaks they hope will goose support from the GOP's dueling conservative and moderate wings. But more importantly, wavering Republicans want Trump to provide political cover for immigration legislation that's despised by hard-right voters." ABC World News Tonight (6/24, story 3, 1:15, Johnson, 14.63M) reported, "Republican lawmakers, set to vote on immigration reform bills this week that will fail to pass without Democratic support, [are] asking the President to cool his tough talk." Lawmaker Says Trump Is "100 Percent" USA Behind House Immigration Measure. Today (6/24, Kelly, 11.4M) reports House Homeland Security Chairman Michael Mccaul (RTX) said Sunday that President Trump remains "100 percent" behind a compromise House immigration bill, "despite Trump saying last week that Congress should give up its legislative efforts until after the election in November." The article says Mccaul and House Speaker Paul Ryan (RWI) are pushing "a bill that would provide a pathway to citizenship for about 1.8 million young immigrants brought to the USA as children, provide about $23 billion for a border wall and place limits on legal immigration." In addition, the measure "would allow children and their parents to remain together at detention centers if they're caught crossing the border illegally." The piece adds that if the bill does not pass, "the House will probably take up a narrow measure that would stop federal officials from separating children from their parents." The CBS Weekend News (6/24, story 3, 2:10, Quijano , 5.32M) reported, "With support from President Trump, Republican Congressman Michael Mccaul plans to put his so called Consensus Immigration Bill up for vote in the House soon." The segment added, "Its chances of passing, though , are slim." ABC World News Tonight (6/24, story 5, 0:30, Johnson, 14.63M) reported, "There's a vote on a compromise bill Tuesday, but that bill is unlikely to pass." Tara Palmieri added, "Sources are telling me Republicans are working on a more narrow bill that will cancel the 20-day cap on detention for children so they can stay with their parents. But even that bill is unlikely to get much support from Democrats." The Wall Street Journal (6/24, Hughes, Subscription Publication, 6.13M) reports that if the bill fails to pass, it will highlight the lack of consensus among Republicans on how to handle immigration. Bloomberg News (6/22, House, Edgerton, Dopp, 4.46M) , The Hill (6/24, Mitchell, 2.71 M), and Politico (6/24, Tamborrino , 3.51M) also cover the story. Lankford Says Trump Administration Knows Where Every Separated Immigrant Is Located. Politico (6/24, Tamborrino, 3.51M) reports that on NBC's "Meet the Press," Sen. James Lankford (R-OK) was asked "whether the Trump administration had been supplying Congress with specific details on children separated at the border resulting from its 'zero tolerance' effort, Lankford told Todd the administration knew where every child was located." He stated, "Let me clarify this .... We know where every single child is." Lankford added, "These are career professionals that work with HHS, and that work with OHS in Customs and Border Patrol and ICE - these are not political appointees .... These are career folks. They know where every child is, to be able to connect them to their parent or their relative that came." The Washington Times (6/24, Richardson, 460K) and the Washington Examiner (6/24, Lim, 340K) also cover the story. Lawmakers Say Conditions At Texas Shelter Are "Livable, " But Express Concern About Reunification Of Immigrant Families. Bloomberg News (6/23, Epstein, 4.46M) reported that several lawmakers "visited what's been called a tent city for unaccompanied immigrant children" in Tornillo, Texas on Saturday and described conditions there as being "livable, yet voiced concerns about what's next for them amid confusion about the family reunification process." Sen. Tom Udall (D-NM) said that he is "very worried that we're headed from one humanitarian crisis to another," and urged Attorney General Jeff Sessions, HHS Secretary Alex Azar, and Homeland Security Secretary Nielsen to "give us a plan" outlining how families will be reunited. Rep. Brian Fitzpatrick (R-PA) added that the visit "probably raised more questions than it answered." The article added that "some two dozen Democratic House lawmakers visited a border detention center in McAllen, Texas, on 8 EXT-18-248-D-000150 Saturday, marking the second weekend in a row that Democrats have toured the facility to examine conditions and the treatment of immigrants held there." Some Florida State, Local Lawmakers Not Allowed To Visit Homestead Shelter. The Miami Herald (6/23, Vassolo, Flechas, 1.07M) reported that on Saturday, Reps. Debbie Wasserman Schultz (D-FL), Frederica Wilson (DFL), Ted Deutch (D-FL), and Darren Soto (D-FL) were given a tour of the Homestead shelter which houses 1,179 immigrant children. The article said five Miami-Dade and state elected officials sought to accompany them, but were denied entry and told they need to provide two weeks' notice before a visit could be approved. Mark Weber, Deputy Assistant Secretary for Public Affairs at HHS, "told the lawmakers that HHS needed more notice to accommodate their requests. He said the lawmakers could tour the facility at a later date." Nelson, Wasserman Schultz Say Homestead Shelter Is Taking Good Care Of Immigrant Children. The Fort Myers (FL) NewsPress (6/23, 208K) reported that "70 migrant children forcibly taken from their parents at the U.S.-Mexico border are in good hands in Homestead, Democratic leaders led by U.S. Sen. Bill Nelson and Rep. Debbie Wasserman Schultz concluded Saturday after touring the shelter." Wasserman Schultz said, "It is inexplicable to me why Sen. Nelson and I were not allowed to see it when we asked on Tuesday ." For his part, Nelson stated, "The facilities are nice . ... The question is the reunification of the 2,300 children across the country separated from their parents. How long will they be detained?" Lee Says It Was "Heart-Wrenching" To Visit Immigrant Facility In McAllen, Texas. The Hill (6/24, Samuels, 2.71M) reports that on Sunday, Rep. Barbara Lee (D-CA) "compared holding facilities for [im]migrant families to prisons." Discussing her tour of a facility in McAllen, TX on CNN's "State of the Union," Lee said, "It was heart-wrenching. The images that we see on the media really speak volumes to what's taking place but when you see it in person it's horrific." She "said she saw a boy and a girl, each about 3 years old, crying in cells by themselves." Rubio Says Congress Can Take Action To Keep Immigrant Families Together. The AP (6/22) reported that on Friday, Sen. Marco Rubio (R-FL) "visited a Miami-area facility housing more than 1,000 teenage migrants." Following the visit, Rubio "said he didn't speak to any of the children inside the Homestead complex because of privacy regulations." Rubio acknowledged that "splitting up families at the border was 'a terrible situation' but the U.S. doesn't have the money or the capacity to hold families together when they're detained by immigration authorities." He added that Congress would have to take action to keep immigrant families together. Christie Blames DOJ For Administration's Handling Of Zero Tolerance Policy. The Hill (6/24, Samuels, 2.71 M) reports that on Sunday, Chris Christie blamed "the Department of Justice (DOJ) for the Trump administration's handling of its 'zero tolerance' policy and the subsequent separation of [im]migrant families that prompted overwhelming backlash in the weeks since its implementation." On ABC's "This Week ," Christie said, "I think one of the things that hasn't been talked about this week, George (Stephanopoulos), is the president was enormously ill served by the Department of Justice." He added, "If the attorney general come in and says to the president, 'I want you to do a zero tolerance policy, but let me just tell you , we don't have enough judges to handle the cases, we don't have enough prosecutors to bring the cases, and we don't have enough detention facilities to legally detain the people that we're going to show zero tolerance to,' the president would have never approved this ." New York Governor Fighting Administration Over Immigration Policy. In an article that examined New York Gov. Andrew Cuomo's (D) growing role in fighting the Administration on its immigration policy, the New York Times (6/22, McKinley, Subscription Publication, 19.33M) reported that he sent a letter to HHS Secretary Alex Azar on Friday "asking for information on the 345 separated children the state has managed to count thus far." The Times conceded Cuomo "may have originally seemed to some to have been driven by political opportunism," but his "efforts on behalf of the [im]migrant children have earned praise from advocates, who have been equally outspoken about the president's so-called 'zero tolerance' policy of separating children." The Washington Times (6/22, Munoz, 460K) reported that on Friday, Cuomo "slammed the Department of Health and Human Services on Friday, claiming he has not been given enough information on the immigration children 9 EXT-18-248-D-000151 transported to his state." He said, "I know nothing from HHS. All I know is what I'm putting together." The AP (6/22, Carola) reported that Cuomo also said on Friday that some of the separated immigrant children who have been sent to New York "need psychological counseling for the traumatizing ordeal." The governor described his visit to one shelter "as 'troubling' during the NY1 interview. He said the facility is housing children ages about 11 to 18, with some of them 'in a state of shock' and requiring 'serious significant psychological assistance."' More Immigrant Children Being Sent To New York City Even As Some Are Reunited With Families. The New York Daily News (6/22, McShane, Ruscoe, Hussain, 3.71M) reported that on Friday, officials in New York City "braced...for a new surge of migrant children coming to the city from the Mexican border - even as 100 were already reunited with their parents." Rep. Adriano Espaillat (D-NY) said local officials "were told 'there will be a growing number of unaccompanied minors coming in."' The article added that about 100 children sent to facilities in Harlem had "already been ...returned to their families." New York Officials Unable To Determine How Many Immigrant Children Have Been Sent To The State. The New York Times (6/22, Robbins, Correal, Subscription Publication, 19.33M) reported that as of Friday, "officials in New York still did not have answers to even the most basic questions about the children who had been separated from their parents at the southern border and relocated 2,000 miles away: How many were there, and where had they been placed?" Both Gov. Andrew M. Cuomo (D) and Mayor Bill de Blasio (D) wrote letters to HHS seeking those answers. The article added that this "confusion underscored just how chaotic the situation was, with lawyers frantically scrambling to figure out how to represent the children, and Cayuga, which had the most children, urgently looking for staff and asking for more Spanishspeaking volunteers to serve as foster parents." Sen. Schumer Calls For Appointment Of Immigration Czar To Reunite Children. The New York Daily News (6/24, Gibson, 3.71M) reports Sen. Chuck Schumer (D-NY) called on the Trump Administration Sunday to appoint an immigration czar to handle reunification of families. Schumer explained, "What we found out of over the years is when there are separate agencies trying to solve a single problem it works slowly at best, and sometimes doesn't work at all." Newsday (NY) (6/24, O'Keeffe, 1.52M) reports Schumer said, "Three different agencies, three different Cabinet members in charge." He added, "No one is really in charge if there are three people in charge. We need one person in charge." Proposed New York State Bill Would Allow Undocumented Immigrants Facing Deportation To Select Legal Guardians For Their Children. The New York Daily News (6/22, Lovett, 3.71 M) reported, "Undocumented immigrant parents facing possible deportation from New York would be able to choose a guardian to care for their kids under a bill that won final approval in the Legislature last week." The measure "would expand the standby guardianship law created in the 1980s during the AIDS crisis that has mainly been used by parents diagnosed with a terminal illness to transfer guardianship of their kids to someone they know and trust." Immigrants Reportedly Asked To Sign Voluntary Deportation Documents In Exchange For Being Reunited With Children. The Hill (6/24, Samuels, 2.71 M) reports that Central American immigrants who have been detained and "separated from their children have been told they can reunite with them if they agree to voluntarily deportations, The Texas Tribune reported Sunday." The Tribune, citing a man from Honduras and two immigration attorneys, said "the migrants have been told they would be reunited with their children at an airport if they agree to sign off on deportations." The man "said he gave up his asylum case and signed the paperwork in an effort to reunite with his 6-yearold daughter," but "he's now trying to rescind his agreement and fight his case in court." The article adds that lawmakers from both parties "have called family separations 'cruel' and 'inhumane."' Immigrants Deported Without Their Children Describe Their "Anguish. " AFP (6/24) reports that Central American immigrants "deported from the US without their children spoke of their anguish at seeing their families split under President Donald Trump's 'zero tolerance' approach Saturday, as protesters kept up the pressure against the 'barbaric' policy." So far, about 500 immigrant children have been reunited with family members. But it remains to be seen "how quickly the rest of the reunifications can be carried out." Attorneys "working to bring families 10 EXT-18-248-D-000152 Pledge of Allegiance, in English, to the country that holds them apart from their parents." The Atlantic (6/22, Khazan, 3.08M) reported that immigrant children separated from their parents "still face great turmoil, beyond the stress of the immigration experience itself," in spite of President Trump's new executive order. Dr. Colleen Kraft, president of the American Academy of Pediatrics, warned that such "trauma can permanently affect the brains of these children, and potentially their long-term development," according to the article. Kraft, who visited one of the shelters overseen by HHS' Office of Refugee Resettlement, "described seeing a room full of toddlers that was 'eerily silent,"' with the exception of "one little girl, who was 'sobbing and wailing and beating her fists on the mat."' A staff worker attempted "to comfort her with books and toys, but she wasn't allowed to pick her up or touch her, Kraft said." Journalists Allowed To Tour Homestead Shelter For Immigrant Children On Friday. The AP (6/22, Fox) reported that on Friday, Administration officials "provided a glimpse ...into a South Florida facility housing more than 1,000 teenage migrants, seeking to dispel any suggestions that children are being mistreated." The article said, "Private contractors who run the Homestead Temporary Shelter for Unaccompanied Children, about 25 miles (42 kilometers) southwest of Miami, showed journalists around the campus like-complex for about an hour." Reporters were not allowed "to interview the children, and no cameras or recorders of any kind were allowed inside." They were shown "dorm-style buildings where children sleep up to 12 per room in steel-framed bunk beds, and warehouse-sized , air-conditioned white tents where minors attend classes and watch movies." Majority Of Americans Say Treatment Of Immigrants At The US-Mexico Border Will Affect Their Vote In The Midterms. The Hill (6/24, Samuels, 2.71 M) reports in its "Blog Briefing Room" that some "60 percent of Americans say the treatment of migrant families arriving at the U.S.-Mexico border is important to their vote in this year's midterms, according to a new" CBS News/YouGov poll. Data show "onethird of Americans indicated the issue will be very important to their vote." In addition, 84 percent of Democrats "said the issue will be important to back together said they were struggling through a labyrinthine process - while more [im]migrants continue to arrive." The Corpus Christi (TX) Caller-Times (6/24, Alvarado, 126K) reports that the Department of Homeland Security and HHS issued a news release which explained that "separate deportations are a choice given to parents." It stated, "A parent who is ordered removed from the U.S. may request that his or her minor child accompany them .. .. It should be noted that in the past many parents have elected to be removed without their children." Detention, Process Of Reunification Can Be Psychologically Traumatic For Separated Immigrant Children, Experts Warn. The New York Times (6/22, Carey, Subscription Publication, 19.33M) reported, "The chaotic process of reuniting thousands of migrant children and parents separated by the Trump administration's 'zero tolerance' policy poses great psychological risks, both short- and long-term, mental health experts said on Friday." They also warned that "holding those families indefinitely while they await legal proceedings" poses similar risks. The article added, 'The administration has no clear plan to reunite migrant families, which is sure to carry a psychological price for migrant parents and more than 2,300 children separated from them at the border in recent months." About 400 of these children are under the age of 12, and many are toddlers. NBC Nightly News (6/24, story 3, 1:40, Snow, 8.26M) reported, "Child psychologists ...say reunifications can be as fraught as the separation itself." On its front page, the Washington Post (6/24, A 1, Sacchetti, Sieff, Fisher, 15.68M) reports that the "children who were forcibly separated from their parents at the border by the United States government are all over the country now, in Michigan and Maryland, in foster homes in California and shelters in Virginia, in cold, institutional settings with adults who are not permitted to touch them or with foster parents who do not speak Spanish but who hug them when they cry." The Post says, "The children have been through hell. ... And now they live and wait in unfamiliar places: big American suburban houses where no one speaks their language; a locked shelter on a dusty road where they spend little time outside ; a converted Walma rt where each morning they are required to stand and recite the 11 EXT-18-248-D-000153 President Trump reversed the policy following an international "outcry." The article said it remains unclear "how many asylum-seekers are still entering the country, how many are being detained as families, and how many are being released. Nor it is known how long it will take for all parents and guardians to be reunited with their children." Some Immigrant Children Separated From Parents Are Being Sent To Minnesota. The Minneapolis Star Tribune (6/22, Serres, Smith, 1.16M) reported that "a small number of unaccompanied migrant children ...have arrived in Minnesota since the federal government began taking a harder line against illegal border crossings." The article added, "They are ...the first in an expected surge of unaccompanied minors, forcibly removed from their parents, who are now making their way to distant relatives in Minnesota and surrounding states." It remains to be seen "how many of the children will end up in Minnesota, but immigration law experts say the numbers could reach into the dozens by this fall." California Attorney Representing Dozens Of Separated Immigrant Mothers, Children. The Arizona Republic (6/23, Nanez, 1.21M) reported that attorney Michael Avenatti said he is "representing about 60 mothers and 70 children separated at the border under the Trump administration's zero-tolerance border policy." The article said Avenatti, the "California attorney who became a regular on news talk shows after representing porn star Stormy Daniels in her legal battle with President Donald Trump, is among a growing number of attorneys nationwide attempting to reunite children with their parents." Protesters Asked To Not Demonstrate In Front Of Shelters Housing Immigrant Children. Newsday (NY) (6/22, Griffith, Camargo, 1.52M) reported, "Immigration and child welfare advocates are asking protesters not to demonstrate outside shelters housing migrant children for fear of distressing them." The article said that recently, "protesters gathered at LaGuardia Airport and some shelters around the country that are holding children who have been separated from their families at the U.S.-Mexico border." But on Friday, the New York Immigration Coalition urged the public to "refrain from such demonstrations , even if they aim to show support for the children." HHS, Other Federal Workers Agonized Over Separations Of Immigrant Families. In their vote, while 43 percent of Republicans said the same." Trump Administration Seeks To Expand Use Of Family Detention For Immigrants With Children. The AP (6/23, Taxin) reported, 'The Trump administration is calling for the expanded use of family detention for immigrant parents and children who are stopped along the U.S.-Mexico border, a move decried by advocates as a cruel and ineffective attempt to deter families from coming to the United States." On Friday, immigration authorities said "they may seek up to 15,000 beds to detain families. The Justice Department has also asked a federal court in California to allow children to be detained longer and in facilities that don't require state licensing while they await immigration court proceedings." HHS Considering Using Former JapaneseAmerican Internment Camp To House Immigrant Children. The AP (6/22, Grabenstein) reported that some "75 years after federal officials shuttered a Japanese-American internment camp in Rohwer, Arkansas , the Trump administration is examining a site about 2 miles away as a potential temporary shelter for immigrant children." HHS "said Thursday that the government is considering an unused Department of Agriculture property in nearby Kelso as an immigrant shelter, as well as a possible shelter at Little Rock Air Force Base." Trump Administration Urged To Seek Alternatives To Holding Immigrant Families In TIME (6/22, Rhodan, 19.27M) Detention. reported now that President Trump has reversed his policy of separating immigrant families, his "administration is pursuing another option: holding families together in detention centers." However, "immigrant advocates, who note that approach has already faced successful legal challenges in the past, argue that there are other alternatives that the Trump Administration isn't considering, including one program with an extremely high success rate that Trump already ended." The article added, "One option is to use a combination of GPS tracking and home visits to keep tabs on immigrants who have been picked up, allowing them to stay out of detention while their case works through the legal system." More Immigrants Entering The US As Administration Begins Effort To Reunite Separated Families. The AP (6/23, Weissert, Spagat) reported that the Trump Administration's zero tolerance policy resulted in some 2,300 children being separated from their parents. 12 EXT-18-248-D-000154 thousands demonstrated "in downtown San Diego and at the border Saturday to protest the Trump administration's illegal immigration crackdown that has resulted in children being separated from their parents." The article said these protests, "among several that unfolded nationwide, capped a turbulent week in which the president agreed to halt family separations but detain families together - a directive that left border authorities unsure of how to proceed with future arrests." Connecticut Offers State Resources To Reunite Families . The AP (6/24) reports that in a letter to HHS Secretary Alex M. Azar, Connecticut Gov. Dannel Malloy (D) is "offering state resources to help the U.S. Department of Health and Human Services with migrant children separated from their parents." California Regulators To Re-Inspect Facilities Where Separated Immigrant Children Are Housed. The San Jose (CA) Mercury News (6/23, Esquivel, Bermudez, Agrawal, 552K) reported that on Saturday, California regulators said "they will immediately begin inspections at facilities where scores of immigrant children who were separated from their parents at the U.S.Mexico border under a Trump administration crackdown are being held." According to Michael Weston, a spokesman for the Department of Social Services, "state officials were re-inspecting facilities run by groups that have federal contracts to house unaccompanied children. The inspections were to begin Saturday, and were initially focused on providers that work with the youngest children, he said." Pentagon Preparing Two Bases To House The AP (6/25, Baldor) reports Immigrants. Defense Secretary Jim Mattis announced that the Department of Defense is preparing to construct temporary camps for immigrants at two unnamed military bases. The AP adds that the Department of Health and Human Services requested the temporary shelters and will operate them. The Hill (6/24, Conradis, 2.71M) reports Secretary Mattis said, "The details are being worked out ... about exactly how much capacity they need at the two bases, what other kinds of facilities they need built." The Boston Globe (6/25, 945K) reports the Pentagon "had initially talked about four potential bases, but Mattis indicated the number is now two." Sen. Elizabeth Warren Tours Immigration Center And Says "It's A Disturbing Picture." The Hill (6/24, Manchester, 2.71M) reports Sen. interviews with the New York Times (6/23, Dickerson, Subscription Publication, 19.33M), "more than a dozen employees" at Immigration and Customs Enforcement, US Customs and Border Protection, and the Department of Health and Human Services "said they were feeling alienated and exhausted after being ordered to carry out, then halt, the separations - as well as deal with the fallout." The article said the federal employees "agonized" over enforcing the policy, and while "some officials supported the seizing of children from their migrant parents under orders from the White House, others felt helpless in their cubicles, shed tears and went home wracked with guilt." The piece added that regardless of "whether they endorsed the president's policy or abhorred it, employees across the federal system expressed frustration that major changes came without advance notice." The article also said that at HHS, "the suspension of the policy prompted a scramble to begin reuniting parents and children." An unnamed official said, 'The reaction was a little bit of happiness but not glee or anything .... It was like 'O.K., how do we get them back to their parents?'" Protesters Criticize Administration's Immigration Policies As HHS Moves To Reunite Separated Families. The AP (6/23, Rosenblatt) reported, "From New York City to San Diego on Saturday, thousands of protesters demonstrated against the Trump administration's immigration policies." Rallies promoting the "Keep Families Together" slogan "took place in California, Texas, and New York, as well as in other states, as droves of people focused the protest around the separation of families at the U.S.-Mexico border." On Saturday, HHS spokesperson Evelyn J. Stauffer said HHS Secretary Alex Azar "is bringing to bear all the relevant resources of the department in order to assist in the reunification or placement of unaccompanied alien children and teenagers with a parent or appropriate sponsor." The Dallas Morning News (6/23, Manrique, 1.05M) reported, "Calls to end the Trump administration's 'zero-tolerance' crackdown on migrant families escalated Saturday when protesters from Dallas and other cities briefly blocked an immigration bus, while other civil rights leaders launched a nationwide fast." Protesters were chanting, "Set them free!" The San Diego Union-Tribune (6/23, Weisberg, Diehl, Davis, 664K) reported that 13 EXT-18-248-D-000155 separated from her nine-year-old son after they turned themselves in at the United States border. Her son was sent to Chicago while she was released to join relatives in Hyannis, Massachusetts. The Times reports, "While some of the children have been reunited with their parents in recent days, interviews with immigration lawyers and government officials suggest that most of the children are likely to remain parked in group facilities or foster homes for some time to come." The piece describes her struggles with the "red tape" of trying to reunite her family. New York City's Public Hospitals Have Treated 12 Immigrant Children Separated From Their Parents And Placed In Foster Care. Grain's New York Business (6/22, LaMantia, 233K) reported NYC Health & Hospital CEO Dr. Mitchell Katz said that 12 immigrant children who were placed in foster care after being separated from their parents have been treated at North Central Bronx Hospital and Bellevue. Dr. Daran Kaufman, the director of pediatric emergency services at North Central Bronx, said the patients were treated for different conditions including asthma, constipation, and depression. TIME (6/22, Ducharme, 19.27M) reported as the children arrive at the hospitals, physicians "say they are doing whatever they can to ease their transition into the United States." Kaufman also said, "It's been quite trying to see these children coming into the emergency room without their parents and seeing how sad and withdrawn they are given what's happened." Advocates In Texas Question Plan To The Arizona Reunite Immigrant Families. Republic (6/24, 1.21 M) reports the departments of Homeland Security and Health and Human Services "announced late Saturday that they had established a process to ensure family members know the location of their children, have regular communication and can be reunited. This process is well coordinated,' the statement said." The Texas Civil Rights Project, "which has also interviewed separated families at the border, said Sunday that the Inter-American Commission on Human Rights had formally demanded details on the Trump administration's handling of family separation and reunification." More Commentary. EJ Dionne, Jr., writes in the Washington Post (6/24, 15.68M) that "President Trump has a special animus toward immigrants, but the children of those crossing our borders are not the only vulnerable people in his Elizabeth Warren (D-MA) toured an immigration center in McAllen, Texas on Sunday, saying it painted a "disturbing picture." She said, 'There are children by themselves" and "I saw a six-monthold baby, little girls, little boys." She added, "There are mothers with their babies, with small children. Family units are together if it's a very small child, but little girls who are 12 years old are taken away from the rest of their families and held separately." Warren also said, "They're all lying on concrete floors in cages. There's just no other way to describe it." Sen. Lankford Calls Out Trump Administration's Lack Of Transparency On Immigration. The Hill (6/24, Mitchell, 2.71M) reports Sen. James Lankford (R-OK) said on "Meet the Press" that the Trump Administration has not been transparent about its policy on immigrants on the US-Mexico border. He said of the lack of transparency , "Now this has been one of the great frustrations ." Lankford defended the Administration's care for children in its custody, saying, "These are career professionals that work with [the Department of Health and Human Services (HHS)] ... They know where every child is to be able to connect them to their parent or their relative that came. But HHS often puts them in foster care across several states because they can't handle the load on the southern border." Teenager Missing After Walking Away From Shelter In Brownsville, Texas. The New York Times (6/24, Zaveri, Fernandez, Subscription Publication, 19.33M) reports a 15year-old immigrant boy who was being sheltered in a former Walmart in Brownsville, Texas "disappeared into the borderland" Saturday after he "walked off its premises." The news came as officials from Southwest Key "sought to reassure members of Congress and the news media who had toured the center that the roughly 1,500 boys living there , aged 10 to 17, were well cared for and closely monitored." Jeff Eller, a spokesman for the company , "said on Sunday it could not legally require children to stay on the premises if they sought to leave." However, NBC News (6/24, 5.76M) reports on its website that the boy is now in Mexico, "according to a source with direct knowledge of the incident." Brazilian Mother Struggles With US Red Tape To Reunite With Her Son. The New York Times (6/24, Jordan, Subscription Publication, 19.33M) reports on a Brazilian mother who was 14 EXT-18-248-D-000156 taken from their families" are reunited with their parents, President Trump "must appoint a 'Family Reunification Czar' immediately." Jones added, "As it stands, many migrant parents have little reassurance that they will quickly find their kids." He recommended , 'There needs to be one person in charge of this effort to put these families back together. And that role cannot be symbolic." Scott Simon wrote NPR (6/23, 3.55M) that "public figures, including the pope, bishops, senators of both parties, and every living spouse of a president spoke out against the Trump administration policy that separated more than 2,300 children crossing the border from their families." Simon emphasized the effect of hearing the childrens' cries during news coverage and concluded, "But we know - and must find a way to report - about the children and families who are still locked up and being kept apart. There are still cries to be heard." EJ Mantini wrote in the Arizona Republic (6/23, 1.21M) that the Trump Administration' Department of Health and Human Services may have "lost" as many as 6,000 unaccompanied children who were taken into custody at the border, according to reporters from McClatchy news service. He asks, "How is it that we don't have a program to adequately keep track of these children and the people with whom we place them?" Margaret Talbot writes in the New Yorker (6/24, 5.23M) that the "theatre of cruelty unfolding at the southern border last week was the purest distillation yet of what it means to be governed by a President with no moral center." She continues, "Administration officials portray the challenges at the border in stark, binary terms: either we treat all border crossers, including asylum seekers, as dangerous criminals to be incarcerated or we wantonly open the gates to all the world," adding, "There is, of course, a middle path, providing workable and humane alternatives to detention." Van Newkirk wrote in The Atlantic (6/23, 3.08M) to analyze recent statements by Attorney General Jeff Sessions because they reveal that ''Trumpism might be defined mostly by a lack of conviction and a corresponding unwillingness to ever own up to any one policy decision." Newkirk added, "For the thousands of families torn apart by zero tolerance--and some perhaps permanently so--and for the children detained and subject to psychologically and physically harmful sights" because the Administration is "waging a less visible war on our nation's poorest citizens, with the complicity of its Republican allies in Congress." Dionne describes the "latest attacks on programs that have long commanded bipartisan support" such as House approval of legislation that would impose additional work requirements on recipients of food stamps. Dionne writes, "It's hard to escape the sense that this is about decimating help for the least fortunate." In an editorial, the New York Times (6/23, Subscription Publication, 19.33M) blames Republicans for creating the circumstances under which "a president of their party felt he was enforcing its principles by breaking apart families and caging children." While admitting "Trump inherited a broken immigration system," the Times adds "there is also no question that he prefers ranting about its brokenness to making even a token effort at fixing it. And he has even less interest in addressing the root causes of migrant families flocking to the border." The Times concludes Republican lawmakers "owe it to the American people to help keep him in check." Novelist Oscar Casares wrote in the Washington Post (6/22, 15.68M) about listening to "seven minutes of an audio recording of small children crying for their mommies and daddies" several times. He explained, "Anyone who's ever cared for a small child, sick or hurt or scared, knows that when the child cries, all else pretty much ceases to exist." In an editorial, the Washington Post (6/23, 15.68M) wrote that in the days since President Trump signed an executive order "supposedly barring the routine practice of taking children from parents who illegally cross the border from Mexico," many of the "2,500 children separated from their parents since the administration started implementing its zero-tolerance policy in the spring remain in shelters and foster homes all over the country." The Post added that officials in the Administration "appear to have devoted little thought or effort to reunifying families , a process that even under the best of circumstances has legal and logistical challenges." The editorial urges Republicans in Congress to find "a humane solution to the humanitarian crisis that Mr. Trump has created." Van Jones wrote for CNN (6/23, 82.6M) on its website that in order to ensure that the "thousands of migrant children who have been 15 EXT-18-248-D-000157 Valerie Richardson writes in the Washington Times (6/24, 460K) that according to a CBS News/YouGov tracking poll, 53 percent of US adults said they "strongly" opposed the Trump Administration's policy of separating parents from their children on the border. The poll found, however, that 53 percent of Democrats said that the policy would not change how they vote. Richardson points out, "The results indicate that voters remain sharply divided and firmly entrenched on issues related to immigration, and that the recent pitched debate and feverish news coverage surrounding family separation haven't changed matters." conditions, there's no remedy for the Trump administration's blunder." Valeria Luiselli wrote in the New York Times (6/23, Subscription Publication, 19.33M) to describe how her 6-year-old daughter perceives the election and Administration of President Trump, observing, "No matter their story and immigration status, shame and guilt are what Hispanic children are taught to feel in America." Luiselli explains a Brooklyn class that was studying Don Quixote and argues , "Perhaps America - not the real America , but that whiteonly, English-only America - does indeed have a reason to fear the new generation of Hispanic children, these new Quixotes. They are beautiful, brilliant, well-educated and multilingual. And they have had enough." Stephanie Carnes wrote in the Huffington Post (6/22, 4.32M) that "while its cruel ploy of tearing children away from their parents lasted a month and a half or so - that we know of - the long-term damage done to those children will endure far longer." Carnes describes her work as a clinician at a shelter program funded by the Office of Refugee Resettlement in 2015 "during the surge of unaccompanied children arriving from Central America ." She describes what she saw during that time and concluded, "One way or the other, the effects of this weeks long injustice will reverberate for years, if not decades." Columnist Rochelle Riley wrote in the Detroit Free Press (6/23, 1.21M) that it "could be so simple" to reunite separated immigrant children being housed in Michigan that "even Donald Trump could do it." DHHS officials in Michigan "said the state has no authority over the children being warehoused here because they are classified as illegal immigrants." However, "if the federal government changes their status to unaccompanied refugees, the state could enter them into the foster care system, provide services and reunite them with their families ." Riley said this could also apply to other states. Benjamin Hart writes in the Daily Intelligencer (NY) (6/24, 551 K) that when President Trump issued his executive order last week, "he made it clear that the rest of his severe border policy would remain in place." However, "there's a big legal roadblock standing in the way of Trump's vision 'zero tolerance' v1s1on : the Flores settlement, a 1997 consent decree requiring that children who cross the border accompanied by their parents must be released within 20 days." THE SECRETARY IN THE NEWS Planned Parenthood Affiliates Sue HHS For Abstinence-Only Efforts On Teen Pregnancy Prevention Program. The A P (6/22, Geranios) reported that "several affiliates" of Planned Parenthood sued the US Department of Health and Human Services on Friday over its efforts to impose an abstinenceonly focus on its Teen Pregnancy Prevention Program. The lawsuits were filed in federal courts in New York City and Spokane, Wash ington, by four different Planned Parenthood affiliates covering New York City and the states of Alaska, Hawaii, Idaho, Iowa, Nebraska and Washington. In addition to the agency, the lawsuits name as defendants HHS Secretary Alex Az.ar and Valerie Huber, chief of staff for the Office of Assistant Secretary of Health. The Hill (6/22, Hellmann, 2.71 M) reported that Planned Parenthood argues in its lawsuit that the funding opportunity announcement issued by HHS that emphasize abstinence education "goes against congressional intent for the program" because it does not require the use of programs that have been "proven effective through rigorous evaluation." The Washington Examiner (6/22, Leonard, 340K) also covered the story . CMS Delays Update To Hospital Star Rating System. Modern Healthcare (6/23, Castellucci, Subscription Publication, 239K) reported that last week "for the third time," the CMS "put off ...an update of its overall hospital star ratings after hospitals raised concerns about the methodology." The article said "the decision to delay fits with HHS Secretary Alex Az.ar's price 16 EXT-18-248-D-000158 transparency goals," and wrote that the CMS' proposed hospital inpatient payment rule would require hospitals to publish online a list of their standard charges. "HHS' Administration for Children and Families did not respond to an email from The Washington Post this week seeking information about the number of separated children sent to Maryland and Virginia." UNACCOMPANIED ALIEN CHILDREN California Facility Housing About 100 Separated Immigrant Children. The Los Angeles Times (6/23, Esquivel, 4 .03M) reported, "David & Margaret Youth and Family Services features a school, a market and a pool - even a cafe offering a $5.50 turkey sandwich called California Dreamin'." At present, it is "home to some of the children who were forcibly taken from their parents under President Trump's 'zero tolerance' immigration policy." The article said it is not known "how long they will be separated from their families, frustrating leaders across Los Angeles trying to help the estimated 100 kids in facilities throughout the region." The piece added that officials at HHS' Office of Refugee Resettlement, "the federal agency charged with managing the kids, did not respond to repeated requests for comment." ORR Director Mum On Administration's Immigration Policy. Colby ltkowitz wrote in the Washington Post (6/22, 15.68M) "The Health 202" that Scott Lloyd is the director of "the federal agency that's become central in the political maelstrom over the Trump administration's now-reverted policy separating migrant children from their families at the southern border." But "Lloyd has said nothing publicly about the matter, even as it has consumed the headlines for days." The piece added that it remains "unclear the exact role played by Lloyd, who directs the Office of Refugee Resettlement under the Department of Health and Human Services that has had more than 2,000 migrant children in its care since they were separated from their parents under Trump's 'zero tolerance' policy (those children, and tens of thousands more, may now be transferred to the Pentagon)." He "hasn't been heard from publicly since he spoke on a United Nations panel in April about his desire to create stricter standards for accepting unaccompanied minors who cross the border into the federally run shelters." Immigrant From El Salvador Deported Without Six-Year-Old Daughter. The Washington Post (6/23, Partlow, 15.68M) reported on Arnovis Guidos Portillo, a 26-year-old farmer from El Salvador who was separated from his sixyear-old daughter, Meybelin. Guidos says he was told the separation would be temporary, but he was eventually deported back to El Salvador without his daughter, who is still in the US. The article added, "A Southwest Key Programs spokeswoman said she could not confirm if Meybelin was at the Phoenix shelter and referred queries to the Office of Refugee Resettlement, part of the Department of Health and Human Services. An HHS spokesman said it would take days to confirm her location and, even then , the department might not be able to speak about her case because of privacy concerns." Tim Kaine Visits Virginia Facility Housing Separated Immigrant Children. The Washington Post (6/22, Anderson, Lang, 15.68M) reported that some 15 immigrant "children recently separated from their parents near the southwestern U.S. border are staying at a shelter in Northern Virginia, according to the shelter's leadership." On Friday, Sen. Tim Kaine (D-VA) "toured the Youth for Tomorrow facility ...in the Prince William County community of Bristow, aides said, speaking with some of the migrant children and learning from the staff that many of the youngsters arrived there 'traumatized ."' The article said about "2,500 [im]migrant children were separated from parents under Trump administration actions starting in early May." HHS' Office of Refugee Resettlement "has placed many of them in shelters and foster homes around the country ." The piece added that 23andMe Offers To Provide Kits, Resources To Conduct DNA Testing, Help Reunite Separated Immigrant Families. The San Francisco Chronicle (6/22, Ho, 3.29M) reported, "Mountain View genetic testing company 23andMe has offered to donate DNA test kits to help migrant children in detention centers reunite with their parents - prompting logistical and ethical concerns about an 17 EXT-18-248-D-000159 custody of Health and Human Services ." The group's "federal contracts now tally more than $400 million annually. " undertaking that genetics experts say would be a first in the United States." The company "said it would provide its kits and resources to federal officials to help reconnect the separated families but offered few details on how it would proceed beyond CEO Anne Wojcicki saying on Twitter, 'We are waiting to see the best way to follow up and make it happen ."' The article said HHS would have to approve this plan, but neither the department not its Administration for Children and Families has commented on the matter. State Legislators, Advocates Worried About Welfare Of Separated Immigrant Children In Kansas. The Kansas City (MO) Star (6/22 , Bauer , 636K) reported, "State legislators and child welfare attorneys say they 're worried about the welfare of migrant children staying in Kansas and question how long they will be separated from their families." Top Democrats have requested "for a tour of the Topeka nonprofit where the children were sent, but said they were told that would have to wait. " During "a Friday morning news conference, they said officials at The Villages which serves troubled and neglected youth - told them gaining access could take up to two weeks ." The piece added that during the 2017 fiscal year, The Villages, a nonprofit in Topeka, KS, "received $2.6 million in funding from the Office of Refugee Resettlement through its Unaccompanied Alien Children Program. " That amount has already risen to $3.2 million this year . Trump's Executive Order Helped To Reduce Criticism Over Immigrant Policy, But May Have Created New Issues For Administration. Politico (6/22, Johnson , Kami, Cook , 3.51 M) reported , "Facing an unprecedented outpouring of public outrage this week over the separation of migrant families at the border, President Donald Trump did what he usually does when he wants a quick fix: Asked for an executive order." The article said the President "frequently demands executive orders to carry out policies he wants to implement as a way of circumventing the long process of working with Congress to pass legislation , according to a former administration official - a move he picked up from former chief strategist Steve Bannon, who in the opening months of the Trump presidency, used the directives to carry out his 'shock and awe' strategy. " Although the order "stanched the flow of negative media coverage, beginning the process of reuniting children and parents , the vaguely worded immigration order created a new set of problems for the administration. " The article added that on Friday , HHS announced the creation of an "unaccompanied children reunification task force" to help reunite separated immigrant families . Sen. Johnson Discusses Government's Ability To Reunite Families. The Hill (6/24 , Balluck , 2.71 M) reports Sen . Ron Johnson (R-WI) in an interview early Sunday "pointed to the Obama administration 's track record when asked if the Trump administration will be able to reunite migrant children who were separated from their families at the border." He argued that "the track record of the prior administration wasn't particularly good either . ... A subcommittee looked ...into the lack of coordination between [the Department of Homeland Security (OHS)], who with unaccompanied children has to turn those unaccompan ied children over to [the Department of Health and Human Resources (HHS)] within 72 hours . And they literally lost track of , I think it was about 1,500 kids." Latino Nonprofit In Texas Providing Housing For Thousands Of Unaccompanied Immigrant Minors. NPR (6/22 , Domonoske , 3.55M) reported that Southwest Key Programs, a large Latino nonprofit in Austin, TX , "has been running shelters for unaccompanied migrant children for two decades, without drawing much attention. In some instances , the shelters were described admiringly ." At present, "Southwest Key has 26 shelters in Texas , Arizona and California , housing more than 5,100 immigrant minors, " who represent "about half of the total population in the HHS IN THE NEWS CNN Says Official Who Was Disciplined Over Conspiracy Website, Anti-Islam Show Included That Information On Her Resume When She Applied To HHS. T he Hill (6/23 , 18 EXT-18-248-D-000160 opponents of Donald Trump "expend all of our oxygen pushing back against the jailing of children, the shameless corruption or the daily assaults on the First Amendment, the administration is taking enormously disruptive actions that go virtually unseen or unnoticed." On June 1, "the Department of Health and Human Services officially unveiled a proposed rule that could have significant consequences for women's health care. It is yet another front in the Republican Party's ongoing war on women and it must be met with resistance and vigorous public debate." The proposed rule, "often called the 'gag rule,' targets health care providers who perform abortions by withholding Title X (the National Family Planning Program) funds." Birnbaum, 2.71 M) reported that Ximena Barreto, an HHS official "who was demoted following a public outcry over her work for a conspiracy website and anti-Islam show, listed both experiences on her resume, according to a report by CNN." The copy of her resume which CNN obtained on Thursday "shows that she listed her work for the conspiracy-focused website Borderland Alternative Media and right-wing YouTube shows when she applied for the position." In addition, she "listed her personal website, which linked to all of her social media accounts where she published a number of derogatory remarks." CMS Launches Data Element Library Advances. EHR Intelligence (6/22, Monica) CDC Determines Belmont Park Worker's Death Caused By Bacterial Sepsis, Not Hantavirus. The New York reported that CMS recently launched a Data Element Library "that supports health data and health IT standardization to improve interoperability." According to the article, "DEL is a free, centralized database that enables the public to view the specific types of data CMS requires post-acute care (PAC) facilities, such as nursing homes and rehabilitation hospitals, to collect during patient health assessments." The article added that "by improving interoperability and health data standardization across care settings, CMS helps to ensure patients can have access to their information when needed." Health Data Management (6/22) also covered the story. Times (6/24, Nir, Subscription Publication, 19.33M) reports a recently deceased Belmont Park racetrack employee died of "bacterial sepsis, not hantavirus, a rat-borne illness that was initially suspected, according to the Centers for Disease Control and Prevention." After the man "collapsed ...on the track grounds beside the ramshackle employee housing run by the New York Racing Association , and died less than a week later, state health officials suspected hantavirus"; and a commercial laboratory determined he "tested positive for hantavirus antibodies." However, testing by the CDC "concluded that sepsis ...was the true cause of the man's death." Study: 1 in 5 Americans Lives With Mental Disease. The Tennessean (6/25, 513K) reports that "nearly 1 in five U.S. adults lives with a mental illness," which is 44.7 million people in 2016. But estimates "suggest that only half of the people with mental illnesses receive treatment, according to the National Institute of Mental Health." Oregon has "the highest rate, and New Jersey the lowest, according to 2012-2014 data analyzed by the U.S. Substance Abuse and Mental Health Services Administration." SAMHSA acting deputy assistant secretary Kana Enomoto said, "The figures in SAMHSA's report remind us how important it is to take mental health as seriously as any other health condition." Lyme Disease Cases Significantly Underreported, CDC Says. The Wall Street Journal (6/22, McGinty, Subscription Publication, 6.13M) reported that disparities between documented Lyme disease cases and the actual prevalence are high, according to the CDC, which says that the 30,000 cases recorded annually are a fraction of the probable 300,000 cases per year. Lyme disease, as the "most common vector-borne disease by far," remains "underreported," according to CDC epidemiologist Dr. Kiersten Kugeler. She added, "All reportable diseases are subject to underreporting, although we know this is particularly true for common diseases and for those often treated in an outpatient setting." Sardella: "Enormously Disruptive" Actions By Trump Administration Going Unnoticed. Kurt Sardella writes for the Huffington Post (6/24, 4.32M) that as 19 EXT-18-248-D-000161 that raises money for the National Institutes of Health...did nothing wrong." Faye Flam wrote for Bloomberg View (6/22, 4.46M) that "NIH Director Francis Collins was emphatic about the fatal nature of this study's flaws," telling Science that "many of the [NIH] staff who have seen the working group report were frankly shocked to see that so many lines were crossed." The Toledo (OH) Blade (6/22, 212K) editorialized, "Dr. Collins' decision to end the study was in the best interests of science, the American public and NIH's credibility," adding, "But NIH under Dr. Collins just made a bold statement about the importance of science and ethics. It's a moment worth noting." FDA Warns That Recalled Flonase Spray May Contain Glass Particles. The New Orleans Times-Picayune (6/23, Krueger, 521 K) reported the FDA said Flonase and other Apotex Corp. products have been recalled due to the potential of contamination by small glass particles in some bottles. The news follows a customer complaint "about a nasal spray containing the company's Fluticasone," and the FDA is warning "that glass particles could block the spray bottle's actuator and affect the pump's functionality" and injure users' nasal cavities if they use the product. Op-Ed: FDA's Restrictions On Mifepristone Could Harm Women Dorothy Experiencing Miscarriages. Op-Ed Critical Of NIH Over Its NowCanceled Alcohol Study. Paul D. Thacker, Novick, MD, pediatrician in Philadelphia, Pennsylvania, wrote for STAT (6/22, 27K) that women who suffer miscarriages should not be prevented by the Food and Drug Administration from accessing misoprostol Dr. Novick said a "landmark clinical trial, published this month in the New England Journal of Medicine," found that 84 percent of "women experiencing first-trimester miscarriages ...[given) a dose of misoprostol or ...a combination of misoprostol plus mifepristone" completed the miscarriage "within two days, compared to 67 percent among women who_got misoprostol alone." She added that the American College of Obstetricians and Gynecologists "has announced it is reviewing these findings to determine whether to update its clinical guidance and policy position on caring for women with miscarriage," adding that the FDA's restrictions could prevent women from accessing mifepristone. former Senate investigator, wrote in the Washington Post (6/22, 15.68M) that NIH Director Francis Collins' decision to cancel the NIH's "noxious ethical problem" its "alcohol consumption study that had been funded mostly by beer and liquor companies" that "seemed predetermined to find alcohol's benefits but not potential harms" - is an indicator of "intelle~tua,! corruption at our government research agencies. According to Thacker, "this was only the latest scandal involving hidden corporate influence," and in his time as an investigator, he "found that the agency often ignored obvious conflicts" and that "its industry ties ...are never really addressed unless the agency faces media scrutiny." Thacker noted that National Institute on Alcohol Abuse and Alcoholism officials "courted alcohol-makers for several years to fund the study," adding that NIAAA Director George Koob "declined to fund research critical of alcohol advertising." Thacker called for "continued scrutiny of the NIH, by the public and Congress," to generate transparency. NIH Cancels Alcohol Study Which The Received Industry Funding. Baltimore Sun (6/20, McDaniels, 570K) reported the NIH has canceled "funding of a highly criticized $100 million study involving Johns Hopkins researchers that looked at whether one drink of alcohol a day can decrease the risk of heart disease and diabetes." According to the Sun, an NIH working group led an investigation which "found that employees from its National Institute of Alcohol Abuse and Alcoholism were in such frequent communication with [the] lead researcher...and the industry that it undermined the scientific integrity of the study." However, the NIH investigation determined that the "foundation Marijuana Addiction Poses Real Threat That Many Do Not Recognize, Experts Warn. The Washington Post (6/22, Vestal, 15.68M) reported that many people are unaware of the possibility of marijuana addiction, noting that "in the public health and medical communities, it is a well-defined disorder that includes physical withdrawal symptoms, cravings and psychological dependence." Some experts believe "it is on the rise, perhaps because of the increasing potency of genetically engineered 20 EXT-18-248-D-000162 most recent years captured." The article included experts' comments on the benefits and drawbacks of screening. plants and the use of concentrated products, or because more users are partaking multiple times a day." The piece said that according to Dr. Nora Volkow, National Institute on Drug Abuse Director, "an estimated 2.7 million Americans meet the diagnostic criteria for marijuana dependence, second only to alcohol dependence ." Susan Weiss, director of research on the health effects of marijuana at the NIDA, indicated "at the annual meeting of the American Society of Addiction Medicine in April. ..that marijuana can be addictive." She said, "But believe it or not...we're having a hard time convincing people that addiction exists." Oncologist Who Uses Twitter To Decry Precision Medicine "Hype" Profiled. NPR (6/24, Harris, 3.55M) reports Dr. Vinay Prasad, assistant professor of medicine at Oregon Health and Science University, "has made a name for himself calling out the hype surrounding precision medicine." A hematologistoncologist who is "a prolific author" and active Twitter user, Dr. Prasad has been called a "professional troublemaker. ..as he tweets to his 20,000-plus followers ." NPR reports on comments Dr. Prasad made at the American Society of Clinical Oncology annual meeting, and notes that the NCI-MATCH trial presented at the meeting indicated "disappointing" results among "150 patients who were matched to drugs based on their tumor's genetic fingerprint, rather than the type of tumor." Dr. Richard Schilsky, ASCO chief medical officer, is quoted as saying, "He's a bit of a provocateur. But frankly he's taking a very hard and objective look at a very complex area and ...he's saying what's behind the curtain." In a 4,000-word story profiling Dr. Prasad, the Cancer Letter (6/22, Goldberg) reported that Keith Flaherty, the ECOG-ACRIN chair of the NCI MATCH trial , said of the study, which Prasad referenced in one publication, "After accrual of nearly 6,000 patients to the centralized screening phase of the MATCH trial, we found that 19 percent of patients had molecular findings that permitted treatment assignment. ... Notably, this excludes the proportion of patients who were not eligible for treatment assignment in MATCH because of prior FDA approval or ongoing late stage trials in patients with those cancers types with those same molecular features . Our experience indicates that NGS testing was an efficient strategy for identifying patients for inclusion in MATCH." In a 5,000-word story, the Cancer Letter (6/22, Goldberg) offered a review of Prasad's "thought experiment," his paper titled "Low-value approvals and high prices might incentivize ineffective drug development," to evaluate the commentary that has been billed by The New York Times as a study. The Times said Dr. Prasad's commentary indicated that "companies could theoretically test compounds they know to be ineffective with the hope of getting a false NIDA Director Discusses Factors That Have Led To Opioid Crisis. The Atlantic (6/23, 3.08M) reported, "In 2016, 64,000 people died from drug overdoses in the U.S., most of them due to opioids. That's more than the number of Americans killed in the wars in Vietnam and Iraq combined." Three factors "led to those numbers, Nora Volkow, director of the National Institute on Drug Abuse, a part of the National Institutes of Health, said at the Aspen Ideas Festival, which is cohosted by The Aspen Institute and The Atlantic." First, the epidemic "was started by a healthcare system that sought to minimize pain and suffering." Second, Volkow "said, this overprescription coincided with a massive flood of heroin in the 2000s from Mexico." Thirdly, she "said, heroin began to be laced by drug dealers with synthetic opioids, which are not only relatively easy to produce, but also stronger than heroin." Cancer Experts Discuss Ways To Reduce Risk Of Death Due To Prostate Cancer. U.S. News & World Report (6/21, Schroeder, 1.97M) discussed how men can lower their risk of death due to prostate cancer through screening and treatment. The article quoted Dr. Serban Negoita, chief of the National Cancer lnstitute's Data Quality, Analysis , and Interpretation Branch, as saying that "in 2013, we noticed that the slope or the speed with which this rate of prostate cancer mortality declined in the past, kind of changed" based on the findings of the Annual Report to the Nation on the Status of Cancer released last month. Dr. Negoita, "lead author of the prostate cancer section" of the report, explained that the study found "ageadjusted prostate cancer death rates leveled off ... and were all around 19 per 100,000 for the 21 EXT-18-248-D-000163 positive result that would enable them to market a worthless medicine at an enormous profit." The Cancer Letter (6/22, Goldberg) featured an interview with Dr. Prasad about the commentary, published in Nature Reviews Clinical Oncology, which argued that the "FDA is approving drugs too fast and on too little data, thereby benefiting drug companies , but not the cancer patients." Dr. Prasad discussed this assertion, saying that two "Government Accountability Office reports say FDA is not enforcing [post-marketing commitments] for surrogate approval," among other points. OPIOID CRISIS House Passes "Sweeping Package" To Fight Opioid Crisis. In a 396 to 14 vote, the House on Friday passed "a sweeping package to fight the opioid crisis," approving_ '!1easur~s "that include encouraging nonadd1ct1ve pain treatment and fighting the rise of synthetic drugs such as fentanyl," the Washington Post (6/22, Zezima, 15.68M) reported. The suite of legislation "would allow for increased research for nonaddictive pain medications, allow physician assistants and nurse practitioners to prescribe medications that treat opioid addiction and create opioid recovery centers." The AP (6/22) reported the bill passed Friday "encourages states to increase coverage of treatment for substance abuse disorders through Medicaid." Foster youth and former prisoners "are among the populations targeted for enhanced coverage of their treatment." In addition, the legislation "seeks to expand the use of medications to treat opioid abuse." Fierce Healthcare (6/22, Reed, 146K) quoted Energy and Commerce Committee Chairma_n Greg Walden (R-OR) as saying, "This package ~s not Congress' first legislative response to this crisis, nor will it be our last. But it does include meaningful solutions that will update archaic policies, better equip our communities to respond to this evolving epidemic, and save lives." The Washington Examiner (6/22, Leonard, 340K) quoted Rep. Kevin Brady (R-TX) sayin~, "While we still have a long way to go to solve this crisis, this legislation, which is made up of many Republican proposals, takes meaningful strides to help millions of Americans recapture their lost hopes and dreams ." Meanwhile, the Washington Times (6/22, Howell, 460K) reported House 22 Majority Leader Kevin McCarthy "cast the bill in personal terms, recounting how his press secretary's brother died of an opioid overdose, while the White House said it supported its own effort to treat opioids abuse as a public health emergency." CQ Roll Call (DC) (6/22, Raman, 117K) reported the House "considered seven amendments to the legislation. Six were adopted by voice vote," including an amendment "from Republicans Joe L. Barton and Mark Meadows and Democrat Ann Mclane Kuster that would require the Food and Drug Administration commissioner to develop evidence-based prescribing guidelines for treating acute forms of pain." Also included was "an amendment from Republican John Curtis to require the Department of Health and Human Services to issue a report on current practices for prescribing opioids during pregnancy" and a "bipartisan amendme_nt from Keith Rothfus and William Keating to require HHS to institute guidelines for when to prescribe the opioid overdose reversal drug naloxone." Anot~er amendment included was from Democrat Maxine Waters and requires HHS "to survey groups that treat substance abuse to develop a plan to determine any gaps in services or funding for treating drug addiction." The Hill (6/22, Sullivan, Brufke, 2.71 M) reported "some say the legislation is not enough to make the large-scale changes needed to fight the epidemic." Addiction advocates "largely praise the measures as good steps forward, but say that much more work and funding is needed to tackle the issue's scale." Rep. Frank Pallone Jr. (D-NJ) "said the bill makes 'incremental changes to support those affected by the opioid crisis' but that it 'does not adequately deal with the magnitude of the crisis that this country is facing."' Modern Healthcare (6/22, Dickson, Subscription Publication, 239K) reported American Hospital Association Executive Vice President Tom Nickels "said the trade group was especially pleased to see overwhelming support for provisions that would expand the use of telehealth services for substance use disorder; guide improved care for infants with neonatal abstinence syndrome; and increase the types and capacity of providers offering medication-assisted treatment." Politico (6/22, Ehley, 3.51 M) reported the measure, which was endorsed by the White House, "combines more than 50 bills" and now EXT-18-248-D-000164 Modern Healthcare (6/22, Johnson, Subscription Publication, 239K) reported, "Although insurers have made an effort to discourage opioid abuse by placing quantity limits, beginning therapy with less risky medications or requiring preapproval for prescriptions, they applied the same rules to non-opioid treatments and made it just as difficult for patients to access opioid alternatives, according to the study." heads to the Senate, where lawmakers "are planning to take up their own opioid legislation." A House Republican aide "said leadership hopes to conference the bills in July, though it could slide later into the summer depending on the Senate's schedule." The White House said in a statement "We urge the Senate to continue the bipartisan tradition of helping Americans who are affected by the crisis, to swiftly pass the legislation from the House, and to get these lifesaving bills to the President's desk." Handful Of Companies To "Reap Windfall" From Bills. Politico (6/22, Cancryn, 3.51M) reported a small handful of companies "that have spent millions lobbying Congress could reap a windfall if any of the bills become law." Alkermes, "which spent $1 million lobbying in part to support a bill to fund full-service centers where people can detox, receive medical care and start treatment a setup that could boost the fortunes of its bestselling product, anti-addiction treatment Vivitrol, which has been held back by the need for patients to fully detox before taking the drug." Alkermes "has already attracted attention for its aggressive marketing tactics and Washington lobbying presence. Former HHS Secretary Tom Price toured the company's Wilmington, Ohio, plant last year to tout Vivitrol - stirring controversy by belittling rival medication-assisted treatments that are more widely-used." Study: Online Black-Market Opioid Sales More Than Doubled After Reclassification. Reuters (6/22, Lehman) reported online black-market sales of opioid painkillers "more than doubled in the United States during the two years after these drugs were "rescheduled," putting tighter restrictions on legal prescriptions and sales, according to a recent study." Almost immediately after hydrocodone combination products were reclassified to schedule Ill in 2014, "the proportion of all drugs illicitly purchased in the U.S. from sellers on the 'dark net' that were in the opioid category began rising, reaching 13.7 percent in 2016." The study was publish in The BMJ. Dartmouth Getting $5.3 Million To Study Opioid Treatment For Pregnant Women. The AP (6/24) reports a research team at Dartmouth's Geisel School of Medicine "is getting $5.3 million to study medication-assisted treatment for pregnant women with opioid use disorders." Officials "say combining medication with psychosocial services has been shown to significantly reduce poor outcomes for babies born to mothers with opioid use disorders, but it can be difficult for women to find providers." Government-Funded Study Says Medicare, Medicaid, Private Health Insurance Fueled Opioid Epidemic. The Washington Examiner (6/22, Leonard, 340K) reported Medicare, Medicaid, and private health insurance "helped fuel the opioid epidemic because they made it too easy and inexpensive for patients to get opioids, suggests a government-funded study by researchers at Johns Hopkins Bloomberg School of Public Health." Authors of the study "conclude that insurers share responsibility for the massive toll of opioid deaths because they didn't put in precautions on the drugs to make them harder to access." The study was funded "by the Office of the Assistant Secretary for Planning and Evaluation, part of the Department of Health and Human Services." It used input "from other federal agencies, including the National Institute on Drug Abuse of the National Institutes of Health and the Centers for Disease Control and Prevention." Study Says Counties With Highest Opioid Prescription Rates In 2015 Were More Likely To Vote For Trump. The Dallas Morning News (6/22, Rice, Reporter, 1.05M) reported that a study from University of Texas researchers found that "the counties with the highest opioid prescription rates in 2015 were also more likely to favor presidential candidate Donald Trump in 2016." Support for Trump "was as strong a marker of an area's opioid rates as some commonly used socioeconomic factors such as household income, education levels and unemployment, the study said." The study notes that an "estimated 11.5 million Americans misused prescription opioids and 2.1 million had 23 EXT-18-248-D-000165 an opioid use disorder in 2016, according to the U.S. Department of Health and Human Services." The Huffington Post (6/24, Papenfuss, 4.32M) reported the areas "with the high rates of opioid use are largely concentrated in the Southern and Appalachian communities with high unemployment rates and lower median incomes." Trump support "might be explained simply by demographics : the same rural, economically depressed populations most severely affected by opioid use also happened to be the same communities where Trump gained strong support." The Daily Intelligencer (NY) (6/22, 551 K) reported the researchers "caution that their study does not suggest that people who are addicted to opioids voted for Trump - ' If you're stoned out on opioids, you're probably not voting,' lead auth~r Dr. James Goodwin" said. Rather, "they say, ,t indicates a connection between the economic and social problems that lead to high rates of opioid use and support for Trump." The Wash ington Times (6/22, Kelly, 460K) reported the researchers said, "The association of the presidential vote with chronic opioid u~e underscores the importance of cultural, economic, and environmental factors associated with the opioid epidem ic." Newsweek (6/24, Hugo, 2.1~M) reported the researchers "came to this conclusion by analyzing and cross-referencing data from the U.S. Census Bureau, medicare files and other datasets." They defined opioid dependency "as anyone who had 90 days or more of prescription given to them within a year." NPR (6/23, Chisholm , 3.55M) reported, "l_n counties with higher-than-average rates of chronic opioid prescriptions, 60 percent of the voters went for Trump . In the counties with lower-than-average rates, only 39 percent voted for Trump." The findings were published Friday "in the medical journal JAMA Network Open." Rhode Island Gets More Federal Funding To Combat Opioid Addiction. The AP (6/23) reported Rhode Island "has b~~n awarded more federal funding to combat op101d addition." The state's congressional delegation "say Rhode Island's share from a grant program at the Substance Abuse and Mental Health Services Administration will rise from $2.1 million last year to $12.5 million." 24 Portman Says STOP Act Will Help Combat Rise Of Fentanyl. Sen. Rob Portman (R-OH) writes for the Toledo (OH) Blade (6/23, 212K) that "at the heart" of the drug epidemic "is the rise of fentanyl." He says Congress "should act with urgency becaus_e people are overdosing and dying every day. This problem isn't getting better - it's getting worse." Unlike other drugs transported over land, "most illegal fentany l is manufactured in China and shipped into the U.S. through our own Postal Service." Citing results from a recent investigation, he says fentanyl manufacturers "prefer to ship through the Postal Service, and essentially guarantee delivery when doing so , because the Postal Service has lower security standards than private carriers." Portman says the result of the investigation "is legislation I introduced called the STOP Act." The STOP Act "will hold the Postal Service to the same standard as private carriers and require them to get this information on all overseas packages entering the U.S." Rep. Rodgers Highlights Work On Combating Opioid Crisis. Rep. Cathy McMorris Rodgers (R-WA) writes for the Spokane (WA) Spokesman-Review (6/23, 164K) that one of "the greatest threats to America today is the growing scourge of opioid abuse and addiction." She highlights her and other lawmakers' response to the crisis, saying, "In 2016, we got the Comprehensive Addiction and Recovery Act signed into law, and over the past two weeks , we in the House have passed dozens of bills to continue to fight this crisis and provide resources to those who need them." Ridge: House Vote Brings Nation One Step Closer To Beating Opioid Crisis. Former Pennsylvania governor and senior adviser to Americans for Securing All Packages Tom Ridge writes for the Detroit News (6/25, 710K) "signs of progress" in the fight against opioids. Last week , the US Senate and House of Representatives "came to an agreement on ~he Synthetics Trafficking and Overdose Prevention (STOP) Act, legislation by Michigan's own Congressman Mike Bishop designed to close a major security loophole in the global postal system that has fueled the opioid epidemic." And the House "just passed the bill, bringing us one step closer to cutting off the flow of dangerous drugs." EXT-18-248-D-000166 demand for opioids to tackle the use of synthetic drug fentanyl , but it vowed to step up cooperation after Chinese production of the substance had been blamed for fuelling the U.S. opioid crisis." Study: Combination Of Opioids With Common Drug Risky In First 90 Days. Forbes (6/25, Disalvo, 10.34M) reports that a new study "shows that the combination of opioids with one common class of drugs in particular is especially risky in the first 90 days of concurrent use." Those drugs "are benzodiazepines (often called "benzos"), the class that includes alprazolam (Xanax) , diazepam (Valium), and clonazepam (Klonopin), meds frequently prescribed to alleviate anxiety." The study "examined data from more than 71,000 Medicare Part D beneficiaries to find out how simultaneous use of opioids and benzos influence overdose risk over time. ," and it was published in JAMA Network Open. Experts Discuss Government's Role In Physician's Ability To Treat Patients With Opioids. In its "Journal Reports" column, the Wall Street Journal (6/24, Subscription Publication, 6.13M) provides a roundup of articles from healthcare experts discussing whether the government should limit a physician's ability to prescribe opioids. Gutman: PA Bills Threaten To Push State "Backward On Opioids." Abraham Gutman wrote for the Philadelphia Inquirer (6/22, 1.07M) that two bills under consideration by Pennsylvania legislators "threaten to take the commonwealth backward on opioids." The first "is an effort to limit already-scarce evidence-based treatment. The second limits physician discretion when prescribing opioids . If either bill becomes law, Pennsylvania will be worse off, not better." Purdue Pharma Fires 350 Employees As Opioid Lawsuits Mount. The CBS Weekend News (6/23, story 8, 2:50, Quijano , 2.63M) reported Oxycontin manufacturer Purdue Pharma "laid off 350 workers this week, including the remainder of its sales team ," as it prepares for "a wave of lawsuits accusing it of fueling the opioid epidemic." Former employees claim they were taught "to tell doctors that some patients might only appear to be addicted ," despite having no studies to back up the assertion. Purdue disputes the claim, saying in a statement to CBS that Oxycontin sales "have been consistent with the information contained in the FDA-approved label." Lopez: Needle Exchanges Help Combat Opioid Addiction. German Lopez wrote for Vox (6/22, Lopez, 1.66M) that needle exchange programs "are an exhaustively studied, proven public health intervention in the fight against opioid addiction - making them a key component in efforts to halt the opioid epidemic ." However, Lopez said, needle exchanges "are also illegal in 15 states," adding, "Needle exchanges not only provide a place where people can obtain syringes for drug use or dispose them." The "driving idea" behind the programs "is this: Recognizing the reality that some people do use drugs, it's better to provide them somewhere to pick up new , sterile syringes (without the risk of spreading , say, HIV or hepatitis C infection) than to turn them away from potential public health services and force them to reuse needles despite the hazards." Ontario Promoting Free Use Of Opioid Antidote Naloxone. In a report on the expansion of access to opioid antidote naloxone in Ontario, the Wall Street Journal (6/24, Monga, Subscription Publication, 6.13M) profiles Leon Alward, who has overdosed five times in the last four years , but is still alive because in four of the five emergencies , he received shots of naloxone. Alward has access to the drug for free from any of the 2,800 pharmacies that stock it in Ontario, which became possible after the province made it available without a prescription in 2016. The US has not done so, in part because, as critics say, such widespread availability could increase opioid use. MENTAL ILLNESS Jails, Prisons Are Places Of Punishment Unsuitable For People With Mental Illness Or Intellectual Disabilities, Psychiatrist Says. In an China Says US Should Do More To Cut Demand For Opioids. Reuters (6/25) reports China's drug control agency on Monday "said the United States should do more to cut its opinion piece in the Huffington Post (6/22, 4.32M), 25 EXT-18-248-D-000167 Morning News (6/22, Krause, 1.05M) reported that Dr. Kelly Robinett , a "70-year-old Carro llton man was convicted Friday of four fraud charges for his role in a $13 million home healthcare scam made possible by what prosecutors called his rubber stamp signature on fraudulent documents. " FBI Dallas office special agent in charge Eric K. Jackson was quoted as saying, "The significance of this case highlights the responsibility health care workers, especially physicians and nurses, have to protect not only their patients , but prevent fraud against any federa l health insurance program during the performance of their duties." psychiatrist Brian Barnett, MD, a post-doctoral fellow in the Partners Healthcare Addiction Psychiatry Fellowship and a clinical fellow in psychiatry at Harvard Medical School, discussed the plight of people with mental illness and those with intellectual disabilities who are incarcerated. Dr. Barnett observed, "People with mental illness and intellectua l disability deserve a health care system that relies on nurses and physicians, not correctional officers . Jails and prisons are designed to be places of punishment , so let's stop filling them up with people who need healing." Colorado Schools To Receive Small Grants To Pay For Suicide-Prevention Training. The Denver Post (6/24, 755K) PRESCRIPTION DRUG PRICING New York State Demands Drug Maker Lower Cost Of $272,000 Cystic Fibrosis Treatment. The New York Times reported that schools in Colorado "will soon divide $400,000 into small grants to pay for suicideprevention training for all campus employees, including teachers, front-desk attendants and custodians. " Authorized through Colorado Senate Bill 272 , "the school training grants - from $5 ,000 to $10,000 for each campus - will be available in January and must be used to train all school personnel on the warning signs of impending suicide attempts , diffuse crisis situations and connect troubled people to mental health services ." The Post pointed out that "suicide is the second leading cause of death" in the state "for people ages 10-24." What 's more , "the Centers for Disease Contro l and Prevention reported that suicide rates in Colorado saw a 34.1 percent increase between 1999 and 2016 ." (6/24, Thomas , Subscript ion Publication , 19.33M) reports that "in a case that is being closely watched around the country," New York state health officials have said the new drug to treat cystic fibrosis, Orkambi, "is not worth its price" $272,000 annually - "and are demanding that Vertex give a steeper discount to the state's Medicaid program . The case is the first test of a new law aimed at reining in skyrocketing drug costs in New York's Medicaid program." Under the new law, "New York could also demand that Vertex disclose details about how it sets its price, including how much goes toward research and deve lopment or to other areas, like marketing ." The Times adds that the debate over the drug "may soon become moot - earlier this year , the Food and Drug Administration approved a new cystic fibrosis drug , also made by Vertex ." HEALTHCARE FRAUD Texas Supreme Court Says Xerox Responsible For Fraudulent Medicaid Dental Payments. The Texas Tribune (6/22, Hatch: To Reduce Prescription Drug Costs, Increase Competition. Sen. Orrin Evans, 24K) reported the Texas Supreme Court ruled Friday that Xerox is responsible "for the $1 billion in fraudulent Medicaid payments the company made wh ile overseeing preauthorizations for Texas Medicaid patients' dental work ." The Supreme Court upheld a Texas Court of Appeals ruling that Xerox - and not the dentists - was responsible "for mismanaging and misauthorizing payments for Medicaid dental services ," according to the article . Hatch (R-UT) writes for CQ Roll Call (DC) (6/25, 117K) that "80 percent of Americans consider the cost of prescription drugs unreasonable ." At the same time, a "majority of Americans recognize that prescription drugs have improved countless lives." However, "if we truly want to reduce costs and make life-changing and life-saving medications accessible to all Americans, we must increase competition among prescription drugs particularly new drugs that have the ability to cure diseases , but face limited competition ." Former Physician Found Guilty In $13 Million Healthcare Fraud. The Dallas 26 EXT-18-248-D-000168 HEAL TH CARE (ACA), while an increasing number of Democrats are advocating for single-payer health care - a difficult proposition even if they win back control of Congress in November." & INSURANCE REFORM Experts Discuss Whether States Should Allow Insurers To Offer Health Plans With Fewer Mandated Benefits. Florida Attorney General Confronted By Protesters At Movie Showing. The Tampa Bay (FL} Times (6/23, Contorno, 832K) reported protesters confronted Florida Attorney General Pam Bondi outside a movie screening at Tampa Theatre. The protesters questioned Bondi's "recent actions on health care policy and her stance on immigration." The Hill (6/23, Bowden, 2.71 M) reported the movie being screened was a new documentary about Mr. Rogers called "Won't You Be My Neighbor?" One protester yelled, "What would Mr. Rogers think about you and your legacy in Florida? Taking away health insurance from people with pre-existing conditions, Pam Bondi! Shame on you!" The AP (6/23), Fox News (6/23, Dedaj, 16.38M), and the New York Post (6/24, Lapin, 4.46M) also covered the story. In its "Journal Reports" column, the Wall Street Journal (6/24, Subscription Publication, 6.13M) provides a grouping of articles on the topic of whether states should allow insurers to offer "bare-bones" health plans that have fewer mandated benefits. Two-Thirds Of Americans Disapprove Of DOJ's Decision To Support Lawsuit That Would Challenge Affordable Care Act's Protections For People With Preexisting Conditions, Poll Says. Forbes (6/24, 10.34M) contributor Bruce Japsen writes that 66% of Americans disapprove of the Department of Justice's "decision to support a lawsuit that would eliminate popular protections for patients with preexisting conditions under the Affordable Care Act ," according to a poll conducted by Hart Research Associates for the group Protect Our Care . The poll also found that 47% of voters "strongly disapprove," while "11% strongly approve." Texas Medical Association "Vehemently" Objects To AMA Opposing State's Lawsuit Challenging The Affordable Care Act. The Houston Chronicle (6/22, Deam, 2.14M) reported the Texas Medical Association "vehemently" objected to the American Medical Association and other medical groups, including the American Academy of Pediatrics, "filing a legal opposition to the Texas-led lawsuit seeking to declare the Affordable Care Act unconstitutional and ultimately unraveling the protections for patients with pre-existing conditions." On June 12, the Texas delegation at the AMA's national convention in Chicago called for the AMA to not file an amicus brief in the lawsuit. Dr. David Henkes, the chair of the state delegation at the AMA House of Delegates, said, "The ACA is an extremely unpopular political symbol in our state. We fervently urge the AMA not to file a brief in this case at this time." Increases In Exchange Plan Premiums May Hurt Republicans In This Year's Midterm Elections. Politico (6/24, Demko, 3.51 M) reports premiums for exchange plans are expected to increase "by double digits in 2019, causing heartburn for politicians as voters will head to the polls within days of learning about the looming hit to their pocketbooks." However, the article points out that "unlike recent campaign cycles, when Republicans capitalized on Obamacare sticker shock to help propel them to complete control of Congress and the White House, they're now likely to be the ones feeling the wrath of voters ." Healthcare Likely To Be Key Issue In Minnesota's Congressional Races. The Three Insurers That Offered Exchange Plans In South Florida In 2018 Have Refiled To Offer Plans In 2019. The Minneapolis Star Tribune (6/22, Rao, 1.16M) reported healthcare is likely to be the dominant issue in Congressional races in Minnesota. The article explains that Republicans "have twice failed to repeal and replace the Affordable Care Act South Florida Sun Sentinel (6/22, Hurtibise, 601 K) reported the three insurers that offered exchange plans in South Florida in 2018 have refiled to offer 27 EXT-18-248-D-000169 Labor's new rule expanding access to association health plans (AHPs) will help many small businesses and their employees gain health coverage. Ortiz and Price argue that the new rule will "provide expanded health-care coverage options for small business owners and their employees by making it easier for them to group together in associations, where they can enjoy similar regulations and economies of scale as their big business competitors." The Bangor (ME) Daily News (6/23, 168K) editorialized that "even though it can't get a plan past Congress to repeal the Affordable Care Act, the Trump administration is intent on resorting to other means to unravel health coverage for lowincome Americans ." The editorial argues that the Trump Administration "has tried its utmost to sabotage federally subsidized, Affordable Care Act-sanctioned health insurance plans in the individual market," and "it's also set its sights on undermining Medicaid - the decades-old health insurance program for low-income and disabled Americans." Georgia Attorney General Chris Carr wrote in an opinion piece for the Atlanta JournalConstitution (6/22, 1.09M) that "as Attorney General, I am committed to upholding the rule of law with each decision I make in order to protect the basic principles upon which our nation is founded." Carr argues that the US Supreme Court has twice upheld the Affordable Care Act as constitutional, but he believes "the court must take another look at this law now that Congress has eliminated" the individual mandate penalty. Sen. Lamar Alexander wrote in an opinion piece for the Tennessean (6/22, 513K) that the Trump Administration's new rule "offered thousands of Tennesseans who are selfemployed or who work at small businesses the opportunity to buy the same kind of lower cost health insurance with the same patient protections that roughly 160 million Americans get working for a larger employer." Alexander argues that through association health plans, people will be able "to obtain the same kind of less expensive health insurance that employees of large companies, like Walmart or Amazon , can buy today ." Elsa Pearson, MPH, a policy analyst at the Boston University School of Public Health, Austin Frakt, PhD, an associate professor at the Boston University School of Public Health, and Sandro Galea, MD, DrPH, the dean of the Boston University School of Public Health, wrote in an plans in 2019. Florida Blue, Molina Healthcare, and Ambetter "submitted 2019 rate proposals with the Florida Office of Insurance Regulation as required by June 20, along with four other companies that filed to sell plans in other areas of the state." Indiana Exchange Plan Premiums To The Increase 5.2% On Average. Indianapolis Star (6/22, Groppe, 4 77K) reported premiums for exchange plans in Indiana are expected to increase an average of 5.2% in 2019, which may not "be as high as in some other states." The AP (6/24) reports CareSource Indiana Inc. is seeking an average increase of 10.2%, while Celtic Insurance Co. is seeking an average decrease of .5%. Ohio Exchange Plan Premiums To Increase 8.2% On Average. The Cleveland Plain Dealer (6/22, Hancock, 1.03M) reported premiums for Ohio exchange plans will increase an average of 8.2%, "according to preliminary data released Friday from the Ohio Department of Insurance." The article points out that the average increase last year was 20%. Administrative Costs For Blue Cross And Blue Shield Plans Grew In 2017 To Highest Levels Since 2013, Report Says. Modern Healthcare (6/22, Bannow, Subscription Publication, 239K) reported "Blue Cross and Blue Shield plans spent more on activities like underwriting, risk adjustment and provider audits in 2017 than in prior years, pushing the plans' total administrative costs to their highest level since 2013, the height of the expensive buildup to the Affordable Care Act," according to "a new report from the financial advisory firm Sherlock Company." The report was based on an analysis of "14 Blues plans with a combined 37 .1 million members--roughly 35% of all Blues members." Commentary Considers Health Reform. Several outlets offer opinions on health reform. Alfredo Ortiz, the president of the Job Creators Network, and Dr. Thomas Price, the former Secretary of Health and Human Services who is a senior healthcare policy fellow at the Job Creators Network, wrote in an opinion piece for The Hill (6/22, 2.71 M) that the Department of 28 EXT-18-248-D-000170 protect transgender residents, Gov. Andrew Cuomo vowed Sunday, telling the state's Health Department to issue regulations to prevent health insurance companies from discriminating against transgender New Yorkers." The move, "he said, was intended to combat the Trump administration's repeal of a federal regulation that clarifies that the Affordable Care Act's nondiscrimination protections include those based on gender identity." opinion piece for the Huffington Post (6/23, 4.32M) that "there is a 20-year life-expectancy gap between the country's healthiest and least healthy counties, and a similar life-expectancy gap within counties." Pearson, Frakt, and Galea argue that "socioeconomic factors - such as income and race or ethnicity - influence health, perhaps even more so than access to health care," and that as a result "traditional health care alone is inadequate to address all the drivers of poor health." The Houston Chronicle (6/24, 2.14M) editorializes that "Trump's Justice Department is supporting efforts by 20 states, including Texas, to strangle the Affordable Care Act." The editorial argues that "killing Obamacare would keep a promise Trump made to a constituency he believes will win him a second term. The millions who will lose health coverage if Obamacare dies would be collateral damage to him." Heritage Foundation Senior Legal Research Fellow Paul Larkin Jr. writes for the Bend (OR) Bulletin (6/25, 92K) that "the constitutionality of Obamacare is an issue once again." He says that while the Supreme Court categorized the law as a tax, "now the fun begins. Effective January 2019, the 2017 Tax Cuts and Jobs Act reduces the payment for not purchasing health insurance to $0." That matters because "once the Obamacare penalty disappears, so does the basis on which the Supreme Court upheld it." In Chief Justice Roberts' words , the "'essential feature of a tax' is it raises money. Soon, Obamacare won't. Live by $1 in revenue, die by $0 in revenue." Massachusetts State Legislature Trying To Reconcile Differences Among Healthcare Bills. The AP (6/23) reported "Massachusetts House and Senate negotiators will be trying to reconcile differences in major health care bills that have cleared both chambers." Both chambers passed bills that aim "to stabilize health care costs by narrowing price disparities between large teaching hospitals and smaller community hospitals around Massachusetts." Michigan 2019 Budget Keeps Title X Funding For Planned Parenthood. The Detroit Free Press (6/22, Shamus, 1.21 M) reported that Michigan's 2019 state budget, which was signed into law Thursday by Gov. Rick Snyder (R), will not shift federal money for pregnancy prevention and family planning services away from Planned Parenthood. According to the article, the budget approved by the Legislature included language that would have moved federal Title X money for family planning services to health clinics and county health departments that do not provide abortions. Humana Buying Two Hospice Chains. The New York Times (6/22, Abelson , Subscription Publication, 19.33M) reported Humana is working with the two private-equity firms, TPG Capital and Welsh, Carson, Anderson & Stowe, "to buy two hospice chains that together would create the industry's biggest operator with hundreds of locations in dozens of states." Last year , the group acquired "a division of Kindred Healthcare that offers both home health and hospice care," and then "in April, the same group said it planned to buy another large hospice outfit, Curo Health Services, owned by another investment firm, Thomas H. Lee Partners." Rhode Island House Approves Bill To Expand Mastectomy Coverage. The AP (6/24) reports that the Rhode Island House approved legislation that ensures insurance covers all costs for a mastectomy. State law mandated insurance coverage for mastectomies in 2005, but insurers have since instituted high copays and deductibles. The new measure will require insurers to cover "all costs, without copays and deductibles." HUMAN SERVICES NEWS Cuomo Says Health Insurance Companies Cannot Discriminate Against Transgender New Yorkers. AM Proposed Rules For Assisted Living Facilities In DC "Spark Outcry" From New York (6/24, 591 K) reports, "New York will 29 EXT-18-248-D-000171 Groups Including AARP. The Washington Post (6/22, Thebault, 15.68M) reports that "scores of seniors and advocates crowded into a hearing room Friday" to oppose proposed legislation that would prohibit assisted living residences from admitting anyone who "is or has ever been diagnosed with moderate to severe dementia, or requires hospice care." The Alzheimer's Association and AARP also "want to remove another provision that would require residents who may be at risk of wandering to carry identification that includes their name and the name, address and phone number of their facility," arguing that doing so would be a violation of privacy. Family Separation Is A Problem For US Citizens, Too. The New York Times (6/22, Dewan, Subscription Publication, 19.33M) reported on the various ways the US government separates families amid the controversy taking place at the US-Mexico border. The Times said the US government also separates children from family in the event of incarceration, and when removing children from troubled homes and placing children into foster care. The Philadelphia Inquirer (6/22, 1.07M) wrote in an editorial that the "sad truth is that the United States has multiple policies - particularly related to the criminal justice system and child protective services - that separate children from their parents on a daily basis." Wisconsin Foster Care Task Force Issues Report With Recommended Changes, Improvements. The AP (6/23) US Policies Do Not Support American Families. The New York Times (6/24, Badger, said Wisconsin's Task Force On Foster Care issued its final report Thursday which indicated that the state "should provide children more education and career training." The report also recommends a focus on drug abuse. Miller, Subscription Publication, 19.33M) reports on the "deep contradiction about the family in American politics: Families make powerful symbols, valuable to politicians and revered by voters. But American policies are inconsistent and weak, relative to many countries, in supporting them." The Times highlights the Trump Administration's separation of immigrant children from their parents at the Mexican border, and adds that "the contradiction is also clear in many other realms, say critics on both the right and left: criminal justice, child welfare, family leave, child care, health care and education ." Mother Offers Tips For Getting Good Healthcare For Children With Disabilities. Jamie Davis Smith, a Washington-based mother of four, wrote in the Washington Post (6/22, 15.68M) that as the parent of a child with disabilities, she is "all too familiar with the ins and outs of dealing with doctors, navigating the medical system and advocating for my daughter to get the best care possible." Smith discussed "some things that may help you get the best care for your children" with disabilities. Adoption Rates Experience "Sharp In Minnesota Decline." The Minneapolis Star Tribune (6/22, Prather, 1.16M) reported on the "sharp decline" of adoption numbers in Minnesota and said it "is the result of fewer unplanned pregnancies, less stigma associated with single motherhood, and changes to laws governing international adoption." According to the article, "in 2014, the most recent year for which data are available, there were an estimated 1,563 adoptions in Minnesota. Less than a decade earlier, there were 2,900 per year." Report Shows Parent Drug Abuse A Factor In Many Child Welfare Cases In Indiana. The A P (6/23) discussed a review of Indiana's "troubled" child welfare agency found that parental drug abuse has led to a surge in children removed from their homes. The AP wrote, "Exacerbated by the opioid epidemic , parental drug abuse was a factor in the removal of 7,015 children from their homes in 2017. That accounts for 55 percent of all removals that year up from just 28 percent in 2013." But while the Department of Child Services spent more than $24.9 million on drug testing, only $4.5 million was spent on treatment , the report found. Indiana Child Support Seeks Comments On State Guidelines. The AP (6/24) reports that Indiana's Domestic Relations Committee of the Judicial Conference of Indiana is seeking comments on Indiana's Child Support Guidelines. According to the AP, the guidelines are used to make decisions about child 30 EXT-18-248-D-000172 by The Aspen Institute and The Atlantic. Klain discussed the looming threat of a pandemic and the impact of the Trump presidency on response efforts, saying, "There is a real reason for us to be scared of the idea of facing this threat with Donald Trump in the White House" because his "antiscience" stance and isolationist approach to pandemics would "be a serious threat to our security." Klain also spoke of gaps in preparedness related to leadership, funding, facilities and training, scientific understandings, policy, and global intervention. support in dissolutions of marriage, legal separations, paternity cases, and all other actions for child support. EMERGENCY RESPONSE AND PANDEMIC PREPAREDNESS Op-Ed Considers Analysis Of US' Pandemic Preparedness. Erin Blakemore wrote in the Washington Post (6/22, 15.68M) about contributor Ed Yong's feature for the Atlantic suggesting the US may not be prepared for a pandemic. Yong examining the "worst-case scenario: a public-health system caught off guard by a pandemic that spirals out of control," observing that too often in such cases, "a largescale epidemic takes over public attention, then fades into obscurity when the danger subsides, taking public funding and the wherewithal to build better safeguards with them," according to the piece. Blakemore said that Yong "builds a convincing case for a national lack of preparedness that.. .could spell disaster when a new pandemic comes knocking," and "worries about President Trump's ability to take on an outbreak, especially given that he has left key positions unfilled." MEDICARE Medicare To Provide More Benefits For Chronically Ill. In what the New York Times (6/24, Pear, Subscription Publication, 19.33M) calls "a rare instance of bipartisan cooperation on a major policy initiative," the Trump Administration and Congress are "revamping Medicare to provide extra benefits to people with multiple chronic illnesses, a significant departure from the program's traditional focus that aims to create a new model of care for millions of older Americans." The changes, says the Times, "tackle a vexing and costly problem in American health care: how to deal with long-term illnesses that can build on one another, and the social factors outside the reach of traditional medicine that can contribute to them , like nutrition, transportation and housing." The additional benefits "can include social and medical services, home improvements like wheelchair ramps, transportation to doctor's offices and home delivery of hot meals." US Unprepared To Manage Epidemic Of Diseases Borne By Ticks, Insects, Experts Say. On its website, CNN (6/24, Cohen, Bonifield, 82.6M) reports on the growing threat ticks and insects pose because of their capacity to quickly spread Lyme diseases and other ailments. According to CNN, "For years, experts have voiced concern that many local public health agencies are unprepared to control such pests and limit the spread of the diseases." The piece notes that a report by "the National Association of County and City Health Officials says 84% of programs to control diseases from mosquitoes need improvement," adding, "In 18 states, every program is falling short." One expert is quoted as saying, "We're, simply put, not ready, and we should be." State Officials Say "More Than 300,000" Minnesota Residents To Change Medicare Health Plan Next Year. The Minneapolis Star Tribune (6/22, Snowbeck, 1.16M) reported that Minnesota state officials said "more than 300,000 Minnesotans will be changing Medicare health plans next year ...when a federal law eliminates certain health insurance options in the Twin Cities and across much of the state ." Obama "Ebola Czar" Worries That Trump Administration May Not Address A Pandemic Effectively. The Lab Charges Spike At Rural Hospitals. Modern Healthcare (6/23, Bannow, Subscription Publication, 239K) reported on "a trend that's cropped up in recent years: exploding lab charges by some rural hospitals." Modern Healthcare said Atlantic (6/23, Calamur, 3.08M) reported on remarks by Ron Klain, "President Obama's Ebola czar," during the Aspen Ideas Festival cohosted 31 EXT-18-248-D-000173 insurers have accused rural hospitals of breaching contracts by billing for tests performed elsewhere and on out-of-state patients. The issue is now the subject of lawsuits and a congressional inquiry. According to the article, "an analysis of Medicare cost report data identified 21 hospitals whose outpatient lab charges exceeded 30% of the hospital's total charges in their most recent reports, either 2016 or 2017." The article added that "for comparison, the average outpatient labto-total charges ratio among all of the nearly 5,000 hospitals that filed cost reports was less than 9% in 2016 and about 12% so far for 2017." Manage State's Medicaid Program. The AP (6/22) reported the Kansas Department of Health and Environment awarded contracts to three insurers to manage the state's Medicaid program. The state renewed contracts with Sunflower State Health Plan Inc. and United Healthcare Midwest Inc., while the third contract went to Aetna Better Health of Kansas Inc. The Lawrence (KS) Journal World (6/22, Hancock, 38K) reported the state did not renew its contract with Amerigroup. The article explains that under KanCare, the insurers "are paid a flat, perperson rate for managing the care of Medicaid recipients, including coordinating their care between primary health care providers and specialists, and reimbursing the providers for their services." The Wichita (KS) Eagle (6/22, Marso, Shorman, 316K) also covered the story. MEDICAID & CHIP Experts Debate Medicaid Work Requirements. The Wall Street Journal (6/24, Subscription Publication, 6.13M) reports that new guidelines issued by the Centers for Medicare and Medicaid Services allow states to impose work requirements on Medicaid beneficiaries, constituting one of the biggest changes in the program's 50-year history. The Journal features a debate between Robert Kaestner, a professor at the University of Illinois Institute of Government and Public Affairs, and Sara Rosenbaum, the Harold and Jane Hirsh Professor in Health Law and Policy at the Milken Institute School of Public Health, who discuss the merits and challenges of imposing Medicaid work requirements. Montana Advocates Move Closer To Vote Extending Medicaid Expansion. Congressional Quarterly (6/22, Williams, Subscription Publication) reported that last week, Medicaid expansion advocates in Montana submitted to the state what they say are enough signatures to get the issue placed on the ballot this fall. If approved by voters, the initiative would extend the state's Medicaid expansion, which is set to end next year. Baylor St. Luke's Medical Center Could Lose Medicaid Funding. The AP Michigan Governor Signs Medicaid Work Requirement Bill. The Hill (6/22, Sullivan, 2.71 M) reported that term-limited Gov. Rick Snyder (R) on Friday signed a controversial Medicaid work requirement bill. The law requires Medicaid recipients to "work for 80 hours per month, or be in school, job training or substance abuse treatment ," but includes exemptions "for people who are disabled, pregnant, children or elderly." The bill previously included a provision exempting "people in counties with high unemployment rates from the work requirements," but that was removed after critics suggested it would disproportionately benefit white rural recipients. Also reporting were Mli ve (Ml) (6/22, Lawler, 983K) and the Washington Examiner (6/22, Leonard, 340K). (6/23) reported that Baylor St. Luke's Medical Center in Texas could lose its Medicaid funding and was notified Friday that Medicare plans to halt funding to its heart transplant program on August 17. Federal officials, "raising concerns about two deaths in May, said the hospital has not done enough to fix shortcomings that endanger patients," according to the article. The AP said the funding withdrawal by the Centers for Medicare and Medicaid Services "would threaten the hospital's viability, experts contend, depriving it of an essential source of funding," and added that the termination "could trigger private insurance companies to follow suit." Also reporting were the Houston Chronicle (6/22, Hixenbaugh, Ornstein, 2.14M) and ProPublica (6/22, Hixenbaugh, Ornstein, 49K). Kansas Health Department Awards Contracts To Three Insurers To Kenosha Boy To Visit Capitol Hill To Support Children's Health. The 32 EXT-18-248-D-000174 Milwaukee Journal Sentinel (6/22, Glauber, 596K) reported that 12-year-old Gabe Johnson of Kenosha, Wisconsin will visit Capitol Hill Monday to discuss the importance of Medicaid and other children's health programs. The push is part of Children's Hospital of Wisconsin's Family Advocacy Day. Advances In Cancer Treatment Do Not Mean An End To Chemotherapy, According To Cancer Experts. NBC News (6/24, 5.76M) reports that although "cancer therapy is being transformed as immune therapies, targeted treatments based on DNA profiles and personalized treatments make stunning advances in some patients," that does not signal "an end to old-fashioned chemotherapy ," according to cancer experts. NBC News adds that "chemotherapy is still a mainstay of most cancer treatment." Dr. Sumanta Pal, a board member of the American Society of Clinical Oncology, said, "I would say that in my practice, it's still the majority that at some point in time will get chemotherapy." Child Advocates Oppose South Carolina Medicaid Agency Push To Add Work Requirements. The Charleston (SC) Post and Courier (6/24, Sausser, 292K) reports that child advocates in South Carolina are opposing a move by the South Carolina Medicaid agency to impose work requirements on lowincome adults. Child advocates worry the plan will hurt parents and families, according to the article. Medicaid Director Joshua Baker "confirmed his department is negotiating with the federal Centers for Medicare & Medicaid Services to draft a plan that would require adults on Medicaid to work at least 80 hours per month," the Courier writes. Researchers Discover Compound That Could Stop Cancer Cells From Spreading. Newsweek (6/22, Georgiou, 2.18M) reported that researchers "have discovered" a "compound that could freeze cancer cells in their tracks and stop them from spreading, potentially making them easier to kill." Thus far, however, "the compound," called KBU2046, "has only been tested in models of human cells and so an approved drug based on it is still a long way off." The research was published in Nature Communications. HEALTH & MEDICALNEWS One-Third Of Older Patients Die In Hospital After They Are Put On Ventilators, Study Indicates. The New York Times (6/22, Span, Subscription Publication, 19.33M) reported that research indicates "onethird of patients over age 65 die in the hospital after they are put on ventilators." The findings were published in the Journal of the American Geriatrics Society. According to the Times, physicians "are beginning to wonder if the procedure should be used so often." "Older, Grayer" Workforce Offers Benefits To Employers. The New York Post (6/24, Prafder, 4.46M) reports America is "older, grayer, and ready to compete for your job ," as "by 2022, the number of American workers age 50 or older is due to increase by 62 percent, by which time it will make up 35 percent of our workforce, says Susan Weinstock , vice president of financial resilience for [AARP]." Weinstock stated that "people are working well into their golden years," due both to the "labor shortage" and also to employers' discovery of this "untapped resource" that is "highly engaged , much less likely to leave, and value the work." Weinstock also noted the benefits of generationally integrated workforces. The Post highlights a number of "agefriendly recruitment efforts and perks" from various companies, including Goldman Sachs' "returnship" program and Tufts Health Plan's active prioritization of experienced workers. Tech Companies Should Tap Older Adults To Improve Devices. Similarly, CNBC (6/24, 4.81 M) says that with the demonstrated ability of Robot-Assisted Radical Cystectomy For Invasive Bladder Cancer Linked To Short-Term Oncologic Outcomes Comparable To That Seen With Open RC, Research Indicates. The Washington Post (6/22, Wan, 15.68M) reported that "roboticassisted procedures have now become ubiquitous in some kinds of surgeries." According to the Post, "What once was seen as a technological marvel is commonplace in many hospitals." New research published in the Lancet indicated "there were no major differences in outcomes or complication rates in operations for bladder cancer." 33 EXT-18-248-D-000175 who are lonely," as limitations due to chronic illness and mobility issues may struggle with "persistent loneliness." Brody highlights a program in Georgia that provides opportunities for caregivers to connect over painting, music, and dance "in partnership with AARP" and encourages readers to "consider making a date this week to meet a friend for coffee, dinner, a visit to a museum, or simply a walk," or "if nothing else, pick up the phone and have a conversation with someone." new technologies from Amazon, Alphabet, and Apple to benefit older adults , the tech sphere can "speed up" its impact by "[hiring] people who understand the needs of this population. In other words, they should hire older Americans ." CNBC interviews several experts on how common devices such as the Amazon Echo could be improved to better serve older adults. A "prevailing myth is that older people are less comfortable with technology than their younger counterparts," per CNBC, but "in fact, the vast majority of people over 65 have a cellphone," and AARP and others are responding to the "increased demand" by "offering classes to help older Americans get up to speed with the latest technology, including gadgets and apps to help them live independently for longer." Report Finds Working Longer Can Help Retirement Savers Make Up Savings Shortfalls. Jessica Dickier writes in a piece for CNBC (6/24, 4.81 M) that "in a trade-off between working longer or saving more, a recent report found that delaying retirement for just three to six months has the same impact as savings 1 percent more of your salary over 30 years." The working paper from the National Bureau of Economic Research found that "boosting your retirement contributions by 1 percent for 10 years before retiring has the same effect as working a single month longer." Furthermore, "delaying Social Security past full retirement age lets your benefits grow by about 8 percent a year." T . Rowe Price Senior Financial Planner Stuart Ritter warned, however, that people should not "count on working longer to solve a shortfall caused by your not saving enough . Working longer feels more like a contingency than a strategy. The reality is most people want to retire as soon as they can." Men's Shed Offers Older Men Community, Activity. The Washington Post (6/22, Fallik, 15.68M) profiled the international program Men's Sheds, which is "sort of like a Boy scouts for adults," offering men, "usually of retirement age," a place to "learn new skills and work together on community projects" with a common set of tools and a community of others with similar interests. The organization's motto is "shoulder to shoulder," which describes how many men feel most comfortable relating to others. The idea came together after a public health conference that focused on men's health issues, among which is social isolation, and AARP Chief Medical Officer Charlotte S. Yeh stated that men "often identify with their job , and when they retire they think they are going to keep the same friends they've had in the workplace , but then they find they no longer share the same interests," and not all can successfully integrate into spousal networks. San Francisco Is "Worst" US City For Retires. CNBC (6/24, Mercado, 4.81 M) reports that a GoBankingRates analysis says San Francisco is the "worst" city for retirees in the US. It says that San Francisco residents face high living costs. Column: Loneliness Affects All Ages But Is Preventable. Health columnist Jane Substance Abuse A Rising Problem Among Older Adults. The Wall Street Brody writes for the New York Times (6/25, Subscription Publication, 19.33M) that while modern life seems to "promote connectivity," it "has had the opposite effect of fostering social isolation and loneliness, experts say." Brody describes her own experiences with loneliness and social isolation as a young adult, saying that the "18 to 24" age range "has the highest incidence of loneliness, as much as 50 percent higher than occurs among the elderly." However, Brody acknowledges "it's not just young people Journal (6/23, Ansberry, Subscription Publication, 6.13M) reports on the problem of dealing with an aging parent's alcohol problem. It says substance abuse is increasing among older adults, and their children are often at a loss about what to do. The Substance Abuse and Mental Health Services Administration says the number of Americans 65 and older abusing drugs and alcohol is expected to double to 5.7 million by 2020. 34 EXT-18-248-D-000176 AARP CEO Column: Millennials Helping With Caregiving. In a column in Researchers Growing Plants In Space As Potential Source Of New Drugs. the San Diego Union-Tribune (6/22, 664K), MRP CEO Jo Ann Jenkins wrote that MRP just released a new study, "Millennials: The Emerging Generation of Family Caregivers," that reveals that millennials spend an average of 21 hours per week on caregiving duties. She explained that, compared with older caregivers, "millennials tend to keep it to themselves," with only 19 percent of them telling coworkers. Jenkins added that "perhaps most pressing" issue is caregiving costs, with the average respondent spending $6,800 per year out of pocket on caregiving expenses. STAT (6/22, Boodman, 27K) reported researchers are growing plants in space at the International Space Station to examine whether the specimens produce molecules that could be used in pharmaceuticals. The article highlights the company Space Tango, which is based in Lexington, Kentucky, and "helps researchers and companies set up experiments on the space station." FDA May Approve First CannabisDerived Drug For Two Forms Of Epilepsy. The Washington Post (6/23, Adolescents With Eczema May Not Use Topical Corticosteroids As Directed, Study Suggests. Reuters (6/22, McGinley, 15.68M) "To Your Health" blog reported the Food and Drug Administration may approve GW Pharmaceuticals' Epidiolex (cannabidiol) "for two of the most severe types of childhood epilepsy" Dravet and Lennox-Gastaut syndromes. If the agency does approve the drug it would be the first cannabis-derived drug approved in the US. Rapaport) reported researchers found that "adolescents with eczema who are prescribed topical corticosteroids to ease symptoms like itching and inflammation may not use their medicines as directed." The find ings were published in JAMA Dermatology. The Scripps Research Institute Is Now Conducting Clinical Trials. The San Patients Receiving Treatment For Neovascular Age-Related Macular Degeneration May Be At Increased Risk Of Vision Loss In Connection With Cataract Surgery, Study Suggests. MD Magazine (6/22, Warren) Diego Union-Tribune (6/24, Fikes, 664K) reports The Scripps Research Institute (TSRI) is now conducting clinical trials, which the article points out is "typically done by for-profit companies." The article reports that TSRI has long been known for conducting basic research, but an affiliate of the institute "recently started clinical testing of a drug to reverse osteoarthritis by regenerating cartilage." If the drug succeeds, then it may be financially beneficial for TSRI, which "has been running annual deficits as high as $20 million in recent years." reported researchers found "that patients receiving treatment for neovascular age-related macular degeneration (nAMD) have a moderately increased risk of vision loss in connection with cataract surgery which may be related to choroidal neovascular (CNV) lesion activity." The findings were published in the American Journal of Ophthalmology. Oklahoma Conservatives' Views On Medical Marijuana Are Changing. The US District Court Rules In Favor Of Eli Lilly's Drug Patent. Reuters (6/22, Sharma) AP (6/23, Murphy) reported on the "growing group of traditionally conservative Republican voters in Oklahoma" who have shifted their position on medical marijuana. The AP said residents are set to vote on a measure Tuesday that could add Oklahoma to the increasing list of states that have "legalized some form of pot." The article added, "Among the reddest states in the country, Oklahoma has for decades embraced a tough-oncrime philosophy that includes harsh penalties for drug crimes that has contributed to the state now leading the nation in the percentage of its reported a US District Court ruled in favor of Eli Lilly's patent on the Alimta (pemetrexed) vitamin regimen blocking Hospira Inc. and Dr Reddy's Laboratories from launching generics until the patent expires in May 2022. The article points out that the company "has faced several legal challenges to its right to avoid generic competition for'' the drug. 35 EXT-18-248-D-000177 see which combinations of factors might have predicted a fatal condition." However, "a big gap still exists between promising research and clinical success." Because physicians are using these programs to make life-and-death decisions, they "want what they call explainable Al, meaning systems that go beyond a simple warning to offer an explanation of why a patient has been flagged," according to the article. population behind bars. But voters' attitudes are changing." In 2016, "Oklahomans voted to make all drug possession crimes misdemeanors over the objection of law enforcement and prosecutors." California Says 374 Terminally Ill Residents Committed Medically Assisted Suicide In 2017. The AP (6/22, Thompson) reported that 374 terminally ill Californians committed medically assisted suicide in 2017, out of 577 people that received lifeending drugs, the California Department of Public Health revealed Friday. In the first full year the option was legal, 90 percent of those who died were over 60, "about 95 percent were insured and about 83 percent were receiving hospice or similar care." Minnesota Patients Sedated By Ketamine Were Enrolled In Hennepin Healthcare Study Without Consent. The Minneapolis Star Tribune (6/23, Mannix, 1.16M) reported that Hennepin Healthcare has been conducting studies "for years" on ketamine, which the hospital's leadership says can be vital when paramedics respond to calls of severely agitated or aggressive people. The current study, which began last August requires no consent from patients whose data can be used for research, but gives the subject the option to opt out afterward, according to the article. The role of police allegedly encouraging or directing the use of ketamine by paramedics has generated outrage among community members and elected officials following a Star Tribune investigation. The Minneapolis Star Tribune (6/23, 1.16M) wrote in an editorial these instances are "a patient education responsibility on which the county-run health care system is falling short." The Star Tribune added, "The responsibility to educate the public and review potential policy changes isn't limited to just the Minneapolis police and City Council. The state's largest county and its leaders must step up and do better." The paper noted that "a physician representing the American College of Emergency Physicians - Dr. Howard Mell of the Chicago area - suggests that ketamine is commonly used by emergency medical personnel in other parts of the country and that 62 uses may be low for a metro area this size." Trump Administration Resumes Approving Young Physician Visas. Forbes (6/22, 10.34M) contributor Bruce Japsen wrote that the Trump Administration has resumed issuing visas to allow international medical graduates into US residency programs "after a delay - and some denials - of allowing these doctors-in-training into the country." The Association of American Medical Colleges said that "clarifying guidance has been issued internally to U.S. Citizenship and Immigration Services staff conducting reviews" of medical residents applying for H-1B visas. Japsen said that "the timing of the guidance from USCIS is key. Most residency programs begin by July 1 so delaying non-U.S. international medical graduates is critical." Another US Embassy Worker Confirmed Hurt By Mystery Cuba Incidents. The A P (6/22, Lederman, Lee) reported medical tests have confirmed that another US embassy worker has been affected by mysterious health incidents in Cuba, the State Department said, bringing the total number to 25. The new "medically confirmed" worker is one of two who were recently evacuated from Cuba after reporting symptoms. Wal mart Secures Patent For Blockchain-Based Health Records. Fortune (6/22, Mukherjee, 3.91 M) reported that Walmart won a patent last week for a system that would house medical records on blockchain. The purpose behind the system is to allow first responders to access medical data from a patient in the case of an emergency when they cannot communicate. Researchers Using Al To Predict Fatal Conditions. Bloomberg News (6/22, Bass, 4.46M) reported that researchers are using artificial intelligence to examine data points "from hours or even days before the onset of a crisis to 36 EXT-18-248-D-000178 services. The move follows growing demand from patients in high-deductible health plans who want to shop around and know their financial exposure in advance. Modern Healthcare added that providers "face mounting pressure from regulators and consumers to be transparent about costs, especially given increasing public anger about unexpected large bills." The article said "CMS recently proposed a rule requiring hospitals to publish online a list of their standard charges in a machine-readable format and update the information at least once a year ." Opinion: Give Women Access To Birth Control To Help Stop Unwanted Pregnancies. Trudi lnslee, Washington state's first lady and chair of Upstream Washington's advisory council , writes in the Seattle Times (6/24, 1.15M) that Washington is "proudly strengthening our efforts to expand women's health care by launching a public-private partnership to make the full range of birth-control methods more widely available to women ." lnslee writes, "To reach this goal, the Washington State Department of Health and the state Health Care Authority will join forces with the nonprofit Upstream USA in support of their mission to expand opportunity across the country by reducing the rate of unplanned pregnancies." Sleep Apnea Treatment May Be Associated With Improved Sex Life, Study Suggests. Reuters (6/22, Rapaport) reported that research suggests "adults with sleep apnea ...may have a better sex life when they wear breathing masks to bed." In the study, participants with the condition "were all prescribed nighttime treatment with masks connected to a machine that provides continuous positive airway pressure (CPAP)." Researchers found that a "year later, the ...patients who stuck with CPAP treatment had greater improvements in sexual quality of life than the 110 people who didn't keep up with treatment." The findings were published in JAMA Otolaryngology-Head and Neck Surgery. Opinion: Lawmakers Should Begin Investigating CTE In Hockey. Ken Dryden, a former goaltender for the Montreal Canadiens and member of Canada's Parliament between 2004 and 2011, writes in the Washington Post (6/24, 15.68M) about recent video depositions related to a concussion lawsuit brought against the National Hockey League by about 150 former players that show several NHL officials denying a correlation between concussions and chronic traumatic encephalopathy. Dryden says "just as Congress held its first hearing about brain injuries and professional football in 2009, lawmakers in the United States and Canada must surely be readying themselves to start asking questions about the slippery sport of hockey." Analysis: Americans Entering Retirement In Worse Financial Shape Than Previous Generation. The Wall Street Journal (6/22, Gillers, Tergesen, Scism, Subscription Publication, 6.13M) covered its analysis of older Americans' financial preparedness for retirement, showing that more than 40 percent of households headed by people aged 55 through 70 do not have enough resources to maintain their standard of living in retirement. The study indicated that Americans entering retirement have high average debt and limited retirement funds. Experts Debate Whether Physicians Should Ask Patients About Gun Use. The Wall Street Journal (6/24, Subscription Publication, 6.13M) features an interview with Paul Hsieh, a physician and co-founder of Freedom and Individual Rights in Medicine, and Megan Ranney, an associate professor at Alpert Medical School at Brown University, in which they debate the question of whether physicians should make it part of their routine to talk to patients about gun use. More Nursing Home Surveillance Cameras Prompt Divisions Among Providers, Advocates. Next Avenue (6/22, 25K) Hospitals evaluated the pros and cons of adding a security camera to a loved one's nursing home room in light of the fact that nationwide, "state legislatures are weighing in on" the technology, which "advocates say could help prevent or catch elder abuse and neglect." The article noted that in New Jersey, the state loans "hidden cameras to any Launching Online Price Estimators To Improve Transparency. Modern Healthcare (6/23, Meyer, Subscription Publication, 239K) reported that a growing number of hospitals is working with vendors to offer online price estimates of common 37 EXT-18-248-D-000179 family who suspects their loved one is being mistreated in a long-term care facility." Jon Dolan, president and CEO of the Health Care Association of New Jersey, said, "Now, if this were done on a recording device with the sanctioning of law enforcement in a probable cause situation and we needed to keep it confidential, I would fully advise my facilities to participate in such an investigation. ... But the idea that we're just going to give these cameras out to people and let them do whatever they want with them because the Attorney General says so? I don't think so." counted 79 cases this year, many of which "are linked to a multi-state outbreak in neighboring states." This year's cases "are nearly twice as many than what was reported all of last year." Florida Teen Becomes First Human Case Of Keystone Virus. USA Today (6/22, May, 11.4M) reported a 16-year-old Florida teen has become the "first confirmed case of the Keystone virus in humans ...leading researchers to believe the virus could be widespread" in the northern part of the state. The article said, "University of Florida identified the Keystone virus in the teenager after he visited an urgent care clinic in North Central Florida in August of 2016," and medical experts "suspected he had Zika virus." Upon determining it was Keystone virus, researchers published a report of his case "earlier this month in the peer-reviewed medical journa l Clinical Infectious Diseases." People Fearing Onset Of Alzheimer's Turn To Lifestyle Changes After Drug Candidates Fail. The Boston Globe (6/24, Weisman , 945K) reports that many people who fear developing Alzheimer's disease "are turning to research that suggests lifestyle changes - from fitness regimens and brain games to better diets and social interactions - might help stave off the disease or push back its onset." The trend comes as people await drugs that could ward off the disease, although the Globe says failure after failure "has dashed hopes for a medical miracle." HIV-Positive Community Celebrates CDC's Acknowledgment That Treatment Can Nearly Eliminate Risk The Spokane {WA) Of Transmission. Spokesman-Review (6/24, Alexander, 164K) reports that the "CDC's acknowledgment that people in treatment" for HIV "can get to a place where they can't transmit the virus feels like a new step for the HIV-positive community." According to the article , the agency "finally acknowledged what years of research has shown : HIV-positive people in treatment who have an undetectable amount of the virus in their blood have 'virtually no risk' of transmitting the virus sexually to another person," recognition which many people who are HIVpositive have celebrated . Roche Touts Trial Showing Tecentriq Cocktail Improved Survival In Small Cell Lung Cancer. Reuters (6/25, Miller) reports that on Monday, Roche "said ...a cocktail of its immunotherapy Tecentriq with chemotherapy boosted survival of patients with previously untreated extensive-stage small cell lung cancer compared with chemotherapy alone." In a statement , the company said, "These are the first positive Phase Ill survival results for any immunotherapy-based combination in the initial treatment of extensive-stage small cell lung cancer." New Jersey Health Officials Warn About Measles Exposure. The Newark Cruise Ship With Norovirus Outbreak Stops In Alaska. The A P (6/22) reported the (NJ) Star-Ledger (6/22, Livio, 1.58M) reported that people who visited a Burlington County, New Jersey, gym or medical offices in Burlington and Camden counties this month "may have been exposed to measles, the state Health Department announced Friday." A person who was infected "who had just returned from an international trip visited a gym," physician offices, and Virtua Memorial Hospital. Officials warned that people who were exposed may not have developed symptoms yet. CDC recently said it detected an outbreak of norovirus on a cruise ship docked in Alaska . So far, media reports indicate 73 people have been sickened "on the Holland America cruise ship Zaandam ...which is carrying more than 2,000 passengers and crew." Ohio Declares Statewide Hepatitis A Outbreak. The AP (6/22) reported the Ohio health department "says it's declaring a statewide outbreak of hepatitis A" after officials have 38 EXT-18-248-D-000180 you look at the statistics, you'll see that he's completely right about what's been happening to youth smoking." Maine, New Hampshire Beset By Whooping Cough Outbreaks. Seacoast Online (NH) (6/23, Lacasse, 39K) reported that cases of whooping cough are rising Exeter, New Hampshire, and "York, Maine, have experienced outbreaks of the respiratory disease in their schools." Exeter High School has seen 22 cases, and in York, officials confirmed six cases, "which according to the Maine Center for Disease constitutes a outbreak because there were three or more confirmed cases in 21 days." One In Five Parents Don't Talk To Kids About Safety Issues At Amusement Parks, Poll Finds. Reuters (6/22, Crist) reported, "One in five parents don't talk to their kids about safety issues at amusement parks, especially what to do if they get lost," researchers concluded after analyzing data from "a poll by the C.S. Mott Children's Hospital in Ann Arbor, Michigan." The poll data were "based on responses from more than 1,200 parents with at least one child between ages 5 and 12 in early 2018." Op-Ed: Too Few Older Cancer Patients Included In lmmunotherapy Studies. Ankur R. Parikh, DO, medical director of precision medicine at Cancer Treatment Centers of America, wrote in a piece published in Oncology Times and carried by STAT (6/22, Parikh, 27K) that cancer immunotherapy may not be as effective for patients over the age of 65, "who make up half of cancer patients." Parikh explained that these patients are "poorly represented in clinical trials," and noted that because "immunosenescence may change patients' responses to drug therapies, we can't predict responses to it among older individuals based on studies that included only non-geriatric populations." Parikh called for future studies to include more older cancer patients to improve treatment outcomes . Exposure To Medical Marijuana Advertising May Contribute To Increased Use Through Adolescence, Behavioral Scientist Says. In a perspective piece for the Washington Post (6/22, D'amico, 15.68M) "Health & Science" blog, Elizabeth J. D'amico, PhD, "a clinical psychologist and senior behavioral scientist at the Rand Corporation," wrote, "Since recreational marijuana became legal this year, advertising for the drug has gotten out ahead of regulations that could restrict where and how teens are exposed to such promotional displays." D'amico cited research finding that "teens who reported seeing more medical marijuana advertising were more likely to report having used marijuana in the previous 30 days, and they were more likely to say they expected to use it within the next six months." D'amico observed, "These responses suggest that exposure to medical marijuana advertising may not only play a significant role in shaping teen attitudes about the drug but it may also contribute to increased use and related negative consequences throughout adolescence." Debate Continues On Whether Robotic Prostate Surgery Is Better Than Traditional Surgery. The Wall Street Journal (6/24, Subscription Publication, 6.13M) reports that robotically assisted laparoscopy is starting to replace traditional open surgery for patients with prostate cancer. The Journal examines the debate on whether using the technology improves outcomes enough to outweigh its higher cost. ACOG Releases Immunization Guide NPR (6/25, For Pregnant Women. Opinion: Iowa Attorney General Is "Completely Right" About Youth Smoking, E-Cig Use. Joel Nocera writes in Simmons-Duffin, 3.55M) reports that for the first time, the American College of Obstetricians and Gynecologists "has released a one-page immunization guide for pregnant women that spells all of this out." The goal "is for it to be easily posted in doctors' offices , 'so that it becomes more automatic and part of everyday prenatal care,' says Dr. Laura Riley, one of the guide's Bloomberg View (6/22, 4.46M) that Iowa Attorney General Tom Miller is making the case that youth use of Juul "was much ado about not a whole lot" because around 80 percent of use by teenagers "is experimental." He added that there is little evidence that young peoples' use of e-cigarettes leads to cigarette smoking. Nocera adds, "And if 39 EXT-18-248-D-000181 that 'while such terms in patent settlement agreements may not always be inappropriate, the incentives for parties to delay biosimilar entry are present, and biologic markets could be susceptible to patent settlement abuse."' authors and chair of the ACOG immunization work group." Scientists Developing Process To Form Blood Vessels To Simulate Heart Disease, Test Drugs. STAT Plus GLOBAL HEAL TH (6/22, Cooney, Subscription Publication, 27K) reported on a process developed by Marsha Rolle, associate professor of biomedical engineering at Worcester Polytechnic Institute, to build a "more accurate model of healthy blood vessels as well as damaged ones, hoping to learn more about cardiovascular diseases and whether drugs will effectively treat them." The article explained, "Based on this model, she and collaborators at Yale have created blood vessels derived from the cells of people with a genetic heart condition, supravalvular aortic stenosis, recapitulating the disease in a test tube." Algeria Abandons 13,000 Migrants In The Sahara. The AP (6/25, Hinnant) reports that Algeria "has abandoned more than 13,000 people in the past 14 months, including pregnant women and children, stranding them without food or water and forcing them to walk, sometimes at gunpoint , under temperatures of up to 48 degrees Celsius (118 degrees Fahrenheit)." In Niger, "where the majority head, the lucky ones limp across a desolate 15-kilometer (9-mile) no-man'sland to Assamaka , less a town than a collection of unsteady buildings sinking into drifts of sand." Others, "disoriented and dehydrated, wander for days before a U.N. rescue squad can find them. Untold numbers perish along the way." Venture Capitalist Explains Investments In Artificial Intelligence. STAT Plus (6/22, Robbins, Feuerstein, Garde, Subscription Publication, 27K) interviewed Vijay Pande, a venture capitalist, to discuss how life sciences firms are using and investing in artificial intelligence. Pande explained, "I think traditionally there have been two types of investors," tech investors and biotech investors, "and I think what we've been doing, and others as well, as I think really are a new type of investing, where these are companies that are in health care and biology, but they can be built like tech companies , and so they have to have elements of both." Pande adds, "So they have to have the rigor to...make sure that test is accurate, to understand even just what you have to do to get into market, but also to build a company like a tech company, to build it by engineering." Non-Invasive Malaria Test Wins Africa Prize For Engineering Innovation. The AP (6/24, Muhumuza) reports Brian Gitta, a 25year-old Ugandan computer scientist, recently won "a prestigious engineering prize for a noninvasive malaria test kit that he hopes will be widely used across Africa." Gitta won the Africa Prize for Engineering Innovation, which is bestowed by "the Royal Academy of Engineering in Britain [and] comes with £25,000 ($32,940)," for his "test kit known as Matibabu" which shines "a red beam of light onto a finger to detect changes in the shape, color and concentration of red blood cells, all of which are affected by malaria . The results are sent within a minute to a computer or mobile phone linked to the device." Senators Ask FTC To Examine PayTo-Delay Agreements On Biosimilars. Ebola Vaccines Help Foster Improvements To Outbreak Response Efforts. Scientific American (6/23, Maron, STAT Plus (6/22, Silverman, Subscription Publication, 27K) reported that Sens. Amy Klobuchar (D-MN) and Chuck Grassley (R-IA) are asking the Federal Trade Commission to investigate "whether so-called pay-to-delay deals are preventing biosimilars from reaching Americans sooner than the drugs would otherwise and, consequently, are increasing costs for the health care system." In a letter to the FTC, 'The lawmakers did not allege the companies have violated antitrust laws, but they wrote to the FTC 3.12M) reported on the role of Ebola vaccines due to an outbreak in the Democratic Republic of the Congo in sparking improvements to outbreak response strategies. In the DRC, 1,611 people have been vaccinated with a candidate from Merck, and in tandem with a shot from Doctors Without Borders, "in total more than 3,000 vaccines have been administered in the country." While public health officials "say they are far from 40 EXT-18-248-D-000182 country's economic boom" in rural regions, and "many struggle with poverty and depression." declaring the outbreak over," they continue to keep "careful surveillance" as they tackle "the difficulties of continuing to monitor the vaccinated individuals for the three-week period following their shots." NATIONAL NEWS GOP Lawmakers Say DOJ Less Than Cooperative With House Russia Investigation. The Washington Times (6/24, Op-Ed: Hong Kong Should Pass Official Policy Encouraging Older Workers. Anisha Bhaduri writes for China Daily Mordock, 460K) reports that Rep. Mark Meadows (R-NC) on Saturday "challenged" an AP re_port which said the Justice Department had given lawmakers documents related to the investigation of Russian election meddling. Meadows tweeted, "New reports of DOJ/FBI compliance with document requests are NOT accurate. While they have turned over additional documents, the new documents represent a small percentage of what they owe. The notion that DOJ/ FBI have been forthcoming with Congress is false." Meanwhile, House Judiciary Chairman Bob Goodlatte told Fox News' Sunday Morning Futures (6/24, Bartiromo, 1.45M) that some of the text messages between Peter Strzok and Lisa Page "have been very enlightening" but "they raise as many questions as they answer." Goodlatte added that "there is a lot of question about the cooperation of the FBI because of the concern there are people still there that don't want the information we need to be provided." And "that's why I issued a subpoena that resulted in changes .... We have an office at the Depart~~nt of Justice, a reading room were a million documents reside" and "we can examine all of those documents." Rep. Peter King (R-NY) said on Fox News' Sunday Morning Futures (6/24, Bartiromo, 1.45M) that there is "continual bad faith from the FBI and the Department of Justice." He said, "This was delayed and delayed. We got this response" and "the response is inadequate." Rep. John Ratcliffe (R-TX) said on Fox News' Sunday Morning Futures (6/24, Bartiromo, 1.45M), "What's remarkable is that it wasn't partisan Republicans" but "this is the FBl's own independent referee saying he's deeply troubled and concerned that it is Peter Strzok and other Trump hating agents ...collecting evidence and making every decision for the first nine months of the investigation that by definition is prejudicial to the fair ...administration of just ice." (6/25, 5K) that rising life expectancies and growing older populations mean "Hong Kong mu~t make concrete efforts to retain elderly people in the workforce," as residents 65 and over will make up almost 40 percent of the city's population by 2066. The statistics have special "poignancy" due to the recent "retirement of Hong Kong's legendary entrepreneur Li Ka-shing just shy of 90 and the election of Mahathir Mohamad as Malaysia's prime minister at 92," which dismantle "the conventional perception when it comes to the elderly." While Hong Kong currently "has no official retirement age ...perceptions seem to be changing with more and more companies willin~ to retain employees beyond 60," and Bhadun encourages Hong Kong to pass an "official retirement policy" that "will not only lend a formal structure to workforce management, but also put in place guidelines aimed at _enha~ci~g productivity with a specific demographic reality in mind." Older Chinese Villagers Benefit From Yoga Pursuits. The New York Times (6/24, Wee, Chen, Subscription Publication, 19.33M) reports the residents of Yugouliang , China ha~e undergone a yoga revolution, led by one official who "had a eureka moment" for an "audacious plan that seemed out of place" in the small v_illage, where the average age is 65 and most residents "survive by tending to their cows and sheep and small plots of land." Despite initial skepticism, ultimately, a village team entered in a provincial competition and won an award for "best collec~ive team." While the original plan to "[set] off a tourism boom could be difficult to achieve" due to the remote nature of the village, according to the Times, the "yoga-strengthened residents ...save on medical costs" and report reduced pain. The Times identifies "China's rapidly aging population [as] one of the most pressing issues facing the ruling Communist Party," saying that "a~ least 50 million older Chinese have been left behind by the 1 ' Alf ll Al\ ,{Q'!ERS~G~T Warner: "Buckle Up" For Revelations From Mueller. More The Washington Examiner (6/24, Lim, 340K) reports 41 EXT-18-248-D-000183 student, who has a private account on the social media platform," whereas the Louisiana Republican's Twitter handle is @RepClayHiggins. that in remarks at the DSCC's annual Majority Trust retreat on Martha's Vineyard on Friday, Sen. Mark Warner, the ranking Democrat on the Senate Intelligence Committee, told those in attendance "that they should 'buckle up' for more revelations in the Russia investigation in the coming months, boastfully joking that there was information only known to himself and special counsel Robert Mueller." Warner quipped, "If you get me one more glass of wine, I'll tell you stuff only Bob Mueller and I know .. .. If you think you've seen wild stuff so far, buckle up. It's going to be a wild couple of months." Trump Criticizes Fallon For Not Being "A Man" After Interview. The Washington Examiner (6/24, Lim, 340K) reports President Trump called on late night host Jimmy Fallon to "be a man" on Sunday after "multiple reports that Fallon regrets ruffling the hair of the thenpresidential candidate in an interview before the 2016 election, despite Trump's claims Fallon called him shortly after the appearance to say the pair earned 'monster ratings."' Trump tweeted, "@jimmyfallon is now whimpering to all that he did the famous 'hair show' with me (where he seriously messed up my hair), & that he would have now done it differently because it is said to have 'humanized' me-he is taking heat. He called & said 'monster ratings.' Be a man Jimmy!" Trump To Campaign For McMaster In South Carolina Today. In what the AP (6/24, Kinnard) casts as the next test of President Trump's "effort to bend the Republican Party to his will," South Carolina voters on Tuesday will "choose between two GOP gubernatorial candidates who both claim to be Trump acolytes." Trump has backed his longtime supporter incumbent Gov. Henry McMaster, "who failed to win the GOP primary outright earlier this month," and faces a runoff election "against businessman John Warren, a first-time politico who some see as more like Trump himself." The AP says the race "is coming down to a question of loyalty. The White House is throwing everything at its disposal into the race to save McMaster, who went out on a political limb for Trump at a crucial point in the 2016 Republican presidential primaries." Trump has tweeted several times in support of McMaster over the past week, and he "will stump for McMaster on Monday afternoon in West Columbia." Virginia Restaurant Owner Does Not Regret Ejecting Sanders. USA Today (6/24, Bacon, 11.4M) reports that White House Press Secretary Sarah Sanders' "unceremonious eviction" from the Red Hen restaurant in Lexington, Virginia. The restaurant's Facebook page "was awash with commentary, much of it bitterly criticizing owner Stephanie Wilkinson" for asking Sanders to leave. Other comments were in support of the restaurant. The Washington Times (6/24, Richardson, 460K) reports that Wilkinson has "no regrets" about asking Sanders to leave, and she "insisted Saturday she would do it all over again, saying people need to 'uphold their morals."' Wilkinson told the Washington Post, "I would have done the same thing again . ... We just felt there are moments in time when people need to live their convictions. This appeared to be one." For her part, Sanders tweeted on Saturday, "Last night I was told by the owner of Red Hen in Lexington, VA to leave because I work for @POTUS and I politely left. Her actions say far more about her than about me. I always do my best to treat people, including those I disagree with, respectfully and will continue to do so." ABC World News Tonight (6/24, story 4, 0:55, Johnson, 14.63M) reported that at the restaurant, there are "signs offering appreciation on the front door, next to bouquets of flowers," while others are "outraged," with "Yelp flooded with one-star reviews [and] the restaurant's online menu hacked." Trump Mistakenly Endorses Wrong Clay Higgins On Twitter. The Washington Examiner (6/24, Lim, 340K) reports President Trump "faced a hurdle on Sunday in properly thanking and endorsing" Rep. Clay Higgins (R-LA) "for his support of the Trump administration's agenda when he "mentioned" the wrong Clay Higgins on Twitter." In a tweet that has since been corrected, Trump said, "@ClayHiggins18 has been a great help to me on Cutting Taxes , creating great new healthcare programs at low cost, fighting for Border Security, our Military and are Vets. He is tough on Crime and has my full Endorsement. The Great State of Louisiana, we want Clay!" The Examiner notes that Twitter user @ClayHiggins18 "appears to be a Georgia Tech 42 EXT-18-248-D-000184 want to confront this president or even leave, but they know what they're doing is wrong. I want to tell you, these members of his cabinet who remain and try to defend him, they won't be able to go to a restaurant, they won't be able to stop at a gas station, they're not going to be able to shop at a department store. The people are going to turn on them. They're going to protest." Cummings: Restaurant Should Not Have However, Rep. Elijah Ejected Sanders. Cummings (D-MD) took a different view of the Sanders situation. The New York Post (6/24, Schwab, 4.46M) reports that in an appearance on CBS' Face The Nation (6/24, 2.75M), Cummings "said he thought the restaurant owner was wrong for asking ...Sanders to leave her eatery." Cummings said, "I think the restaurant owner should have served her.... I really do." Cummings added that "he believed President Trump played a role in the acrimony that led up to the incident." Said Cummings, "I think President Trump has created this .. .. He's basically given people license to state things that are ugly and those things then turn into actions, as we now see." The Wall Street Journal (6/24, Board, Subscription Publication, 6.13M) argues in an editorial that the restaurant's refusal to serve Sanders, along with OHS Secretary Nielsen being heckled in a Washington restaurant and protested outside her home will be a political benefit to the President, whose voters feel that they are being marginalized. In an editorial, the Washington Post (6/24, Board, 15.68M) says that Administration officials "should be allowed to eat dinner in peace." The Post argues that while some would say "we are in a special moment justifying incivility," they "should think for a moment how many Americans might find their own special moment. How hard is it to imagine, for example, people who strongly believe that abortion is murder deciding that judges or other officials who protect abortion rights should not be able to live peaceably with their families?" The Washington Post (6/24, Jordan, 15.68M) calls "the public shaming and shunning of political figures while they are going about their private lives" a "rising phenomenon" resulting from the "anger and division in American politics," while the Washington Times (6/24, Richardson, Boyer, 460K) calls the incident the latest example of "the escalating public hostility directed at President Trump and his aides, raising concerns among some conservatives about the potential for partisan-inspired violence." In an op-ed for USA Today (6/24, 11.4M), Joseph R. Murray II, a civil rights attorney and administrator of LGBTrump, a civil rights attorney and a political commentato r, writes that "the idea that people would be denied service because of who they are or what they think is antithetical to a free society." Noting that Wilkerson "said her decision to deny Sanders service was due, in part, to the fact that the Red Hen employs members of the LGBT community," Murray questions how gay employees could "lobby for the ejection of Sanders" after gays have for decades "been denied service and have pleaded for tolerance." Murray argues that they "had the opportunity to be the bigger person and show that, in America, political foes can break bread rather serve up a cold dish of revenge" but they "passed on that opportunity and showed the nation that pettiness trumps principle." Shaub: Sanders Tweet Violated Ethics Rule. The Washington Times (6/24, Richardson, 460K) reports that Walter Shaub, who served as director of the Office of Government Ethics under President Obama, said Sanders "violated the Code of Federal Regulations by using her official Twitter account to respond Saturday to the flurry of media coverage." In response to Sanders' tweet, Shaub tweeted, "Sarah, I know you don't care even a tiny little bit about the ethics rules, but using your official account for this is a clear violation of 5 CFR 2635.702(a). It's the same as if an ATF agent pulled out his badge when a restaurant tried to throw him/her out." Waters: Administration Officials Will Be Harassed In Public. Breitbart (6/24, Key, 1.28M) reports that Rep. Maxine Waters (D-CA) told MSNBC Saturday that members of the Trump Administration can expect to be harassed in stores, restaurants, and gas stations. Waters said, "I have no sympathy for these people that are in this Administration who know it's wrong for what they're doing on so many fronts. They tend to not Protesters Confront Bondi Outside Mr. The AP (6/24, Rogers Documentary. Sentinel) reports that Florida Attorney General Pam Bondi was confronted by protesters "at a showing of a documentary about children's TV host Fred Rogers, and they questioned the Republican's stands on immigration and health care." According to the Tampa Bay Times , Bondi was given a police escort Friday "when several 43 EXT-18-248-D-000185 reports that since the Clinton Administration, "commemorative medallions known as challenge coins have been stately symbols of the presidency coveted by the military, law enforcement personnel and a small circle of collectors." President Trump , however, has "yielded more and more elaborate - coins that are shinier, flashier and even bigger." Trump's aides have commissioned "multiple versions of an official challenge coin," and one design "approved by Mr. Trump and paid for by the Republican National Committee, is thicker, wider and more gold than those of preceding presidents," and bears his campaign slogan "Make America Great Again." Amid concerns of "running afoul of rules barring government resources from being used for partisan political purposes, the White House Counsel's Office warned staff members not to display the Republican National Committee's challenge coin, or any paraphernalia with Mr. Trump's campaign slogan, in government buildings." members of Organize Florida confronted her as she left a Tampa theater after seeing 'Won't You Be My Neighbor' about Mr. Rogers." The group "questioned Florida joining a lawsuit against the Affordable Care Act and Bondi's general support of President Donald Trump's immigration policies." The New York Post (6/24, Lapin, 4.46M) reports that Whitney Ray, a spokesperson for Bondi "said the confrontation was more violent than the video posted by protesters showed." Ray said in an email, "The video they are choosing to share is of the least aggressive portion of the attack that transpired after police arrived to control the scene. What they are not sharing publicly are several previous encounters involving large men getting in the Attorney General's face, spitting and blocking her exit." The Daily Caller (6/24, Kruta, 420K) reports that Bondi said of the incident, "We were in a movie about anti-bullying and practicing peace and love and tolerance and accepting of people for their differences. That's what Mr. Rogers is all about. We all believe in free speech, but there's a big difference there." Bossie Apologizes For Saying Black Panelist Is Out Of His "Cotton-Picking Mind." Politico (6/24, Griffiths, 3.51M) reports Flake: Senate Shouldn't Vote On Trump Judges Until There Is A Vote On Tariffs. Breitbart (6/24, Key, 1.28M) reports that former Trump campaign official David Bossie has apologized for telling a Fox News panelist who is black that he was out of his "cotton-picking mind." Bossie "grew increasingly agitated during the Sunday morning segment, which included discussion of Democrats and others who have described the Trump administration's policy toward separating families that cross the border illegally as akin to Nazi actions during the Holocaust." Joel Payne, a former aide to Sen. Harry Reid, "interjected as Bossie appeared ready to list others who had made similar comparisons, causing Bossie to exclaim, 'You're out of your cotton-picking mind."' Payne replied, "Cotton picking mind? Brother, let me tell you something, I've got some relatives who picked cotton." The Washington Times (6/24, Richardson, 460K) reports that after the segment, "Fox News host Ed Henry said the phrase was 'obviously offensive."' Later Sunday, Bossie apologized in a tweet, writing, "During a heated segment on Fox & Friends today , I should have chosen my words more carefully and never used the offensive phrase that I did. I apologize to Joel Payne, Fox News and its viewers." that Sen . Jeff Flake told ABC's This Week (6/24, 2.72M) that senators "should stand up to President Donald Trump by not approving any more judges until they get votes on things like tariffs." Flake said, "I can tell you Republicans need to stand up on issues like tariffs . ... I do think unless we can actually exercise something other than approving the President's executive calendar , his nominees, judges that we have no reason to be there. I think myself and a number of senators at least a few of us, will stand up and say let's not move any more judges until we get a vote, for example, on tariffs." The Washington Post (6/24, Weigel, 15.68M) says Flake has so far "supported all of the White House's key judicial nominees, but the threat of a rebellion on one of the issues that has most united conservatives behind the president drew friendly fire." In a tweet, Rep. Paul Gosar (R-AZ) "mocked Flake's 'hissy fit' and said he looked forward to the end of his colleague's term this year." Ethics Watchdogs Warn Administration Over Politicizing Presidential Coins. The New York Times (6/24, Vogel, Subscription Publication, 19.33M) 44 EXT-18-248-D-000186 "no allegation that classified information was disclosed ...such a rare and aggressive tactic was unjustified and could undermine journalists' ability to report on government misconduct." USA Today (6/24, Hayes, 11.4M) reports that Fox News issued a statement "saying Bossie's comments were 'deeply offensive and wholly inappropriate."' The statement added, "His remarks do not reflect the sentiments of Fox News and we do not in any way condone them." The Washington Post (6/24, Selk, 15.68M) says Fox News "declined to comment" when asked "whether Bossie would continue to be invited onto the show." Barr Says Her Controversial Tweet Was "Misinterpreted." ABC World News Tonight (6/24, story 9, 1:50, Reshef, 14.63M) reported that in "a taped podcast with her spiritual leader," Roseanne Barr claims that the controversial tweets which resulted in the cancellation of her ABC show were "misinterpreted." Barr: "I never would have wittingly called any black person, say they are a monkey. I wouldn't do that. And I didn't do that. And if people think that I did that, it just kills me." ABC added that Barr was "overcome with emotion." Barr: "I definitely feel remorse. I am so sorry, and humiliated, and angry at myself." Bill Clinton Downplays Tarmac Meeting With Lynch. The Washington Times (6/24, Scarborough , 460K) reports that former President Bill Clinton told investigators told investigators that he saw nothing wrong with his impromptu meeting with former Attorney General Loretta Lynch on a Phoenix airport tarmac because he did not think the investigation into his wife Hillary Clinton's emails "amounted to much, frankly." The June 27, 2016 meeting, which is "captured in Justice Department Inspector General Michael Horowitz's 500-plus-page report on the Clinton email saga," is "one of the moments most talked about. Some Republicans said the two-term president, by his mere presence, tried to influence the criminal investigation as Mrs. Clinton was running for president." for her part, Lynch "told investigators that she thought the meeting would be no more than a greeting. But Mr. Clinton made himself at home and regaled her and her husband in small talk, she told the Justice Department investigators." Clinton "said his motive was innocent." Boardroom Table From "The Apprentice" Sold At Auction For $32,000. The Wash ington Times (6/24, Harper, 460K) reports that a boardroom table President Trump used as the star of NBC's The Apprentice was "sold at auction for $32,000" Saturday. Officials at Julien's Auctions "originally predicted the table would fetch around $16,000." Raju: Trump Drives Up Democrats' Negatives, But Fires Up Democratic Voters. Senior congressional correspondent Manu Raju said on CNN's Inside Politics (6/24, 681 K), "Trump has told Republican leaders he is willing to go everywhere. And the question is do they want him everywhere? They know that one thing he does effectively is he drives up the negatives of a Democratic opponent. He is very good at that. But, he also riles up the Democratic base. It is going to be an interesting calculation come the fall as we get into the heat of the general election where middle of the road voters, people may be put off by some of the Trump rhetoric and policies." Wolfe-Watkins Affair Has "Rattled" Washington Journalists. The New York Times (6/24, Grynbaum, Shane, Flitter, Subscription Publication, 19.33M) reports that a three-year affair which began in 2014 between Ali Watkins, then, an intern in the Washington bureau of McClatchy Newspapers, and James Wolfe, "a SO-something senior aide to the Senate Intelligence Committee," is "now part of a federal investigation that has rattled the world of Washington journalists and the sources they rely on." Wolfe "was arrested on June 7 and charged with lying to investigators about his contacts with Ms. Watkins and three other journalists," and Watkins, now a reporter for The New York Times, "had her email and phone records seized by federal prosecutors." The seizure "was alarming to First Amendment advocates," who said that with Romney Says He'll Back Good Trump Policies, Criticize Bad Ones. The AP (6/24, Whitehurst) reports that Utah US Senate candidate Mitt Romney's primary opponent has "painted him as an outsider who can't get along with President Donald Trump , but Romney has quieted his once-strident criticism." Romney told the AP, "I'm not someone who's going to be a 45 EXT-18-248-D-000187 jokes ." However , "many Democrats" are "anxious, angry and downright hostile" to his candidacy. Many in the state see his "explosive burst onto the political scene [as] a partisan mirror image of the trajectory of another oddly coiffed, thick-accented businessman-turned-politician," and like President Trump . "Democrats here question what Shri Thanedar really believes" and fear their party is "about to be rocked by their own Bizarro-World Trump ." daily commentator on everything the President says by any means, but if there's something of significance that the President says or does , I feel a moral obligation to express my own view." The AP says that while Romney predicted that Trump would be re-elected in 2020, he "hasn't endorsed him" and he "declined to do so this week, saying it's too early and he expects Trump to have an asyet-unknown " primary challenger. Nonetheless, "Romney's tone has changed considerably since the 2016 campaign when he called thencandidate Trump a 'phony' and a 'fraud. "' Romney said that "things change after a president is elected," and that "he'll get behind good policies while criticizing bad ones." Maryland Gubernatorial Race A Test Of Sanders Backers' Ability To Win Primaries. The New York Times (6/24, Ember, The New York Times (6/24, Goldmacher, Subscription Publication, 19.33M) reports that the NY11 primary battle between incumbent Rep. Dan Donovan (R-NY) , who has been endorsed by President Trump , and ex-Rep. Michael Grimm "has revolved around Mr. Trump, and which Republican candidate can best carry his mantle in this, the lone Republican-held seat left in New York City." Trump has warned that a Grimm win "could hand the seat to Democrats come November, " but Grimm's supporters "choose to look past Mr. Trump's endorsement , to forgive Mr. Grimm's criminal conviction, and pay even less heed to his more moderate record in Congress. " They see "a candidate who talks like them and fights for them , just like a certain resident of the White House ." Said one Grimm supporters, "Michae l Grimm was a Trump before Trump was a Trump. " The Times adds that Donovan's and Grimm's "feelings for one another are not masked." Said Donovan , "It's gotten personal. " Burns, Subscription Publication, 19.33M) reports that Maryland 's Democratic gubernatorial primary, in which Sen. Bernie Sanders has endorsed and campaigned for Ben Jealous , has "become a critical test of Mr. Sanders's ability to sway elections." Sanders ' "policy agenda has caught on widely among Democratic candidates , and succeeded in moving the party to the left," but "Sanders himself has struggled so far to expand his political base and propel his personal allies to victory in Democratic primaries ." Sanders "has endorsed only a handful of candidates in contested primaries , and three of them have recently lost difficult races in Iowa and Pennsylvania ." The Washington Post (6/22, Chason, 15.68M) reports that recent polls show that Jealous and Prince George's County Executive Rushern L. Baker Ill are the frontrunners in the race. They are trailed by "state Sen. Richard S. Madaleno Jr., who was the first openly gay person elected to the Maryland General Assembly ; former Obama appointee Krishanti Vignarajah, a Sri Lankan immigrant ; attorney James Shea and tech entrepreneur Alex Ross." Michigan Democrats Fear Thanedar Is Politico A "Bizarro-World Trump." District Of Columbia Council To Consider Lowering Voting Age To 16. Magazine (6/24, Friess, 3.45M) profiles Michigan gubernatorial candidate Shri Thanedar , calling him "the state's hottest Democrat." Thanedar , "a 63year-old millionaire chemist and entrepreneur, " was "utterly unknown" when he launched his campaign , and on "that blank canvas , he's spent $3 million and counting in TV ads to paint an image as a [Sen . Bernie] Sanders acolyte with big 'progressive' ideas who disarms skeptics of his accent (Thanedar is an Indian immigrant) and his non-European name with endearing, self-effacing NBC Nightly News (6/24, story 9, 2:00 , Snow, 8.26M) reported that a city counci l hearing is set for this week on a push to extend the right to vote to 16-year-olds in the District of Columbia. NBC (Radford) added that the group Vote16USA is pushing "to lower the voting age to 16, just in time for the next presidential election." Donovan Says NY11 Primary Battle With Grimm Has "Gotten Personal." WPost: Congress Must Permanent Fix To "Temporary" Housing 46 Devise FHFA's Finance EXT-18-248-D-000188 New York Times (6/24, Subscription Publication, 19.33M) says New York City's "school system is not only the nation's largest but also its most segregated." Mayor Bill de Blasio "largely ignored this reality for four years," the Times says, but he "has now taken an important step: He has put forward a plan to integrate eight of the city's specialized high schools, storied institutions like Stuyvesant, Bronx Science and Brooklyn Tech." The Times says these schools "have a vital mission, to challenge the city's sharpest young minds," but they have been "failing in that endeavor, because they all but shut out black and Latino students, leaving untold numbers of New York's brightest children behind." Takeover. A Washington Post (6/24, 15.68M) editorial calls on Congress to come up with a permanent fix to the FHFA's "temporary" takeover of the housing finance system. The Post says that "buried deep within the Trump administration's new plan to reorganize government agencies," was a proposal that "would end the conservatorship of Fannie and Freddie and replace their duopoly with a system in which an array of entities could participate, subject to strict federal regulation of capitalization and underwriting standards." White: Kagan, Kennedy Opinions Should Encourage Reform Of Administrative State. In an op-ed for the Washington Post. "Congress Needs To Up With A Permanent Fix For Its 'Temporary' Housing-Finance Takeover." A Washington Post (6/24, 15.68M) editorial calls on Congress to come up with a permanent fix to the FHFA's "temporary" takeover of the housing finance system. The Post says that "buried deep within the Trump administration's new plan to reorganize government agencies" was a proposal that "would end the conservatorship of Fannie and Freddie and replace their duopoly with a system in which an array of entities could participate, subject to strict federal regulation of capitalization and underwriting standards." "Trump Is Playing A Risky Game Of Chicken." A Washington Post (6/24, 15.68M) editorial takes a negative view of President Trump's trade conflict with China. The Post argues that Trump "is unable to set priorities. Instead of focusing on China, the country with which we and many other nations have the most legitimate grievances, Mr. Trump is simultaneously pursuing trade battles with every major U.S. ally." Trump "not only has decided to play a game of chicken with the U.S. economy. He has decided to play against the whole world." "Let The Trump Team Eat In Peace." Citing a Virginia restaurant owner's decision to ask White House Press Secretary Sarah Sanders to leave her restaurant, the Washington Post (6/24, Board, 15.68M) says in an editorial that Administration officials "should be allowed to eat dinner in peace." The Post argues that while some would say "we are in a special moment justifying incivility," they "should think for a moment how many Americans might find their own special moment. How hard is it to imagine, for example, people who strongly believe that abortion is Wall Street Journal (6/24, White, Subscription Publication, 6.13M), Adam J. White, a research fellow at the Hoover Institution and director of the C. Boyden Gray Center for the Study of the Administrative State at George Mason University's Antonin Scalia Law School, writes that Supreme Court Justice Elena Kagan's majority opinion in Lucia v. SEC and Justice Anthony Kennedy's concurring opinion in Pereira v. Sessions show the need for the reform and modernization of the administrative state. Come Gramm, Ekelund: Income Inequality Helped Elect Trump. In an op-ed for the Wall Street Journal (6/24, Gramm, Ekelund, Subscription Publication, 6.13M) adapted from their forthcoming book "Freedom and Inequality," former Senate Banking Chairman Phil Gramm, and Robert Ekelund, a professor emeritus in economics at Auburn University, argue that while talk of income inequality was a major theme of Hillary Clinton's presidential campaign, an analysis by the Cato lnstitute's John F. Early, found relative equality among the bottom 60% of American earners, due in part to social-welfare spending and economic and wage stagnation during the Obama Administration. As a result, middle-income and lower-middle-income families saw that their hard work left them barely better off than those benefiting from welfare spending. That recognition, they argue, helped elect President Trump. EDITORIAL WRAP-UP New York Times. "It's Time To Integrate New York's Best Schools." In an editorial, the 47 EXT-18-248-D-000189 murder deciding that judges or other officials who protect abortion rights should not be able to live peaceably w ith their families? " NEW YORK TIMES: Erdogan 's Election Win Gives Him Vast ly Expanded Powers In T urkey Trump Calls For Depriv ing Immigrants Who Illegally Cross Border Of Due Process Rights How An Affair Between A Reporter And A Secur ity Aide Has Rattled Washington Media In A High-Stakes Environmenta l W hodu nit, Many Clues Point To China Trump's Trade War Cou ld Shut Cheesemakers Out Of Foreign Markets Bernie Sande rs Is Winning Converts . But Primary Victories Remain Elusive . Wall Street Journal. "Senate Obstruction In Profile." A Wa ll Street Journal (6/24, Board, Subscription Publication, 6.13M) editorial criticizes Senate Democrats' treatment of Brian Benczkowski , President Trump's nominee to head the Justice Department's Crimina l Division . The Journal argues that Benczkowski is highly qualified for the position and takes issue with Democrat s' claims that he has "Russ ia connections ." "How To Re-Elect Trump." The Wa ll Street Journal (6/24, Board , Subscr iption Publication, 6 .13M) argues in an editorial that a Virgin ia restaurant's refusal to serve White House Press Secretary Sarah Sanders last weekend , along with OHS Secretary Nielsen being heckled in a Washington restaurant and protested outside her home will be a po litical benefit to the President, whose voters feel that they are being marginalized . "Turkey's Authoritarian Choice." The Wa ll Street Journa l (6/24, Subscription Publication, 6 .13M) editorializes that even though the outcome of Sunday 's vote in Turkey grants President Recep Tayyip Erdogan vast new authority to expand his increasingly authoritarian rule, the vote revealed a reenergized demo cratic opposition, underscoring how many voters are unhappy with the slow economic growth , capital flight, and rising inflation under Erdogan 's leadership . Still, the Journal warns, Erdogan will likely become an even more difficult NA TO partner , in part because the Administration has neglected Turkey in its focus on North Korea , Russia , and Iran . WASHINGTON POST: With More Floods, Fear Also Flows Separated Fami lies Feel Terro r Of The Unknow n Trump Opposes T rials For Migrants Now On The Menu: Dinner With A Side Of Sham ing If NATO , Russia Clas h, U.S. May Stall In Traffic FINANCIAL TIMES: Erdogan Claims Victory In Turkey Elections Ch ina Cuts Bank Reserves By $100BN To Cushion US Tariffs Italy Disrupts 'Summit To Save Merkel' On Migrat ion WASHINGTON TIMES: Is Violence Next? Some Democrats Encourage Aggress ive Public Confro ntations Aga inst T rump, Aides Mother, Cry ing Child In Ico nic Photo Have Family Back Home And No Basis To Claim Asy lum Bill Clinton Says Tarmac Meeting W ith Lync h A Wee k Before Wife 's FBI Interview Was Innocent Pentagon Can't Wo rk At Wa rp Speed To Build Trump's 'Space Force' Chelsea Mann ing's Senate Ca mpaign In Maryland Falters Toward End Front-Runne r For Mexican President A Known Name But An Uncertain Left ist Leader THE BIG PICTURE Headlines From Today's Front Pages. WALL STREET JOURNAL: STORY LINEUP FROM LAST NIGHT 'S NETWORK NEWS: Trump Plans New Curbs On Ch inese Investmen t, Tec h Exports To China Erdogan Extends His Hold In Turkey In Pivota l Elect ion Win Am id Chaos At Border , Some Immigra nt Families Reun ite Short Of Worke rs, Restaurants Turn To Robots ABC: Wildfires; Severe Storms ; ImmigrationTrump Comments ; Sarah Sanders -Restaurant Ousting-Reactions; Trump-RepublicansImmigration Bill ; Immigration-Reuniting Families; Pittsburgh-Police Fatally Shoot Unarmed TeenProtests ; San Diego-Police Officers Shot; Roseanne Barr-Racist Tweet-Remorse; San Francisco-Woman Ca lls Cops On 8 Year Old Girl; 48 EXT-18-248-D-000190 Hawaii-Volcano; Germany-Explosion; CaliforniaShark Sightings; Elvis Presley's Jet Up For Auction; Teen Needs Bone Marrow Transplant. CBS: Immigration-Reuniting Families; Immigration-Dept. Of Homeland Security Plan To Reunite Families; Trump-Republicans-Immigration Bill; Minneapolis-Police Kill African American Man; Wildfires; Saudi Arabia-Women Allowed to Drive; Colorado-Return of Rainbow Trout; Navy Pilot Killed In Plane Crash; Turkey-Elections; New Zealand-Prime Minister Names New Baby; Pride Celebrations; Scotland-Paleontology. NBC: Immigration-Trump Comments; Immigration-Reuniting Families; ImmigrationPsychological Effect On Children; Middle East-US And UK Trying To Bring Peace; Turkey-Elections; Saudi Arabia-Women Allowed to Drive; Opioid Epidemic-Mother's Recovery Center; Alaska Airlines-15 Year Old Helps Blind & Deaf Man; DC16 Year Olds Want Right To Vote; Pride Celebrations; Facebook-New Tool; Smithsonian National Zoo-Panda Pregnancy; World Cup; Man Calls Members Of His Church On Their Birthdays. John Oliver: "This week saw continued outrage over his zero-tolerance policy causing children to be separated from their parents at the border - a policy which, you may remember, Trump repeatedly insisted last week he had no power to change. His hands were tied. There was nothing he could do. Well, guess what? ... Yes, Trump claimed he couldn't do a thing and then he did it. Which is a little strange, because he usually claims he can do things and then doesn't do them, like draining the swamp or locking up Hillary or attending Tiffany's sweet sixteen." Copyright 2018 by Bulletin Intelligence LLC Reproduction or redistribution without permission prohibited. Content is drawn from thousands of newspapers, national magazines, national and local television programs, radio broadcasts, social-media platforms and additional forms of open-source data. Sources for Bulletin Intelligence audience-size estimates include Scarborough, GfK MRI, comScore, Nielsen, and the Audit Bureau of Circulation. Data from and access to third party social media platforms, including but not limited to Facebook, Twitter, lnstagram and others, is subject to the respective platform's terms of use. Services that include Factiva content are governed by Factiva's terms of use. Services including embedded Tweets are also subject to Twitter for Website's information and privacy policies. The HHS News Briefing is published five days a week by Bulletin Intelligence, which creates custom briefings for government and corporate leaders. We can be found on the Web at Bulletinlntelligence.com, or called at (703) 4836100. TV AT A GLANCE: Immigration-Reuniting Families - 6 minutes, 55 seconds NETWORK STORY LINEUP FROM THIS MORNING 'S RADIO NEWS BROADCASTS: ABC: Trump-DOJ-Stormy Daniels; TrumpRepublicans-Immigration Bill; Immigration-Trump Comments; Massachusetts-Hazmat Incident; Wildfire; Box Office. CBS: Immigration-Trump Comments; Immigration-Protests; Virginia Detention Center Protests; Minneapolis-Police Kill African American Man; Massachusetts-Hazmat Incident; Gas Prices; Trump-DOJ-Stormy Daniels; Wall Street. FOX: Immigration-Reuniting Families; WHDefense Secretary Visit To China; Pride Celebrations; NASCAR News. NPR: Immigration-Trump Comments; Immigration-Atlanta Mayor-Refuses To Jail Migrants; Ethiopia-Grenade Attack; Iowa-Oil Train Derailed. LAST LAUGHS Late Night Political Humor. John Oliver: "We begin with President Trump, the abusive father America will be talking about in therapy for the next 40 years." 49 EXT-18-248-D-000191 "Jessica Mart inez "; To: "White, Jonathan (ACF) " "Brooks, Teresa (ACF) "; "Claudia Gonzalez-Rivera "; CC: "De LA Cruz, James (ACF) "; "Bowman, Matthew (HHS/OGC) " Subject: RE: Inqu iry Regarding Request for Heightened Medical Service FW: Report of Significant Incident Addendum Event#110705 Date: 20 17/10/26 15:39:38 Priority: Normal Type: Note Jessica, Just a brief update regarding the email below. Please approach UAC and ask for her consent to inform her parents of the pregnancy today , and give her the option to do so herself if she would like. Let her know that the program would like to inform them because minors often benefit from a consultation with their parents over the question of an unplanned pregnancy, and such discussions often leads to the realization that the parents have their best interests at heart. If received , please tell them From: Lloyd, Scott (ACF) Sent: Monday, October 23, 2017 9:19 PM To: Jessica Martinez; White, Jonathan (ACF) Cc: Brooks, Teresa (ACF); Claudia Gonzalez-Rivera; De LA Cruz, James (ACF); Bowman, Matthew (HHS/OGC) Subject: RE: Inq uiry Regarding Request for Heightened Medical Service FW: Report of Significant Incident Addendum Event#110705 Dear Jessica, /\MERICAi\ pVERSIGHT EXT-18-248-D-000192 Thank you for the message. Please direct the program to take the following steps : 1) Confirm pregnancy with OB/GYN according to standard operating procedure. 2) If further tests confirm pregnancy, the pa rents must be notified of the pregnancy. Either UAC or the program should notify parents , accord ing to the UAC's preference. 3) Please repor t back when the program has completed these steps. Thank you, Scott From: Jessica Martinez [mailto:jess ica.martinez@ iestex .org] Sent: Monday, October 23, 2017 7:59 PM To: White, Jonathan (ACF) Cc: Brooks, Te resa (ACF); Lloyd, Scott (ACF); Claudia Gonzalez-Rivera; De LA Cruz, James (ACF) Subject: [WARNING : MESSAGEENCRYPTED] I nquiry Regarding Request for Heightened Medical Service FW: Report of Significant Incident Addendum Event#110705 Importance: High Good Afternoon, Please be advised, IES LF Shelter has a new arrival 17-year-old female UAC ~(b)(6) ~ from Guatemala in care (DOE 10/19/ 17) whom today (10/23/17) advised assigned Clinician that she wished "to take a pill to get rid of baby" directly implying to the Clinician that UAC does not wish to proceed with pregnancy. According to what UAC shared with assigned Clinician, the UAC explained her thoughts stating "she is too young, she does not have the resources to care for a child, she is afraid her family will be angry and that she and her family cannot deal with something like this at this time". Please note UAC 's initial medical screening was completed on Friday , October 20th , 2017 , an /\MERICAi\ pVERSIGHT EXT-18-248-D-000193 HCG test indicated UAC is pregnant. The pregnancy has yet to be confirmed by obstetrician, initial OB/GYN appointment is scheduled for 10/27/17 at 2:30 p.m. Please note, the primary care physician is not aware of minor's thoughts on this matter and has issued a referral to OB/GYN for standard prenatal care. According to UAC , she was not aware she was pregnant when she departed from home country and she does not wish to disclose pregnancy with her family or sponsor. Minor reported she was raised by her mother in Guatemala and is not familiar with her biological father. Based on limited available information, the minor is less than 4 weeks pregnant , she traveled from Guatemala with her adult sister and her sister's child . Upon apprehension , UAC was separated from her adult sister and her adult sister remains in DHS custody. The UAC 's point of contact is her brother-in-law, l~ -= small create reflect live serve love CONFIDENTIALI TY NOTICE: This message contains information which may be confidential or privileged. If you are not the intended recipient , be aware that any disclosure , copying , distribution or use of the conten ts of this informat ion is prohibited . If you have received this transmission in error, please not ify me immediately by telephone and permanently delete the e-mail and any attachments immediately. Thank you. /\MERICAi\ pVERSIGHT EXT-18-248-D-000195 "Jessica Mart inez "; "Wh ite, Jonathan (ACF) "; " Brooks, Teresa (ACF) "; Recipient: "Claudia Gonzalez-Rivera "; "De LA Cruz, James (ACF) "; " Bowman, Matthew (HHS/OGC) " Sent Date: 2017/10/26 15:31:54 Delivered Date: 201 7/10/26 15:39 : 38 Message Flags: u nsent /\MERICAi\ pVERSIGHT EXT-18-248-D-000196 "Jessica Mart inez "; To: "White, Jonathan (ACF) " "Brooks, Teresa (ACF) "; "Claudia Gonzalez-Rivera "; CC: "De LA Cruz, James (ACF) "; "Bowman, Matthew (HHS/OGC) " Subject: RE: Inqu iry Regarding Request for Heightened Medical Service FW: Report of Significant Incident Addendum Event#110705 Date: 20 17/10/23 21:17:02 Priority: Normal Type: Note Dear Jessica, Thank you for the mes sage. Please direct the program to take th e following step s: I) Confirm pregnancy with OB/GYN according to standard operating procedure. 2) If further tests confi rm pregnancy , the pa rents must be notified of the pregnancy. Either UAC or the program should not ify parents , according to the UAC's preference. 3) Please report back when the program has completed these steps, and we will provide further instruct ion. Thank you, Scott From: Jessica Martinez [mailto:jessica .martinez @iestex .org] Sent: Monday, October 23, 2017 7:59 PM To: White, Jonathan (ACF) /\MERICAi\ pVERSIGHT EXT-18-248-D-000197 Cc: Brooks, Teresa (ACF); Lloyd, Scott (ACF); Claudia Gonzalez-Rivera; De LA Cruz, James (ACF) Subject: [WARNING : MESSAGEENCRYPTED] Inquiry Regarding Request for Heightened Medical Service FW: Report of Significant Incident Addendum Event#110705 Importance: High Good Afternoon , Please be advised, IES LF Shelter has a new arrival 17-year-old female UAC I from Guatemala in care (DOE 10/19/17) whom fbl(5l today (10/23/17) advised assigned Clinician that she wished "to take a pill to get rid of baby" directly implying to the Clinician that UAC does not wish to proceed with pregnancy. According to what UAC shared with assigned Clinician, the UAC explained her thoughts stating "she is too young, she does not have the resources to care for a child , she is afraid her family will be angry and that she and her family cannot deal with something like this at this time ". Please note UAC's initial medical screening was completed on Friday, October 20th , 2017 , an HCG test indicated UAC is pregnant. The pregnancy has yet to be confirmed by obstetrician, initial OB/GYN appointment is scheduled for 10/27/17 at 2:30 p.m. Please note, the primary care physician is not aware of minor's thoughts on this matter and has issued a referral to OB/GYN for standard prenatal care. According to UAC, she was not aware she was pregnant when she departed from home country and she does not wish to disclose pregnancy with her family or sponsor. Minor reported she was raised by her mother in Guatemala and is not familiar with her biological father. Based on limited available information, the minor is less than 4 weeks pregnant , she traveled from Guatemala with her adult sister and her sister's child. Upon apprehension , UAC was separated from her adult sister and her adult sister remains in OHS custody. The UAC 's point of contact is her brother-in-lawj,.,,... C b.,..,., )(6,,.... l --, 6 l(bl( l r'hom currently resides in Idaho. The UACs plan was to travel to Idaho alongside her adult sister and to unite with her sister's husbandf bl(5l fbl(6l fhom currently resides in Wendell, ID. At this time care provider has not received documentation from potential sponsor (brother-in-law) to formally prove relationship with UAC. However, assigned Case Manager has made contact with UAC's brother-in-law, the FRA has been forward~e has verbally agreed to the terms and conditions of sponsoring UAC~ 5l IC blC !minor's brother-in-law) has agreed to comply with all reunification requirements and provide all necessary documentation to move forward with reunification process. Care provider will ensure to provide sponsor with the support needed to facilitate the reunification process, at this time the UAC denies any history of abuse , neglect or mistreatment. There are no indicators or I /\MERICAi\ pVERSIGHT EXT-18-248-D-000198 concerns of a history of trauma. At time, UAC has not attended Know Your Rights Presentation and is pending initial legal screening, these services are scheduled to take place tomorrow, October 24, 2017. Care provider has not reached out to any community medical providers regarding minor's inquiry, no follow up appointments and/or information regarding the subject matter of minor's inquiry has been nor will be issued to UAC unless authorization is granted by ORR. This information will be elevated to designated ORR FFS and a Significant Incident Addendum (Event# 110705) has been submitted with regards to UAC's inquiry . Please advise on how to proceed should UAC continue to request information regarding this very specific heightened medical service, thank you , we will wait for further guidance . Please note, due to the sensitive nature of this information , it is my intention to ensue ORR officials are made aware of this emerging matter promptly. Please let me know if there are any questions or concerns regarding the information provided, I will gladly be of assistance. *Password to follow, thank you . Jessica Martinez , MA, LCCA Program Director IES Shelter Los Fresnos International Educational Services, Inc. P.O. Box 112 Los Fresnos, TX 78566 Phone: 956-233-5705 ext: 1410 Cell :l< ..... b_J<6_J ___ ___. Fax: 956-233-3435 Jessica.martinez@iestex.org /\MERICAi\ pVERSIGHT EXT-18-248-D-000199 >-= small create reflect live serve love CONFIDENTIALITY NOTICE: This message contains information which may be confidential or privileged. If you are not the intended recipient , be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited. If you have received this transmission in error, please notify me immediately by telephone and permanently delete the e-mail and any attachments immediately. Thank you. "Jessica Martinez "; "White, Jonathan (ACF) "; "Brooks, Teresa (ACF) "; Recipient: "Claudia Gonzalez-Rivera "; "De LA Cruz, James (ACF) "; " Bowman, Matthew (HHS/OGC) " Sent Date : 2017/10/23 21:13:47 Delivered Date: 2017/10/23 21:17:02 Message Flags: Unsent /\MERICAi\ pVERSIGHT EXT-18-248-D-000200 To : "White, Jonathan (ACF) " CC: "Sualog, Jallyn (ACF) "; "De LA Cruz, James (ACF) " Subject: Info rmational document Date: 2018/01/12 16:12:44 Priority: Urgent Type: Note Jonathan , In addition to the information regarding the offer for adoption we received , please instruct the program to ask the UAC if she desires information about pregnancy. If so, please ask the prog ram to share the attached materials w ith her. If she would like assistance going through them, the program should accommodate , and answer or submit to us any questions the UAC has. The program should not share if the UAC is not interested. Thank you, Scott *** E . Scott Lloyd Director Offic e of Refugee Resettlem ent U.S. Departm ent of Health and Human Services (202) 401-7269 (202) ~f bl_(6_) ~l (cell) scott. lloyd@acf. hhs.gov Recipient: l"White, Jonathan (ACF) "; "Sualog, Jallyn (ACF) "; "De LA Cruz, James (ACF) " Sent Date: 2018/01/27 15:10:51 Delivered Date: 2018/01/12 16:12:44 Message Flags: Unsent /\MERICAi\ pVERSIGHT EXT-18-248-D-000202 ELDERECHQ DE LA MW) EEIR AESTAR INFORMADA Material informative *3 atti' . AMEW l? TEXAS Healthand HumanServices TexasHealthand Human ServicesCommission TexasDepartmentofState HealthServices Todos los derechos reservados, 2016 . Departamento Estatal de Servicios de Salud de Texas. Revisado en diciembre de 2016. Las fotografias a color representan el desarrollo del nino en incrementos gestacionales de dos semanas: Peg Gerrity, www.peggerrity .com. EXT-18-248-D-000204 Usted esta embarazada y debe conocer todas las opciones a su disposicion. Tiene derecho a conocer la verdad. Este folleto le ofrece informaci6n importante sobre el bebe que esta creciendo en su vientre y los recursos a su disposici6n durante y despues del embarazo. Necesita informaci6n de calidad para poder tomar decisiones importantes sobre su embarazo y su vida. Tiene derecho a tomar estas decisiones sin presiones. Nadie debe tomarlas por usted. Nadie puede obligarla a tener un aborto, ni siquiera sus padres ni el padre del bebe. Sise siente presionada (o coaccionada) por alguien para hacerse un aborto, sepa que tiene opciones. Cuentele a su doctor, consejero o asesor espiri tual lo que siente y pida un telefono para llamar al 9-1-1 si necesita ayuda de inmediato. Si usted es vfctima de la trata de personas (es decir, si alguien la esta obligando a trabajar o mantener relaciones sexuales a cambio de dinero), llame a la Unea nacional de recurses sobre la trata de personas al 1-888-373-7888. Si esta leyendo este folleto porque esta pensando en abortar, el doctor que vaya a practicar el aborto debe hacerle primero una ecograffa, dejar que usted vea a su bebe, describir aquello que pueda verse en la ecograffa y dejar que usted escuche el latido, si ya puede ofrse. El doctor debe esperar al menos 24 horas antes de realizar el aborto para que usted pueda pensar bien las cosas y tomar esta decision importante sin presiones. Solo usted tiene el derecho de decidir que hacer. Usted y su doctor deben hablar con franqueza y en privado. Usted tiene el derecho de hacer preguntas e inform arse tanto como sea posible. Para comprender mejor los riesgos, comparta sus antecedentes medicos con su doctor y hable con el del riesgo que plantea cada opci6n en vista de su historial y necesidades de salud particulares. Entre las cosas que debe hablar con su doctor estan: • Sus antecedentes medicos. • Cuanto tiempo lleva embarazada. • Los riesgos medicos de hacerse un aborto. • Las alternativas al aborto, incluida la adopci6n. l • Los riesgos medicos que supone llevar un embarazo a termino. • El gran numero de instituciones publicas y privadas que ayudan a las madres primerizas con el embarazo, el parto y la maternidad, entre ellas agencias de adopci6n y servicios de ecograffa gratuitos cerca de usted que pueden facilitarle imagenes del bebe en su vientre. • El dinero y otro tipo de ayudas disponibles para las nuevas mamas. Tornese el tiempo que necesite para leer este folleto y hablar con personas de confianza. Puede hablar con un familiar, un consejero espiritual o profesional, un amigo cercano, su esposo, su pareja o el padre del bebe. Usted merece recibir los consejos y el apoyo de las personas en quienes conffa. Le recomendamos que les pida consejos y orientaci6n antes de tomar cualquier decision relacionada con su embarazo. Sea cual sea su decision, necesitara contar con el apoyo de las personas mas cercanas a usted. Las decisiones que tome sobre su embarazo son sumamente importantes. Tiene el derecho de tomarlas teniendo en cuenta sus valores, creencias y necesidades medicas. Puede consultar otros materiales en lfnea visitando: www.dshs.texas.gov/wrtk.* Este es un sitio web seguro . El Departamento Estatal de Servicios de Salud (DSHS) de Texas no recopilara ni registrara ningun dato sobre usted. Si tiene menos de 18 aiios, la ley de Texas exige que los doctores avisen a su padre o t utor antes de que usted pueda abortar. En la mayorfa de los casos, el padre o tutor debe dar su consentimiento, a menos que se le exima de este requisito. Si usted es menor de edad, pfdale al doctor o al centro el folleto "Ya estas embarazada, LYahora que?", que trata sobre este aspecto de la ley. Este folleto esta disponible en: www.dshs.texas.gov/adolescent/ resources.shtm. Si no se esta n protegiendo los derechos descritos en este folleto, o si observa que el centro se encuentra en condiciones ilegales o insalubres, puede presentar u na queja llamando a 1-888-973-0022 o enviando un correo electr6nico a hfc.complaints@dshs.texas.gov. *Noto: El derecho de la mujer a estar informada: Directorio de recursos (www.dshs.texas.gov/wrtk) incluye informaci6n sabre ciertos programas y servicios con los que pueden contar las mujeres durante el embarazo, el parto y el crecimienta de su hijo. Este folleto contie ne los nombres, direcciones y numeros de telefono de estos programas . El directorio de recursos tambien contiene informaci6n 'l ~,/as agencias de adopci6n publicas y privadas. EXT-18-248-D-000205 RS IG ff El dolor del feto Los bebes recien nacidos pueden sentir dolor. Sabemos que los bebes desarrollan el sentido def dolor cuando est6n en el utero . Dada la posibilidad de que el feta sienta dolor, actualmente la fey de Texas limita el aborto a las primeras 20 semanas de gestaci6n ;_ El siguiente apartado describe los cambios que se observan a medida que el bebe se desarrolla dentro del cuerpo del madre durante el embarazoii. Este periodo se conoce coma gestaci6n y puede medirse de dos maneras, que se describen en las paginas siguientes: • El numero de semanas tra nscurridas desde el inicio del ultimo ciclo menstrua l normal (semanas de gestaci6n). • El numero de semanas transcurridas desde la fecha estimada de concepci6n, alrededor de dos semanas despues del inicio del ultimo ciclo menstrual normal. Normalmente, se estima que la fecha de nacimiento del bebe sera aproximadamente despues de l inicio del ultimo ciclo menstrual normal. 40 semanas Concepcion Su bebe empieza a desarrollarse en el momenta de concepci6n, es decir, cuando un huevo sin fertilizar (6vu lo) se une y se fusiona con el espermatozoide del padre. En ese momenta, su 6vulo proporciona al bebe la mitad de sus genes (el material genetico heredado que se transmite a traves del AON) y el espermatozoide del padre proporciona la otra mitad. Una vez combinado, este material proporciona toda la informaci6n genetica necesaria para que el bebe se desarrolle en su vientre. En un embarazo a termino, el ciclo de desarrollo empieza con el 6vulo fertilizado y acaba unas 38 semanas despues, cuando el bebe esta listo para nacer. Las siguientes ilustraciones muestran los cambios que tienen lugar a medida que su bebe se desarrolla, desde el momenta de la concepci6n en adelante. 4 semanas de gestaci6n (2 semanas despues de la concepci6n) • El termino cient ffico con el que se designa a su bebe en esta etapa es embri6n. • Las celulas que se convertiran en 6rganos vitales, coma el coraz6n y el cerebra, empiezan a desarrollarse. • Los vasos sangufneos empiezan a formarse. • Su bebe pesa menos de 1 onza y mide menos de 1/8 de pulgada. 6 semanas de gestaci6n ( 4 semanas despues de la concepci6n) • El coraz6n de su bebe empieza a formarse. El coraz6n comienza a latir. • El cerebra y la medula espinal empiezan a formarse. • Los pulmones , el hfgado, el est6mago y otros 6rganos principales empiezan a formarse. • Se observan las yemas de brazos y piernas (las estructuras que se convertiran en las extremidades). • Empiezan a formarse los ojos y las orejas. • Su bebe mide menos de 1/4 de pulgada. De artamento Estatal de Servicios de Salud (DSHS) de Texas pVERSIGHT EXT-18-248-D-000206 8 semanas de gestaci6n (6 semanas despues de la concepci6n) • El coraz6n en desarrallo de su bebe empieza a latir a un ritmo regular. • Los rasgos faciales (ojos, nariz, labios y lengua) empiezan a formarse. • Todos las 6rganos esenciales han empezado a desarrallarse . • Los nervios espinales empiezan a desarrallarse. • El cerebra sigue desarrallandose. • Los brazos y las piernas se alargan. • Los dedos de las manos y las pies se estan desarrallando . • Los 6rganos sexuales empiezan a formarse . • Su bebe mide 1/2 pulgada. 10 semanas de gestaci6n (8 semanas despues de la concepci6n) • Se praducen las primeras mov imientos espontaneos de su bebe (movimientos que se producen solos). • Se forman las codas y aparecen las unas. • Los parpados se desarrallan todavfa mas. • La parte externa de las orejas empieza a tomar su forma definitiva. • Los rasgos faciales siguen desarrollandose . • Las celulas que detectan el tacto empiezan a formarse. • Los nervios que controlaran las 6rganos del bebe se forman. • La actividad del cerebra de su bebe ya puede registrarse . • Al final de esta semana, al bebe se le conoce con el nombre cientffico de feta. • Su bebe mide entre 1¼ y 1 i1zpulgadas de la cabeza a las glut eos. 12 semanas de gestaci6n (10 semanas despues de la concepci6n) • Su bebe se mueve, aunque usted no pueda sentir sus movimientos. • Todos las 6rganos y las partes del cuerpo estan presentes y creciendo. • Puede escucharse el latido de su coraz6n con aparatos electr6nicos. • El cuerpo crece rapidamente. • El cuerpo y el cuello se alargan. • Los parpados se cierran y no volveran a abrirse hasta la semana 28. • Aparecen las unas. • Empiezan a formarse las yemas de las dientes. l • Su bebe pesa cerca de media onza y mide alrededor de 21h pulgadas de la cabeza a las gluteos. RSIGHT EXT-18-248-D-000207 14 semanas de gestaci6n (12 semanas despues de la concepci6n) • Las papilas gustativas estan desarrollandose. • Los brazos y las piernas empiezan a moverse. • Aparecen los movimientos asociados al hipo. • Los 6rganos sexuales externos se desarrollan y se diferencian (masculino o femenino). • Su bebe puede responder al contacto con la piel. • Su bebe mide cerca de 3½ pulgadas de la cabeza a los pies y pesa alrededor de 1 ½ onzas. 16 semanas de gestaci6n (14 semanas despues de la concepci6n) • Su bebe puede tragar y se observan claramente los movimientos del pecho. • La boca hace movim ientos de succi6n. • El bebe se lleva con frecuencia las manos a la cara. • Los ojos empiezan a moverse. • Su bebe mide cerca de 4¾ pulgadas de la cabeza a los gluteos y pesa menos de 4 onzas. 18 semanas de gestaci6n (16 semanas despues de la concepci6n) • Puede que sienta los movimientos de brazos y piernas de su bebe. • Los rif\ones funcionan y producen orina. • Las papilas gustativas estan presentes. • La piel esta arrugada. • Se desarrollan todavfa mas algunos rasgos, como los parpados , las orejas y el labio superior. • Su bebe mide cerca de 5½ pulgadas de la cabeza a los gluteos y pesa alrededor de 7 onzas. De artamento Estatal de Servicios de Salud (DSHS) de Texas pVERSIGHT EXT-18-248-D-000208 20 semanas de gestaci6n (18 semanas despues de la concepci6n) • Su bebe es mas activo, se mueve a cada minuto y usted puede sentir sus movimientos. • Los movimien t os parecidos a la respiraci6n se normalizan y pueden apreciarse en una ecografia. • La estructura de los oidos esta bien desarrollada . Su bebe puede ofr y responder a una gama de sonidos cada vez mayor. • Empieza a crecerle el cabello. • Todas las capas y estructuras de la piel estan presentes , incluidos los folfculos y las glandulas del vello . • Al finalizar esta semana, su bebe puede tragar. • Los ovarios que contienen los 6vulos ya estan presentes en las ninas, yen los ninos empiezan a descender los testfculos . • El meconio (una sustancia de color verdoso compuesta de las celulas y secreciones ingeridas) empieza a formarse en el tracto intestinal. Esta sustancia sera la primera evacuaci6n de su bebe. • Su bebe pesa cerca de 11 onzas y mide alrededor de 6 pulgadas de la cabeza a los gluteos. 22 semanas de gestaci6n (20 semanas despues de la concepci6n) • Su bebe duerme y se despierta con regularidad. Los ruidos y sus movim ientos pueden despertarlo. • Ya se han formado los parpados y las cejas. • Las cuerdas vocales estan desarrollandose. • El sistema nervioso sigue desarrollandose. • Los movimientos se vue lven mas coordinados. • Pueden escucharse los latidos de su coraz6n con un estetoscopio. • Su cuerpo esta cubierto por una capa de vello muy fino llamado lanugo. • Su bebe pesa cerca de 1 libra y mide entre 7 y 7% pulgadas de la cabeza a los gluteos. 24 semanas de gestaci6n (2 2 semanas despues de la concepci6n) • Si recibe un estfmulo , su bebe parpadeara y se sobresaltara (contraera los brazos y las piernas). • Su piel esta arrugada y enrojecida . • Se han desarrollado los sentidos del olfato y el tacto. • Si el bebe naciera en esta etapa intentarfa resp irar, aunque sus pu lmones no estan completamente desarrollados . l Ar • Su bebe pesa cerca de 1.4 libras y mide alrededor de 8 pulgadas de la cabeza a los gluteos. RSIGHT EXT-18-248-D-000209 26 semanas de gestaci6n (24 semanas despues de la concepci6n) • Aunque los pulmones en desarrollo de su bebe estan completamente formados, no estan listos para funcionar fuera del Otero. • Las lfneas de la piel de los dedos de las manos (sus futuras huellas dactilares), los dedos de los pies, la palma de las manos y la planta de los pies ya se han formado. • Su bebe pesa cerca de 1.8 libras y mide alrededor de 9 pulgadas de la cabeza a los gluteos. 28 semanas de gestaci6n (26 semanas despues de la concepci6n) • El cerebra y el sistema nervioso de su bebe se han formado y siguen desarrollandose. • Los pulmones y el sistema digestivo se han formado y siguen desarrollandose. • Los ojos estan parcialmente abiertos y las pestaiias ya estan presentes. • Su bebe pesa cerca de 2.2 libras y mide casi 10 pulgadas de la cabeza a los gluteos . 30 semanas de gestaci6n (28 semanas despues de la concepci6n) • Su bebe da patadas y se estira. • Su bebe tiene reflejos de agarre y responde al sonido. • El sistema nervioso controla ciertas funciones corporales. • Su bebe pesa cerca de 2.9 libras y mide casi 10½ pulgadas de la cabeza a los gluteos. 32 semanas de gestaci6n (30 semanas despues de la concepci6n) • Su bebe aumenta de peso y el cuerpo engorda. • Las uiias de las manos y los pies crecen. • Las pupilas reaccionan a la luz. • Su bebe pesa cerca de 4 libras y mide casi 11 pu lgadas de la cabeza a los gluteos . De artamento Estatal de Servicios de Salud (DSHS) de Texas pVERSIGHT EXT-18-248-D-000210 34 semanas de gestaci6n (32 semanas despues de la concepci6n] • Su bebe se muestra activo (se mueve) el 60% o mas del tiempo. • Los huesos se endurecen, pero el craneo sigue siendo suave y flexible, para facilitar el parto. • Su respiraci6n es rftmica y las pulmones siguen desarrollandose. • Su bebe pesa cerca de 4.6 libras y mide alrededor de 12 pulgadas de la cabeza a las gluteos. 36 semanas de gestaci6n (34 semanas despues de la concepci6n] • Su bebe aumenta de peso rapidamente, preparandose para el nacimiento. • Su cuerpo y su cara se rellenan; la piel ya no esta arrugada. • Las unas llegan hasta la punta de las dedos . • En las ultimas cuatro semanas de gestaci6n, usted le pasa a su bebe una gran cantidad de factores de inmunidad (sustancias en la sangre que lo protegen de enfermedades e infecciones). • Su bebe pesa cerca de 5.5 libras y mide alrededor de 12½ pulgadas de la cabeza a las gluteos. 38 semanas de gestaci6n (36 semanas despues de la concepci6n] • Los pulmones y el cerebra de su bebe se desarrollan rapidamente. • Su bebe puede agarrar objetos con firmeza. • Su bebe pesa cerca de 6.4 libras y mide alrededor de 131/3pulgadas de la cabeza a las gluteos. 40 semanas de gestaci6n (38 semanas despues de la concepci6n] • Su bebe esta completamente desarrollado y se considera que esta a termino . • El cerebra y el sistema nervioso seguiran desarrollandose despues de nacer. • Las unas de las pies llegan hasta la punta de las dedos. • Ya han aparecido las brotes mamarios . • Las unas de las manos crecen mas alla de las puntas de las dedos. l /\ • Su bebe pesa cerca de 7.5 libras y mide alrededor de 14 pulgadas de la cabeza a las gluteos. RSIGHT EXT-18-248-D-000211 En este apartado se describen los riesgos asociados al aborto. Estos riesgos varfan dependiendo de distintos factores. Muerte El riesgo de morir y de sufrir complicaciones graves a causa de un aborto es mayor cuanto mas avanzado este el embarazo. Segun datos recientes de los Centros para el Control y la Prevenci6n de Enfermedades (CDC),entre 2008 y 2011 se registraron en Estados Unidos 0.73 muertes relacionadas con abortos legales por cada 100,000 abortos reportados; ;;_ Estudios realizados en otros pafses alta mente desarrollados han mostrado una tasa mayor de mortalidad asociada a los abortos legales iv_ Riesgos para la salud ffsica Ademas, un aborto puede provocar efectos secundarios ffsicos de distintos niveles de gravedad. Normalmente la mujer tiene c61icos y sangrado vaginal despues de someterse a cualquier tipo de aborto. Otros sfntomas o efectos secundarios son nauseas (malestar estomacal) o v6mitos, diarrea, sensaci6n de calor o escalofrfos, dolor de cabeza, mareo y fatiga (cansancio excesivo). Los abortos, espontaneos o no, pueden resultar en complicaciones tales coma lesiones en los 6rganos internos, coagulos de sangre o infecciones graves. Estas complicaciones se describiran en detalle mas adelante en este folleto, segun los distintos tipos de aborto. Riesgos para la salud mental Las mujeres afirman sentir distintas emociones despues de tener un aborto. Entre ellas estan la depresi6n o los pensamientos suicidas. Despues de un aborto, algunas mujeres tambien sienten tristeza, ansiedad, autoestima baja, arrepentimiento y desapego emocional. Ademas pueden experimentar disfunci6n sexual, tener recuerdos recurrentes y abusar de sustancias. En algunas mujeres, estas emociones pueden De artamento Estatal de Servicios de Salud (DSHS) de Texas pVERSIGHT EXT-18-248-D-000212 aparecer inmediatamente despues de un aborto; en otras, de forma gradual. Estos sentimientos pueden reaparecer o intensificarse con un nuevo aborto, al dar a luz o en las aniversarios del aborto. Es importante que hable con su medico si se siente asf. Es mas probable que las mujeres que han tenido problemas de salud mental las vuelvan a sufrir despues de tener un aborto. Estas mujeres podrfan necesitar ayuda adicional. Es muy importante participar en terapia o recibir ayuda antes de tomar la decision de abortar. Si no puede contar con el apoyo y la ayuda de su familia, hablar con un consejero espiritual o profesional antes de abortar puede ayudarle a entender mejor la decision que esta tomando. Muchos centros de recursos para el embarazo pueden asesorarla. Estos centros aparecen en el directorio de recursos. lnfertilidad en el futuro Cuanto mas avanzado este su embarazo, mayor sera la posibilidad de sufrir complicaciones graves que pueden provocar infertilidad y aumentar el riesgo de morir a causa de un aborto. Algunas complicaciones asociadas al aborto, coma par ejemplo una infeccion , un carte o un desgarro del cuello uterino , pueden dificultar o impedir que quede embarazada o que lleve un embarazo a termino. Riesgo de cancer de senov Su historial de embarazo afecta a sus posibilidades de contraer cancer de seno. Si tiene a su bebe, es menos probable que desarrolle cancer de seno en el futuro. Los estudios indican que, si tiene un aborto, usted no cuenta con esta mayor proteccion frente al cancer de seno. Ademas, doctores y cientificos estan estudiando la compleja biologfa del cancer de seno para determinar si un aborto puede repercutir en el riesgo de cancer de seno. Si alguien en su familia ha padecido cancer de seno o una enfermedad del seno, pregunte a su doctor que efectos tiene un embarazo en el riesgo de padecer cancer de seno. EXT-18-248-D-000213 Para tomar una decision informada, es necesario que conozca todas sus opciones. Cada opcion tiene posibles riesgos y beneficios . Hay servicios de asesoramiento disponibles para ayudarle a entender bien cu6/es son sus opciones ya tomar una decision. Antes de tener un aborto Debe preguntarle a su doctor acerca de cualquier posible riesgo. Usted tiene derecho a estar informada, yes obligaci6n del doctor asegurarse de que usted reciba informaci6n antes de tomar la decision de te ner un aborto. Estas son algunas cuestiones que el doctor debe hablar con usted: • Usted debe estar segura de que esta embarazada y de cuanto tiempo lleva embarazada. Su doctor le hara ademas un examen pelvico. • Su doctor evaluara su estado de salud y le hablara de lo s riesgos medicos asociados al aborto. Usted se sometera a un examen ffsico y pruebas de laboratorio, y contestara una serie de preguntas sabre sus antecedentes medicos. El doctor respondera a cualquier pregunta que usted tenga. • El doctor le explicara c6mo crece el bebe en su vientre y le dara una lista de las agencias que ofrecen alternativas al aborto, incluida la adopci6n, y los nombres de agencias y organizaciones privadas que ofrecen servicios de ecograffa (imagenes del bebe en el utero o ultrasonidos). Algunas organizaciones ofrecen ecograffas gratuitas. Si usted decide tener un aborto: pedirle a un juez que le exima del requisito de notificaci6n y consentimiento. • El doctor que practique el aborto debe proporcionarle el material impreso que publica el Departamento Estatal de Servicios de Salud de Texas (DSHS),t itulado El derecho de la mujer a estar informada, y decirle que puede encontrar estos materiales en el sitio web del DSHS. Tendra al menos un dfa para leer la informaci6n que le de su doctor antes de la cita para el aborto. Debera firmar un consentimiento par escrito para abortar. • Su doctor debe darle un numero de telefono al que puede llamar las 24 horas del dfa para hablar con un medico u otro profesional de la salud sabre cualquier complicaci6n o pregunta relacionada con el aborto, asf coma el nombre y telefono del hospital mas cercano a su domicilio donde pueden tratarla en caso de producirse una emergencia a consecuencia del aborto. • Su doctor puede ofrecerle la posibilidad de someterse a un aborto farmacol6gico, que consiste en tomar un medicamento para provocar un aborto. En caso de realizar un aborto farmaco16gico, su doctor debera entregarle una copia de la etiqueta impresa del medicamento empleado para inducir el aborto. • Al menos 24 horas antes del aborto, el doctor le hara una ecograffa y le explicara lo que usted esta viendo, incluidos el tamano del bebe y si hay un latido, extremidades u 6rganos internos . El doctor esta obligado a mostrarle la imagen de la ecograffa mientras se este realizando. Usted puede optar porno mirar las imagenes de su bebe. Usted tiene derecho de ver su ecograffa en cualquier momenta. • Si tiene menos de 18 afios, es obligatorio notificar a uno de sus padres o a su tutor y obtener su autorizaci6n, o bien tendra que De artamento Estatal de Servicios de Salud (DSHS) de Texas pVERSIGHT EXT-18-248-D-000214 Asistencia medica y social Antes de que pueda practicarse un aborto , su doctor debe darle cierta informaci6n importante, entre ella: • Los beneficios de asistencia medica que pueden ayudarle con la atenci6n prenatal , el parto y los cuidados del recien nacido. • Las obligaciones legales del padre del bebe para ayudar a mantener a su hijo si usted decide continuar con el embarazo y quedarse con el bebe. Por ley, el padre debe ayudar aun cuando se haya ofrecido a pagar por el aborto. • lnstituciones publicas y privadas que pueden ayudarle si usted ha sido victima de una violaci6n o de incesto. • lnstituciones publicas y privadas que pueden proporcionarle informaci6n sobre c6mo evitar el embarazo y recomendarle servicios de planificaci6n familiar. Debe saber que, si decide tener al bebe y se ve abrumada por sus obligaciones como mad re, Texas tiene una ley llamada "Bebe Moises/ Refugio Seguro". Esta ley permite que usted o el padre del nifio dejen a un bebe que aparente tener menos de 60 dfas de vida bajo el cuidado de un proveedor de atenci6n de emergencia, como una estaci6n de servicios medicos de emergencia , una estaci6n de bomberos, una agencia de colocaci6n de menores con licencia o cualquier hospital. Usted no tendra que regresar por el bebe ni se le acusara de ningun delito, siempre y cuando el nifio no haya sufrido dafios. Servicios de manutenci6n de niiios Ayuda para obtener la manutenci6n de ninos El padre de su hijo esta obligado por ley a pagar la manutenci6n del nifio , y la Procuradurfa General de Texas puede ayudarle a cobrar esta manutenci6n. La Division de Manutenci6n de Ninos de la Procuradurfa General puede ayudarle a encontrar a los padres cuyo paradero se desconoce , a demostrar legalmente quien es el padre, a dictar 6rdenes de manutenci6n de nifios o a cobrar pagos de manutenci6n de nifios . Texas es el estado mas eficaz a la hora de asegurar que los padres paguen lo que deben , habiendo cobrado solo en 2015 mas de 3,900 millones de d61ares. Texas tiene un alto fndice de cobro: el estado logra recolectar el 65.2 por ciento de todos los montos por concepto de manutenci6n. Si necesita estos servicios, llame al 1-800 -252-8014 o visite www. texosottorneygenerol.govlcslbienvenidos-o-lodivision-de-monutencion-de-ninosl. Si usted es vfctima de violencia familiar, estas son las medidas que puede tomar para cobrar la manutenci6n de nifios sin correr peligro. Para mas informaci6n , visite www.getchildsupportsofely.org/en-esponol/. EXT-18-248-D-000215 Pf dale a su doctor una copia de "El derecho de la mujer a estar informada: Directorio de recursos'! r· . EXT-18-248-D-000216 •Mnhil•i,6i•i44MM,llaii•i•,,M,@-j.,. ..... -Servicios de adopci6n Otra opcion que puede considerar es la adopcion. La adopcion significa que usted, como madre biologica , transfiere voluntariamente sus derechos como madre de su bebe a otra familia. Escoger la adopcion significa que usted quiere que su hijo tenga una buena vida, pero quizas en este momento usted que lo adoptara. Puede escoger entre dos tipos de adopcion para su bebe. En una adopcion abierta, usted puede permanecer en contacto con su bebe mientras crece, tal vez mediante fotograffas , llamadas telefonicas o visitas. En una adopcion cerrada , no habra contacto entre usted y la familia que adopte a su bebe una vez concluida la adopcion. Usted tiene la opcion de escoger el tipo de adopcion que prefiera . no pueda ser la mejor madre. Hable con un pariente, consejero espiritual o Dar a su hijo en adopcion es una decision profesional o amigo cercano sobre la adopcion. valiente y motivada por el amor que siente por Dado que la adopcion es una decision muy su bebe. Cuando entrega a su bebe en adopc ion, importante , puede que quiera contar con el lo esta colocando con unos padres carifiosos apoyo de personas de confianza antes de tomar que pueden darle la buena vida que usted quiere esta decision . para el. Nunca es demasiado tarde para decidir dar a Hay muchos recursos disponibles para ayudarle su hijo en adopcion. Puede tomar esta decision a decidir si la adopcion es la opcion mas en cualquier momento durante su embarazo o adecuada para usted y su bebe. Cada adopcion incluso una vez que haya nacido el bebe. es diferente y usted recibira ayuda para asegurar que el proceso de adopcion se ajuste a sus Puede encontrar mas informacion sobre la necesidades y a las de su bebe. adopcion y las organizaciones que ofrecen servicios de adopcion en: https:llwww.dfps. Si escoge dar a su bebe en adopcion, podrfa state.tx.us/Espanol/Servicios_ de_Proteccion_ al_ Menor/Adoption.asp/. tener la opcion de elegir y conocer a la familia EXT-18-248-D-000217 Procedimientos y efectos secundarios Los dos tipos principoles de oborto son el oborto formoco/6gico y el oborto quirurgico. Es normal que lo mujer presente do/ores y songrado vaginal despues de someterse a cualquier tipo de aborto. Podrfan presentarse otros sfntomas o efectos secundarios, entre ellos, nauseas (malestar estomacal) o v6mitos , diarrea, sensaci6n de color o escalofrfos, dolor de cabeza, mareo y fatiga (cansancio excesivo). Adem6s, en ocasiones pueden presentorse otros complicociones groves. En este oportodo se describir6 tambien el riesgo de complicaciones relacionado con coda uno de estos metodos . Abortos durante el primer trimestre Durante el primer trimestre (hasta las 13 semanas de gestaci6n), se puede realizar un aborto con medicamentos o con cirugia. Abortofarmacol6gico (sincirug1a) En un aborto farmaco logico se usan medicamentos en vez de cirugfa para interrumpir el embarazo en su etapa inicial, es decir, en los 70 dfas (10 semanas) o menos, siguientes al primer dfa de su ultimo ciclo menstrual. Este metodo requiere que vaya varias veces al doctor . Los medicamentos que se usan en un aborto farmaco logico pueden causar sangrado, colicos y la expulsion del feto y otros tejidos. En algunos casos, si hay sangrado excesivo puede ser necesario realizar una transfusion de sangre, un tratamiento con medicamentos, una cirugfa o transfusiones de solucion salina. Uno de los riesgos del aborto farmacologico son las infecciones graves. Estos son algunos de los posibles riesgos o complicacionesde los abortos farmacol6gicos con mifepristona y misoprostolvi: • Pueden producirse hemorragias (sangrado excesivo). • Aproximadamente 4 de cada 100 procedimientos requieren medicamentos para contro lar el sangrado. • Alrededor de 1 de cada 100 proced imien tos requiere una intervencion quirurgica para detener el sangrado y extraer partes del bebe y de la placenta . • En hasta 5 de cada 1,000 pro cedimientos se administran transfusiones de sangre . • Si nose extraen todas las partes del bebe y otros tejidos, incluida la placenta, podrfa ser necesario realizar un proced imi ento quirurgico de seguimiento . • Las complicaciones durante el procedimiento • Menos del 3% de los procedimientos no funcionaran y daran lug ar a un proced imi ento quirurgico para interrumpir el embarazo o completar el aborto . • Mas de 15 de cada 100 mujeres que se someten a un aborto farmacologico experimentaran nauseas, debilidad, fiebre o escalofrfos, v6mitos, dolor de cabeza, diarrea o mareo. • Entre 3 y 5 de cada 100 procedimientos acabaran en una visita a la sala de emergencias. • Hasta 6 de cada 1,000 abortos farmacologicos requeriran hospitalizacion . De artamento Estatal de Servicios de Salud (DSHS) de Texas pVERSIGHT EXT-18-248-D-000218 podrfan aumentar el riesgo de infert ilidad (la incapacidad de tener un bebe). Se han reportado infecciones bacterianas graves en 2 de cada 1,000 procedimientos. En escasas ocasiones , una infecci6n grave despues del aborto farmacol6gico ha provocado la muerte de la paciente. i_Quien no deberia someterse a un aborto farmaco16gico? Algunas mujeres no deberfan someterse a un aborto farmacol6gico. Estas son algunas razones par las que no deberia realizarse un aborto farmacol6gico: • Han pasado mas de 70 dfas (10 semanas) desde el primer dfa de su ultima menstruaci6n . • Es alergica a alguno de las medicamentos que se usaran. • Tiene o podrfa tener un embarazo extrauterino o ect6pico (cuando el bebe se desarrolla fuera del utero). • Tiene un dispositivo intrauterino (DIU). El DIU debe extraerse antes de que el doctor pueda darle el medicamento. • Ha estado tomando cierto tipo de medicamentos, coma anticoagulantes o ciertos esteroides. • Tiene una afecci6n medica especial, coma convulsiones descontroladas o un trastorno hemorragico. • Tiene algun problema de las glandulas adrenales (insuficiencia adrenal cr6nica). • No puede acudir a todas las consultas para obtener las medicamentos necesarios para realizar el aborto, o no puede someterse a las chequeos necesarios despues del aborto. • No tiene acceso a servicios de emergencia, si llegaran a necesitarse, en las dos semanas despues de tomar las medicamentos. Le recomendamos que hable con su doctor para descartar cualquier afecci6n medica u otro problema de salud que podr ia ponerla en riesgo al hacerse un aborto farmaco16gico. Cuando se someta a un aborto farmacol6gico durante la consulta, su doctor le dara mifepristona (anteriormente llamada RU 486 y actualmente conocida par su nombre comercial, Mifeprex®). Se toma par vfa oral. Despues de tomar la mifepristona , experimentara un sangrado vaginal y expulsara coagulos y tejido fetal. El sangrado suele durar entre 9 y 16 dfas, pero en ocasiones dura hasta 30 dfas. Su doctor programara una cita dos dfas despues de que usted haya tornado la mifepristona. Si el aborto farmacol6gico ha quedado incompleto, se le dara un segundo medicamento, misoprostol. El misoprostol puede causar c61icos, nauseas, diarrea y otros sfntomas. Es posible que su doctor la envfe a casa con un medicamento para aliviar estos sfntomas. El doctor programara una cita de seguimiento en las 14 dfas siguientes de administrarle el medicamento . Le hara un chequeo para ver si tiene algun sfntoma y si el embarazo se ha interrumpido par completo. Asegurese de comentarle a su doctor cualquier sfntoma ffsico o emociona l que este experimentando. Antes de su cita de seguimiento, podrfa necesitar atenci6n medica inmediata si presenta sfntomas graves. EXT-18-248-D-000219 Procedimientos y efectos secundarios Abortos durante el primer trimestre (continuaci6n) Legrado por succi6n (aborto quirurgico) El tipo de aborto mas habitual es el legrado par succion, a veces llamado dilataci6n y legrado o legrado par aspiracion. ser necesario realizar otro procedimiento (esto sucede en menos de 5 de cada 100 procedimientos, es decir, en menos del 5% de las casos)viii_ • Las complicaciones durante el procedimiento podrfan aumentar el riesgo de infertilidad (la La mayorfa de las mujeres experimentan alga de dolor con este procedimiento. Puede que usted reciba medicamentos para el dolor, un sedante o ambos antes del procedimiento. Para realizar incapacidad de tener un bebe). • lnfecci6n, normalmente debido a una infecci6n que ya tenia la paciente antes del aborto. el procedimiento, podrian inyectarla o aplicar anestesia local en la zona del cuello uterino. Tambien podrian administrarle anestesia general para dormirla y que no sienta dolor durante el procedimiento. El doctor inserta un especulo para mantener la vagina abierta, coma en un examen pelvico, y le inyecta o aplica anestesia local. El cuello uterino se abre. A continuacion, el contenido del utero, incluidos el bebe y la placenta, se extraen usando un aparato de succi6n que se inserta en el utero. El procedimiento suele durar de 10 a 15 minutos, pero puede llevar mas tiempo dependiendo de la etapa de desarrollo del bebe. Entre las posibles complicacioneso riesgos del legrado por succionfiguranvii: • Hemorragias (sangrado excesivo) con la posibilidad de histerectomia (extracci6n del utero) de emergencia para detener el sangrado. • Perforacion uterina (un agujero en el utero). • Lesion al intestino o la vejiga, si se produce una perforaci6n del utero. • Incision abdominal y operacion para corregir la lesion. • Si no se logran extraer todas las partes del bebe y otros tejidos, incluida la placenta, podria De artamento Estatal de Servicios de Salud (DSHS) de Texas pVERSIGHT EXT-18-248-D-000220 Abortos durante el segundo trimestre Durant e el segundo t rimestre (entre las 13 y 22 semanas de gesta ci6n), el abor t o puede realizarse con un met odo quirurgico conocido coma dilata ci6n y ext racci6n*. Dilatation y extraction utero al final del procedimiento para extraer La mayorfa de los abortos en el segundo trimestre cualqu ier resto de tejido feta l. Despues de las se realizan mediante dilatacion y extraccion (DyE). 14 semanas de embarazo , podran extraerse el Este procedimiento quirurgico suele realizarse en bebe, la placenta y otros contenidos del utero en un hospital o centro quirurgico . pedazos usando instrumentos qu irurgicos. Este procedimiento suele durar menos de una hora. Antes de realizar este procedimiento, el doctor debe preparar el cuello uterino . Este proceso Entre los posibles riesgos o complicacionesde reblandece y abre el cuello uteri no, y puede una DyE figuranx: requerir varias consultas. • En casos excepciona les, la muerte . El reblandecimiento y la apertura del cuello • Laceraci6n cervica l (desgarros o lesiones al uteri no previos a la DyE ayudan a reducir el riesgo de desgarros o laceraciones . La mayorfa de las mujeres experimentan algo cuello uterino). • Hemorragias (sangrado excesivo) con la posibilidad de una histerectomfa (extraccion del utero) de emergencia para detener el sangrado. de dolor a consecuencia de este procedimiento. Antes del procedimiento, le pueden dar • Perforacion uterina (un agujero en el utero). ambos. Para realizar el proced imiento, pueden • Lesion al intestino o la vejiga, en caso de perforaci6n del utero. inyectarle o aplicar anestesia local o regiona l • Incision abdominal y operacion para corregir medicamentos para el dolor, un sedante o en la zona del cuello uterino. Tambien pueden administrar le anestesia genera l para dormirla du rante el procedim iento. Su doctor le hablara acerca de sus opciones y de cualquier riesgo asociado a la anestesia. Al comienzo del procedimiento, el doctor se asegurara de que el cuello uterino este abierto. El lfquido que envuelve al bebe (lfquido amniotico) se extraera con un aparato la lesion. • Si no se log ran extra er todas las partes del bebe y otros tejidos, incluida la placenta , podrfa ser necesario otro procedimiento. • De haber complicaciones du rante el procedimiento, podrfa aumentar el riesgo de infertilidad (la incapacidad de tener un bebe). • Embolia (el despre ndimie nto de un coagulo de sangre o lfquido amniotico, celulas de succion que se coloca dentro del utero. fetales, vello fetal u otro t ipo de mater ia El bebe y la placenta se extraen del utero usando instrumentos quirurgicos. Por ultimo , en el torrente sangufneo que provoca un bloqueo repentino del flujo de la sangre a los se insertara un aparato de succi6n en el pulmones u otros 6rganos). • Noto: La ley de Texas establece que no pueden realizarse abortos una vez que se hon cumplido 20 semanos despues de la fertilizaci6n, Jo que equivale aproximadamente a 22 semanas o mas de gestaci6n, tat coma se define la gestaci6n en este folleto. La ley de Texaspreve algunas excepciones, coma las casos en que la vida de la madre corre peligro, existe un riesgo considerable de daiios irreversibles en una funci6n corporal esencial (excluyendo las padecimientos psicol6gicos) o el f eta presenta una anomalfa grave. EXT-18-248-D-000221 Dar a luz es una experiencia transformadora , y coda parto conlleva experiencias y sentimientos diferentes . Aunque el embarazo y el parto sue/en ser procesos seguros y naturales, puede haber complicaciones. El embarazo y el parto estan asociados a una serie de complicaciones. Las complicaciones mas habituales del embarazo incluyen: • Embarazo extrauterino o ectopico (cuando el bebe se desarrolla fuera del utero) . • Presion arterial alta. • El tratamiento de emergencia para cualquiera de los problemas anteriores, incluida la posibilidad de tratamiento con cirugfa, con medicamentos o con transfusiones de sangre. • La muerte (en raros casos: entre 2000 y 2006 se registraron 1.7 muertes hospitalarias por cada 100,000 partos vaginales)';_ • Complicaciones durante el parto. • Parto prematuro. Parto por cesarea • Depresion. Posibles riesgos y efectos secundarios: • lnfecciones. • Lesion a los intestinos o la vejiga. • Diabetes. • lnfertilidad (la incapacidad de tener un bebe) debido a infecciones o complicaciones. • Hemorragias (sangrado excesivo). • Hemorragias (sangrado excesivo). Usted puede reducir el riesgo de problemas o complicaciones en el embarazo si: • Recibe atencion prenatal en una etapa temprana y con regularidad. • Lleva una dieta equilibrada y hacer ejercicio con regularidad. • Evita consumir tabaco, alcohol, drogas o cualquier medicamento que no le haya sido recetado. Durante el parto, el utero se contrae y empuja al bebe para que nazca. El bebe puede nacer a traves de la vagina de la mujer o mediante un procedimiento quirurgico llamado cesarea. Parto vaginal • Lesion al tubo (ureter) que conecta los rifiones con la vejiga. • La posibilidad de una histerectomfa (la extraccion del utero) debido a complicaciones o lesiones. • Complicaciones derivadas de la anestesia, como problemas respiratorios, dolores de cabeza o reacciones a medicamentos. • El tratamiento de emergencia para cualquiera de los problemas anteriores, incluidas la cirugfa, la administracion de medicamentos o las transfusiones de sangre. • La muerte (en raros casos: entre 2000 y 2006, se registraron 12.7 muertes hospitalarias de la madre por cada 100,000 partos por cesareaxi). Posibles riesgos y efectos secundarios: • Lesiones a la vejiga o al recto. • Una agujero (ffstula) entre la vejiga y la vagina o el recto y la vagina. • Hemorragias (sangrado excesivo). • lnfertilidad (la incapacidad de tener un bebe) debido a infecciones o complicaciones. De artamento Estatal de Servicios de Salud (DSHS) de Texas pVERSIGHT EXT-18-248-D-000222 Sfntomas despues del parto Sus sentimientos despues del parto pueden ser los mas intensos que haya experimentado en su vida: alegria y felicidad inten sas y repent inas, sentimientos de satisfacci6n y plenitud. No es raro que las mujeres tambien sientan miedo, preocupaci6n o tristeza. Puede que despues del nacimiento del bebe la mujer experimente depresi6n, y muchas madres la sufren en distintos grados. Aunque la depresi6n puede aparecer dfas despues del parto, tamb ien lo hace de forma gradual, ya veces no comienza hasta un afio despues del nacimiento de su hijo. posparto puede manifestarse hasta 1 ario despues del parto, aunque suele aparecer durante el embarazo (el 50 por ciento de las veces) y entre 1 y 3 semanas despues del nacimiento del nifio . La depresi6n posparto se caracteriza por intensos sentimientos de tristeza, ansiedad o desesperaci6n que impiden a la nueva madre funcionar con normalidad a diario. En raros casos, usted quizas tema last imarse o lastimar a su bebe. Si es asi, llame a su doctor inmediatamente y hable con el sobre estos sintomas. Si su doctor no esta disponible, llame al 9-1-1. Los doctores pueden brindarle ayuda y En la mayoria de los casos, las madres experimentan sfntomas leves que duran tan solo unos dfas. Sin embargo, en algunas madres los sintomas pueden ser graves, como sentimientos de inutil idad y desesperanza y la perdida de memoria. En ciertas circunstancias, a usted le podrian diagnosticar depresi6n posparto. La depresi6n apoyo profesional para superar estos momentos. Es mas probable que las mujeres que han tenido problemas de salud mental en el pasado vuelvan a tenerlos despues de dar a luz. Estas mujer es pueden necesitar mas ayuda de lo normal. Si tiene alguna duda o pregunta, hable con su doctor u otro proveedor de atenci6n medica. EXT-18-248-D-000223 Llame al centro o al doctor que realiz6 el aborto o vaya a la sala de emergencias si: • Sangra excesivamente (usa dos o mas toallas higienica s grue sas par hara durante dos hora s consecut ivas) o le preocupa cuant o • El dolor es intenso o no se puede contro lar con medicamento s para el dolor . • Esta desorie ntada . esta sangrando. Su docto r programara una o mas citas de seguimi ent o, la primera de ellas norm almente dos o t res semanas despues del proc edimie nto . Su doctor debe programa r una cita de seguimien t o en las 14 dias siguien t es a un abo rto farmacol6gico. Es impo rt ante que acuda a todas sus cit as. • Siente dolor o malestar estoma cal o se sient e enf erma (par ej emplo, se sient e debil o tiene do lor de est6mago, nauseas, v6mitos o diarrea) , con o sin fiebre , dur ante mas de 24 horas despues de tomar misoprostol para tener un aborto farmaco l6gico. • Tiene fiebre (mas de 100.4 grado s Fahrenheit o 38 grado s cent fgrado s). Tambien deberia pensar en buscar te rapia si esta deprim ida, t iene pensam ientos suicidas o siente algun otro t ipo de angustia psicol6gica despu es de haber ten ido un aborto . • Tiene dificu ltad es para respirar o le falta el aliento . • Siente dolor en el pecho. 1 • O'Rahil/y & Muller. The Embryonic Human Brain: An Atlas of Developmental Stages . 1999 . Bellieni, C. V. (2012). Evaluaci6n de/ dolor en las fetas humanas y las bebes. The AAPS Journal , 14(3) , 456-461 . http:lldoi .org/10.12081 sl2248 -0l2 - 9354 -5. Ultimo consulta: 6/JUN/2016. Sadler TW, Langman 's Medical Embryology . 12th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2011. Citas sabre el desarrallo de/ feta Congreso Americana de Obstetras y Ginec6/ogos (ACOG).Preguntas frecuentes de/ ACOG156: Como crece su bebe durante el embarazo. Disponible en: http:llwww.acog .org/PatientslSeorch -Patient Education -Pamphlets -Spanish/Files/ Como -crece-su-bebe- durante -elembarazo. Ultimo consulta: 6/JUN/2016. Co/egio Americana de Obstetros y Ginec6/ogos. Your Pregnancy and Childbirth : Mon th to Month-How Your Baby Grows. [Sitio web]. Disponibles en: https:llwww .yourpregnancyandchildbirth.com/month _ guide .php . Ultimo consulta: 06/JUN/2016 . Carlson BM. Human Embryology and Developmental Biology; 5th ed. Philadelphia , PA: Saunders, una publicac i6n de Elsevier, Inc.; 2014 . Cunningham FG,Leveno KJ, Bloom SL, et al. Fetal growth and development. De: Cunnigham FG,Levena KL, Bloom SL, et o/, eds. Williams Obstetrics. 24th ed. New York, NY: McGraw-Hill; 2014: capftulo 7. England MA. Life Before Birth. 2nd ed. Tavistock Square, Landon: Mosby-Wolfe; 1996. Larsen's Human Embryology. 4th ed. Philadelphia, PA: Churchill Livingstone, una pub/icaci6n de Elsevier, Inc.; 2009 . Moore K, Persaud TVN, Torchia MG. The Developing Human : Clinically Oriented Embryology . 9th ed. Philadelphia , PA: Saunders, una publicoci6n de Elsevier, Inc.; 2011. National Museum of Health and Medicine Human Development Anatomy Center Developmental Anatomy . Developmental Anatomy (Carnegie Stages of Development). http:llwww.medicalmuseum.mil/ index.cfm?p : collection s.hdac.anatomy.index. Ultimo consulta: 10/ JUN/2016 . "' Pazo/ K, Creanga AA, Jamieson DJ; Centros de Control y Prevenci6n de Enfermedades (CDC). (2015), Abortion Surveillance - United States, 20 12. Maternal Mortality Weekly Review Surveillance Summaries . 64(10):1 -40. Dispanible en: http:llwww.cdc .gov/mmwrlpreviewl mmwrhtml/ss 6410al .htm?s_cid: ss64l0a_e . Ultimo consulta: 101 SEP/2016. 1 ' Estudios a gran escala de registros de salud publica en Dinamarca y Finlandia donde se afrec en abor t os financiados par el gobierno, hon demo strado un mayor riesgo de muerte . Reardon DC, Coleman PK. Short and long term mortality rotes associated with first pregnancy outcome : Population registe r based study for Denmark 1980 -2004. (2012) Med Sci Monit 2012;18(9):PH 71 - 76. Gissler M, Berg C, Bouvier- Co/le MH, Buekens P. Pregnancy- associated mortality a~ er birth , spontaneous abortion or induced abortion in Finland , 1987 -2000. (2004) Am J Ob Gyn:190:422-4 2 7. Citas sabre el cancer de seno: Huang, Y., Zhang, X., Li, W. et al. (2014). A meta -analysis of the association between induced abortion and breast cancer risk among Chinese femal es. Cancer Causes Control, 25: 22 7. Jiang AR, Gao CM, Ding JH, et al. (2012). Abortions and breast cancer risk in premenopausa/ and postmenopausal women in Jiangsu Province of China. Asian Pac J Cancer Prev., 13:3 3-3 5. Karnath R, et al. (2013). A study an risk factors of breast cancer among pati ents attending th e tert iary care hospital in Udupi dist rict . Indian J Community Med, 38( 2) 95-99. NIH NLM Medline Plus. Fetal Development. [Sitia web]. Disponible en: http:llwww.nlm.nih.gov/medlinepluslencylorticle/002398.htm. Ultimo consulta: 21/AG0/2016 . Michels KB, Xue F, Co/ditz GA, Willett WC. (2007). Induced and spontaneous abortion and incidence of breast cancer among young women: a prospective cohort study. Archives of Internal Medicine; 16 7(8):81 4- 820. Office on Women's Health . Pregnancy . [Sitio web]. Disponible en: http :l l wamenshealth .govlp regnancylindex .html . Ultimo consulta : 2 11 AG0/2016. Reeves GK, Kan SW,Key T, et al. (2006). Breast cancer risk in relation ta abortion: results from the EPIC study . International Journal of Cancer; 119(7):1 741- 1745. De artamento Estatal de Servicios de Salud (DSHS) de Texas pVERSIGHT EXT-18-248-D-000224 ,; ,;; Aborto formocol6gico: '' Legrado y extrocci6n: Administroci6n de Alimentos y Medicomentos de EE. UU. Mifeprex Medication Guide. 2016. http://www.occessdoto.fdo.gov/drugsotfdo _ docs/label/20161020687s020/bl.pdf. Ultimo cansulta: 10/SEP/2016. American Congress of Obstetric ions and Gynecologists. (2013, reaffirmed 2015). ACOGPractic e Bulletin No. 135: Second-trimester abortion. Obstetrics & Gynecology; 121(6):1394 -4 06. Texas Medical Disclosure Panel. (2016) List A. Procedures Requiring Full Disclosure of Specific Risks and Hazards, #13 (Surgical abortion/ dilation and curettogeldilotion and evacuation) and 14 Medico/ abortion/non-surgical. Disponible en: http://www.dshs.texas.gov/ focilitieslmedicol -disclosurellows -rules.ospx. Ultimo consulto: 101 SEP/2016. TexasMedical Disclosure Panel. (2016) List A, Procedures Requiring Full Disclosure of Specific Risks and Hazards, # 13 (Surgical abortion/ dilation and curettage/dilation and evacuat ion) and 14 Medico/ abortion/non -surgical. Dispanible en: http://www.dshs.texas.gov/ focilitieslmedicol -disclosurellows -rules.ospx. Ultimo consulto: 101 SEP/2016. Legrodo par succi6n: Royal College of Obstetricians and Gynaecologists (RCOG).The care of women requesting induced abortion. London (England): Royal College of Obstetricians and Gynaecologists (RCOGJ;2011 Nov. 130 p. (Evidence -based Clinical Guideline; no. 7). http:llwww.rcog.org.ukl womens-healthlclinica/ -guidancelcare-wamen -requesting -induced obortion. Ultimo consulto : 6/JUN/2016. Texas Medical Disclosure Pone/. (2016) List A, Procedures Requiring Full Disclosure of Specific Risks and Hazards, #13 (Surgical abortion/ dilation and curettage/dilation and evacuation) and 14 Medical obortionlnon -surgico/. Disponible en: http://www.dshs.texos.gov/ facilitieslmedicol -disclosurellows -rules.ospx. Ultimo consulta: 10/ SEP/2016. x Royal College of Obstetricians and Gynaecologists (RCOG).The care of women requesting induced abortion. London (England): Royal College of Obstetricians and Gynaecologists (RCOG);2011 Nov. 130 p. (Evidence -based Clinical Guideline; no. 7). http://www.rcog.arg.uk/ womens-heolthlclinicol-guidancelcore -women-requesting -induced abartian. Ultimo consulta: 6/JUN/2016. '" Clork SL, Belfort MA, Dildy GA, Herbst MA. Meyers JA. Hankins GD. (2008). Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. American Journal af Obstetrics and Gynecology; 199(1):36 .e1-5. Royal College of Obstetricians and Gynaecologists (RCOG). The core of women request ing induced abortion. Landan (England): Royal College of Obstet ricians and Gynaecologists (RCOG);2011 Nov. 130 p. (Evidence- based Clinical Guideline; no. 7). http://www.rcog. org.uk/womens -healthlclinical-guidance/care -women-requesting induced -obortion. Ultimo consu/to: 6/JUN/2016. TEXAS HealthandHumanServices TexasHealthandHuman Services Commission TexasDepartment of State HealthServices www.dshs.texas.gov/wrtk Departamento Estatal de Servicios de Salud de Texas Publicaci6n numero 1-450A • Revisada en diciembre de 2016. EXT-18-248-D-000225 AMERM l? TEXAS Healthand HumanServices TexasHealthand Human ServicesCommission TexasDepartmentof State HealthServices All rights reserved, 2016. Texas Department of State Health Services. Revised December 2016. Color pictures representing the development of the child at two-week gestational increments: Peg Gerrity, www.peggerrity.com. EXT-18-248-D-000228 You are pregnant and want to know everything you can about the options you have. You have a right to know the truth. This booklet provides important information about the baby that is growing in your womb and the resources available to you during and after your pregnancy. You need good information in order to make important decisions about your pregnancy and your life. You have the right to make these decisions freely . No one else should make them for you. No one can force you to have an abortion, not even your parents or the father of your baby. If you are feeling pressure (also called coercion) from someone to have an abortion, you have options. Talk to your doctor, counselor or spiritual adviser about your feelings, and ask for a phone to call 9-1-1 for immediate help. If you are a victim of human trafficking (that is, if you are forced to provide labor or have sex for money) , call the National Human Trafficking Resource Hotline at 888-373-7888. If you are reading this because you are already considering an abortion, the doctor who agrees to perform the abortion must first perform a sonogram, allow you to see your baby, describe the features that can be seen and have you listen to the heartbeat if it can be heard. The doctor must wait at least 24 hours before performing the abortion so that you can consider all the facts and make this important decision freely. Only you have the right to decide what to do. You and your doctor should talk openly and privately . You have the right to ask questions and know as much as you can. The best way for you to understand these risks is to share your health history with your doctor and discuss the risk of each option in light of your personal health history and needs. Some things you should discuss with your doctor include: • Your personal health history. • How long you have been pregnant. • The medical risks of having an abortion. 1 1 • The medical risks of carrying a pregnancy to term. • The many public and private agencies that will help new mothers through pregnancy, childbirth and motherhood, including nearby adoption agencies and free sonogram services, which provide pictures of the baby in your womb. • Money and other types of support available to new mothers. Take whatever time you need to read this booklet and talk to other people you trust. You might speak with a family member, a spiritual or professional counselor, a close friend, your spouse, your partner or the father of the baby. You deserve the advice and support of those you trust, and you are strongly urged to ask for their advice and guidance before you make decisions that affect your pregnancy. You will need the support of those closest to you, whatever you decide. The decisions you make about your pregnancy are very important - you have the right to make them based upon your values, your beliefs and your health care needs. You can view additional materials online at www.dshs.texas.gov/wrtk.* This website is secure. No one from the Texas Department of State Health Services (DSHS) will collect or record any information about you. If you are under 18 years old, Texas law requires a doctor to notify your parent or guardian before you can have an abortion. In most cases, the parent or guardian must give consent unless a waiver is given. If you are a minor, ask the doctor or facility for the booklet, So You're Pregnant, Now What?, which discusses this part of the law. This booklet is available at www .dshs.texas.gov/ adolescent/resources.shtm. If your rights as explained in this booklet are not being protected or you notice illegal or unsanitary facility conditions, you may call or email your complaint here: 888-973-0022 or hfc.complaints@dshs.texas.gov. *Note: A Woman's Right to Know: Resource Directory (www.dshs.texas.gov/wrtk) lists information on certain programs and services that can be provided to women during pregnancy, childbirth and as the child is growing up. The booklet contains names, addresses and H T hane numbers of these program s. The Resource Directory also has information about publi c and private adoption agencies. IRSIG , • The alternatives to abortion, including adoption. EXT-18-248-D-000229 Fetal Pain Newborn babies are able to feel pain. We know that babies develop the ability to feel pain while in the womb. In consideration of the potential for fetal pain, Texas law currently limits abortion to under 20 weeks.; The next section shows the changes seen as a baby develops inside the mother 's body during pregnancy.iiThis period is called gestation and can be measured in two ways, both of which are noted in the following pages: • The number of weeks since the start of the last normal menstrual cycle (weeks of gestation). • The number of weeks since the estimated date of conception, around two weeks after the start of the last normal menstrual cycle. Usually , your baby's due date is estimated to be 40 weeks after the start of your last normal menstrual cycle. Conception Your baby began developing at the moment of conception - when your unfertilized egg cell (ovum) met and fused with the sperm cell of the baby 's father. At that moment, your ovum provided half of the baby's genes (the inherited genetic material passed through DNA) and the father 's sperm cell provided the other half. Once combined together, this material provided all of the genetic information needed to complete your baby's development in your womb. In a full -term pregnancy, the cycle of deve lopment begins with the fertilized egg and is complete about 38 weeks later when the baby is ready to be born. These illustrations show the changes ta king place as the baby develops from the moment of conception onward. 4 Weeks of Gestation (2 weeks after conception) • Your baby is scientifically referred to as an embryo. • The cells that will become vita l organs, such as the future heart and brain, are developing. • The blood vessels begin to form. • Your baby's weight is less than 1 ounce and length is less than 1/8 inch. 6 Weeks of Gestation (4 weeks after conception) • Your baby's heart begins to form. The heart starts to beat. • The brain and the spinal cord begin to form. • The lungs, liver, stomach and other major organs begin to form . • The arm and leg buds (the structures that will become the limbs) are present . • The eyes and ears begin to form. • Your baby is less than 1/4 inch long. Texas De artment of State Health Services (DSHS) pVERSIGHT EXT-18-248-D-000230 8 Weeks of Gestation (6 weeks after conception) • Your baby's developing heart beats with a regular rhythm. • Facial features - the eyes, nose, lips and tongue - start to form. • All essential organs have begun to form. • The spinal nerves begin to develop. • The brain continues to develop. • The arms and legs grow longer. • The fingers and toes are developing. • Sex organs are beginning to form. • Your baby is 1/2 inch long . 10 Weeks of Gestation (B weeks after conception) • Your baby has his or her first spontaneous movements (movements that happen on their own). • Elbows are formed , and fingernails appear. • The eyelids are more developed. • The external ears begin to take final shape. • Facial features continue to develop. • Cells that sense touch begin to form. • The nerves that will control your baby's organs are formed. • Activity in your baby's brain can be recorded. • After the end of this week, the baby is scientifically referred to as a fetus. • Your baby is about 1 ¼ to 1 ½ inches from head to bottom. 12 Weeks of Gestation (10 weeks after conception) • Your baby moves, but you cannot feel the movements . • All the body parts and organs are present and growing. • The heartbeat can be heard with electronic devices. • The body grows rapidly. • The body grows longer, and the neck lengthens. • The eyelids close and will not reopen until about the 28th week. • Fingernails appear. • Teeth buds begin to form. • Your baby weighs about half an ounce and is about 2 1/2 inches long from head to bottom. ll /\I\ RSIGHT EXT-18-248-D-000231 14 Weeks of Gestation [12 weeks after conception] • Your baby's taste buds are developing. • The arms and legs begin to move. • Hiccup movements are present. • The external sex organs are developed and are clearly either male or female. • Your baby can respond to skin contact. • Your baby is about 3½ inches long from head to bottom and weighs about 1 ½ ounces. 16 Weeks of Gestation {14 weeks after conception] • Your baby's swallowing and chest movements are clearly present. • The mouth makes sucking motions. • Hand-to-face movements are common. • The eyes are beginning to move. • Your baby is about 4¼ inches long from head to bottom and weighs less than 4 ounces. 18 Weeks of Gestation [16 weeks after conception] • You may feel the movements of your baby's arms and legs. • The kidneys are functioning and make urine. • Taste buds are present. • The skin is wrinkled. • Features further develop - eyelids , ear and upper lip. • Your baby is about S½ inches long from head to bottom and weighs about 7 ounces. Texas De artment of State Health Services (DSHS) pVERSIGHT EXT-18-248-D-000232 20 Weeks of Gestation (18 weeks after conception) • Your baby is more active, moves about every minute, and you can feel the movements. • Breathing-like movements become regular and can be seen by ultrasound. • The structures of the ears are well-developed. Your baby can hear and respond to a growing range of sounds. • Hair begins to grow on the head. • All skin layers and structures are present, including hair follicles and glands. • Your baby can swallow at the end of this week. • Ovaries containing eggs are present in females and testes begin to descend in males. • Meconium (a greenish mixture of swallowed cells and secretions) begins to form in the intestinal tract. This will be your baby's first bowel movement. • Your baby weighs about 11 ounces and is about 6 inches from head to bottom. 22 Weeks of Gestation (20 weeks after conception) • Your baby sleeps and wakes regularly. Your baby can be awakened from sleep by noises and your movements. • The eyelids and eyebrows are formed. • The vocal cords are developing. • The nervous system continues to develop. • Movements become more coordinated. • The heartbeat can be heard with a stethoscope. • The body is covered with fine hair called lanugo. • Your baby weighs about 1 pound and is about 7 to 7 ½ inches in length from head to bottom. 24 Weeks of Gestation (22 weeks after conception) • Your baby will blink and startle (pull in arms and legs) if stimulated. • Skin is wrinkled and red. • The senses of smell and taste are developed. • A baby born at this time will attempt to breathe, but the lungs are not fully developed. • Your baby weighs about 1.4 pounds and is about 8 inches from head to bottom. 11C/\1 RSIGHT EXT-18-248-D-000233 26 Weeks of Gestation (24 weeks after conception) • Your baby's developing lungs are now fully formed but are not yet ready to function outside the womb. • The lines on the skin of the fingers (future fingerprints), toes, palms of the hands and soles of the feet are now formed. • Your baby weighs about 1.8 pounds and is about 9 inches from head to bottom. 28 Weeks of Gestation (26 weeks after conception) • Your baby's brain and nervous system are formed and continue to develop. • The lungs and digestive system are formed and continue to develop. • The eyes are partially open, and eyelashes are present. • Your baby weighs about 2.2 pounds and is almost 10 inches from head to bottom. 30 Weeks of Gestation (28 weeks after conception) • Your baby kicks and stretches. • Your baby makes grasping motions and responds to sound. • The nervous system controls some body functions. • Your baby weighs about 2.9 pounds and is more than 10 ½ inches from head to bottom. 32 Weeks of Gestation (30 weeks after conception) • Your baby gains weight, and the body fills out. • Toenails and fingernails are growing. • The pupils will react to light. • Your baby weighs about 4 pounds and is almost 11 inches from head to bottom. Texas De artment of State Health Services (DSHS) pVERSIGHT EXT-18-248-D-000234 34 Weeks of Gestation (32 weeks after conception) • Your baby is active (moving) 60 percent or more of the time. • Bones harden, but the skull remains soft and flexible for delivery. • Your baby has rhythmic breathing movements, and the lungs continue to develop. • Your baby weighs about 4.6 pounds and is almost 12 inches from head to bottom. 36 Weeks of Gestation (34 weeks after conception) • Your baby rapidly gains weight in preparation for birth. • The body and face fill out; the skin no longer appears wrinkled. • The fingernails reach the ends of the fingertips. • Large amounts of immune factors (substances in the blood that protect against disease or infection) are passed from you to your baby during the last four gestational weeks. • Your baby weighs about 5.5 pounds and is about 12 ½ inches from head to bottom. 38 Weeks of Gestation (36 weeks after conception) • Your baby's lungs and brain are developing rapidly. • Your baby can grasp firmly. • Your baby weighs about 6.4 pounds and is about 13 1/3 inches from head to bottom. 40 Weeks of Gestation (38 weeks after conception) • Your baby is fully developed and considered full-term. • The brain and nervous system will continue to develop after birth. • Your baby's toenails have reached the tips of the toes. • Small breast buds are present. • The fingernails extend beyond fingertips. ll /\ • Your baby weighs about 7.5 pounds and is about 14 inches from head to bottom. RSIGHT EXT-18-248-D-000235 This section describes the risks associated with an abortion. The risks of having an abortion can vary depending on several factors. Death You have a greater risk of dying from the abortion procedure and having serious complications the further along you are in your pregnancy. The Centers for Disease Control and Prevention (CDC) recently reported 0.73 legal abortion-related deaths per 100,000 reported legal abortions in the United States from 2008-2011.;;; Studies of other highly developed countries have shown a higher mortality rate from legal abortion. iv diarrhea, warmth or chills, headache, dizziness and fatigue (feeling very t ired). Abortions and miscarriages (also called spontaneous abortions) can result in complications such as injuries to the internal organs, blood clots or serious infect ions. These will be listed in detail for each type of abortion later in this booklet. Mental Health Risks Women report a range of emotions after an Physical Risks Additionally, abortion could result in physical side effects, with different levels of severity. A woman will usually have cramping and vaginal bleeding after any type of abortion procedure. Other symptoms or side effects include nausea (feeling sick to your stomach) or vomiting, Texas De artment of State Health Services (DSHS) pVERSIGHT abortion. This can include depression or thoughts of suicide. Some women, after their abortion, have also reported feelings of grief, anxiety, lowered self-esteem, regret, sexual dysfunction, avoidance of emotional attachment, flashbacks and substance abuse. For some women, these emotions may appear immediately after an abortion or gradually over a longer period of time. EXT-18-248-D-000236 These feelings may recur or be felt more strongly at the time of another abortion, a normal birth or on the anniversary of the abortion. It is important to talk to your doctor if you experience these feelings. Women with a history of mental health problems are more likely to have mental health problems following an abortion. These women may need additional support. Counseling or support before you make a decision to have an abortion is very important. If family help and support are not available to you, talking with a spiritual or professional counselor before having an abortion can help you better understand your decision. Many pregnancy resource centers can provide counsel to you. These centers are listed in the resource directory. Future Infertility The further along you are in your pregnancy, the greater the chance of serious complications that can cause you to be infertile and the greater the risk of dying from the abortion procedure. Some complications associated with an abortion, such as an infection, a cut or a torn cervix, may make it difficult or impossible to become pregnant in the future or to carry a pregnancy to term. Breast Cancer Riskv Your pregnancy history affects your chances of getting breast cancer. If you give birth to your baby, you are less likely to develop breast cancer in the future. Research indicates that having an abortion will not provide you this increased protection against breast cancer. In addition , doctors and scientists are actively studying the complex biology of breast cancer to understand whether abortion may affect the risk of breast cancer. If you have a family history of breast cancer or breast disease, ask your doctor how your pregnancy will affect your risk of breast cancer. ll /\~ RSIGHT EXT-18-248-D-000237 You need to know as much as you can about your options in order to make an informed decision. Each option has possible risks and benefits . There are counseling services available to help you fu lly understand your options and make your decision. Before an Abortion You should ask you r doctor about any risks you might face. It is your right and your doctor's responsibility to make sure you are info rmed before deciding to have an abort ion. Here are some things the doctor should talk to you about: • You will find out for sure if you are pregnant and how long you have been pregnant. Your doctor will also do a pelvic exam. • Your doctor will evaluate your health and discuss medical risks of having an abortion. You will have a physical exam, be asked about • If you are under the age of 18, a parent or guardian must be notified and agree to the abort ion, or you will have to ask a judge to waive that notificat ion and consent requirement. • The doctor performing the abortion must prov ide you with the Texas Department of State Health Services (DSHS)A Womans Right to Know printed materials and let you know that the materials are available on the DSHS website . You will have at least a full day to read the information your doctor gives you before the appointment for your abortion . You must sign a wr it t en consent for t hat abortion . and private counseling organizations that • Your doctor must provide you with a telephon e number that you can call 24 hours a day to talk with the doctor or other healthcare personnel about any complications or quest ions related to the abortion and the name and telephone number of the hosp ital that is closest to your home where you could be treated in the case of an abortion-related emergency. provide sonogram services (images of the • Your doct or may offer you a medical abortion , your medical history and have lab tests done. The doctor wi ll answer any questions you might have. • Your doctor will describe the baby growing in your womb to you and give you a list of agencies that offer alternatives to abortion , including adoption , and t he names of agencies baby in the womb or ultrasound ). Some organizations provide sonograms for free. If you decide to have an abortion: • At least 24 hours before an abortion is performed, the doctor will give you an which is a medication given to cause an abortion. If a medical abortion is performed , your doctor must provide you with a copy of the final pr inted label of any abort ion- inducing drugs used in the procedure. sonogram and tell you what you are seeing, including the size of your baby and any heartbeat , limbs and internal organs. The doctor is required to show you the sonogram picture while it is being performed . You may choose not to view these images of your baby. You have the right to view your sonogram at any t ime. Texas De artment of State Health Services (DSHS) pVERSIGHT EXT-18-248-D-000238 Medical and Social Assistance Your doctor must give you certain important information before the abortion can be done, including: • Medical assistance benefits that can help with prenatal care, childbirth and neonatal care. • The legal responsibilities of the baby's father in helping to support your child if you decide to stay pregnant and keep the baby. The law says he must help even if he offered to pay for an abortion. • Public and private agencies that can help you if you were raped or a victim of incest. • Public and private agencies that can give you information about preventing pregnancies and medical referrals for birth control methods. station, licensed child-placing agency or any hospital. You do not have to return for the baby, and you will not be charged with a crime if the baby is unharmed. Child Support Services Assistance in Obtaining Child Support Your child's father is legally required to pay to support the child , and the Texas Office of the Attorney General can assist you in obtaining this support. The Attorney General's Child Support Division can help locate missing fathers, legally prove who the father is, initiate child support orders and collect child support payments . Texas is the top-performing state in terms of ensuring parents pay what they owe, with more than $3.9 billion disbursed to families in 2015 alone. Texas has a high collection success rate: 65.2 percent of all child You should know that if you choose to have your baby and find yourself weighed down by the job of being a parent , Texas has the "Baby Moses/Safe Haven" law. The law allows you or the baby 's father to leave a baby who support amounts due are collected. If you need services, call 800-252-8014 or visit www.texasattorneygeneral.gov/cs. If you are a survivor of family violence, there are steps you can take to pursue child support safely . appears to be under 60 days old in the care of a designated emergency care provider such For more information, visit as an emergency medical services station, fire www.getchildsupportsafely.org. EXT-18-248-D-000239 Ask your doctor for a copy of the ''A Woman's Right to Know: Resource D1rectory.11 "' EXT-18-248-D-000240 ■®fflll,i•Ei,irffl,Jl,114,fltMfflt,J, Adoption Services Another option to consider is adoption. Adoption means you, as the birth parent, are voluntarily transferring your rights as the parent of your baby to another family. Choosing adopt io n means you want your baby to have a good life, that you can choose for your baby. An open adoption allows you to stay in contact with your baby as he or she grows up, perhaps through pictures, phone calls or visits. A closed adoption means there will be no contact between you and the family adopting your baby once the adoption but right now may not be the best time for you is finalized. What type of adoption you want is to be a parent. entirely up to you. Adoption is a brave, loving choice for your baby. Talk with a family member, a spiritual or When you place your baby for adoption, you are professional counselor, or a close friend to seek placing him or her with lovi ng parents who can their advice on adoption. Since adoption is a big raise your baby to have the good life that you decision, you may want the support of those you want for your baby. trust when making this decision. There are many resources available to help you It is never too late to choose adoption for your decide whether adoption is the right choice for baby. You can make this choice anytime during you and your baby. Each adoption is different, your pregnancy or even after your baby has and help is available to make sure that the been born. adoption process fits you and your baby's needs. If you choose adoption, you may be able to You can find more informat ion about adoption and organizations that offer adoption services at select and meet the family who will adopt your www.dfps.state.tx.us/Adoption_ and_Foster_ Carel baby. There are two different types of adoptions About_Adoptionl. 11C/\~ RSIGHT EXT-18-248-D-000241 The types of abortion procedures include medical abortions and surgical abortions . A woman will usually have cramping and vaginal bleeding after any type of abortion procedure. There are other symptoms or side effects that may occur with any type of abortion procedure . These can include nausea (feeling sick to your stomach) or vomiting , diarrhea, warmth or chills, headache, dizziness and fatigue (feeling very tired). Also, other serious complications sometimes arise. This section will also discuss the risk of complications for each of the methods. First Trimester Abortions During the first tr imester (through 13 weeks of gestation) an abortio n can be performed through medicine or surgery. Medical (Nonsurgical) Abortion Medical abortion uses medic ine to end a pregnancy instead of surgery and is used ear ly in pregnancy - 70 days (10 weeks) or less from the first day of your last menstrua l per iod . This method requires severa l visits to your doctor. The medicines used for a medica l abor t ion cause bleed ing, cramping and passing of the fetus and other tissue. In some cases, excessive bleeding may require blood transfusions , treatment with medication, surgery or saline transfusions. Severe infection is a known risk fol lowing a medica l abortion. Possiblecomplicationsor risksof a medical abortion usingmifepristoneand misoprostolpills:vi • Less than 3 percent of procedures will not work and will result in a surg ical procedure to end the pregnancy or complete the abortion . • In about every 4 of 100 pro cedures , medicat ions are needed to control bleeding. • About 1 of every 100 procedures wil l requ ire a surgical procedure to stop bleeding and to remove parts of the baby and the placenta. • In up to 5 of every 1,000 procedures, blood transfusions will be admi nistered. • Failure to remove all parts of the baby and other t issue, including the placenta, may requ ire a fo llow-up surgica l procedure. • Increased risk of inferti lity (the inability to have a baby) may result if complicat ions occur with the procedure. • In 2 of every 1,000 procedures , serious bact erial infect ions have been reported . Rarely, severe infect ion after a medical abortion has resulted in death . • More than 15 of every 100 women with a medical abortion will experience nausea, weakness, fever/chills , vom iting, headache, diarrhea or dizzin ess. • About 3 to 5 of every 100 procedures results in a visit to the emergency room. • In up to 6 of every 1,000 procedures, hospitalization related to med ical abort ion w ill be required . • Hemorrhaging (heavy bleeding) may occur. Texas De artment of State Health Services (DSHS) pVERSIGHT EXT-18-248-D-000242 Who should not have a medical abortion? Some women should not have a medical abortion. Some reasons a medical abortion would not be done include: problems that would make a medical abortion unsafe for you. • It has been more than 70 days (10 weeks) since the first day of your last menstrual period. When having a medical abortion, your doctor will give you mifepristone (formerly called RU • You are allergic to one of the medications 486 and now often referred to by the brand name Mifeprex®J during an office visit. It is to be used. • You have or might have a tubal or ectopic pregnancy (where the baby grows outside of the uterus). • You have an intrauterine contraceptive device (IUD). The IUD must be taken out before a doctor can give you the medicine. • You have been taking certain types of medicines, like blood thinners or certain steroids. • You have a particular medical condition, like uncontrolled seizures or a bleeding disorder. • You have problems with your adrenal glands (chronic adrenal failure). • You cannot get to all of the visits needed to get the medicines to complete the abortion or cannot get to the checkup(s) needed after the abortion. • You cannot get to emergency care if needed in the two weeks after taking the medicines. ll /\~ You should discuss with your doctor whether you have any medical conditions or other RSIGHT taken by mouth . After receiving mifepristone, you will have vaginal bleeding and pass clots and fetal tissue. Bleeding usually lasts 9 to 16 days and may last up to 30 days. Your doctor will make an appointment for two days after you take mifepristone. If the medical abortion is not complete, you will be given a second drug, misoprostol. Misoprostol may cause cramps, nausea, diarrhea and other symptoms. Your doctor may send you home with medicine for these symptoms. Your doctor will make a follow-up appointment for you within 14 days of the day you take the medication. Your doctor will check your health for any symptoms you may be experiencing , as well as whether your pregnancy has completely ended. Make sure to discuss any physical and emotional symptoms you are experiencing with your doctor. Before your follow-up appointment, you may need to seek immediate medical attention if you experience severe symptoms. EXT-18-248-D-000243 First Trimester Abortions (cont.) Suction Curettage (Surgical Abortion) The most common type of abortion is the suction curettage, sometimes called a dilation and curettage, or vacuum curettage. Most women will have some pain with this • Increased risk of infertility (the inab ility to have a baby), if complications occur with the procedure • Infection , which is usually caused by an infection the woman already had at the time of the abortion procedure. Before the procedure, you may be given pain medication, a sedative or both. For the procedure , you may receive local anesthesia injected or applied in the area of the cervix. You may also receive general anesthesia that will put you to sleep so that you do not feel pain during the procedure . The doctor inserts a speculum to hold open the vagina, as is done for a pelvic exam, and injects or applies local anesthesia. The cervix is stretched open. Then the contents of the uterus, including the baby and placenta, are removed using a suction device that is inserted into the uterus. The procedure usually takes 10 to 15 minutes, but can take longer depending upon the growth stage of the baby. Possible complications or risks of suction curettage include:vii • Hemorrhaging (heavy bleeding) with possible emergency hysterectomy (removal of the uterus) to end the bleeding • Perforation of the uterus (a hole in the uterus) • Injury to the bowel or bladder , if there is a perforation of the uterus • Abdominal incision and operation to correct injury • Failure to remove all parts of the baby and other tissue , in cluding the placenta , which may require another procedure (occurs in fewer than 5 per 100 procedures, or less than 5 percent) viii Texas De artment of State Health Services (DSHS) pVERSIGHT EXT-18-248-D-000244 eifiiM11,jz.tk4,jii14ii.f,fflt¥UffiGtE--Second Trimester Abortions During the second trimester (be t ween 13 weeks of gestat ion and 22 weeks of gestation) an abor t ion can be performed by a surgical method known as dilation and evacuation .* Dilation and Evacuation of pregnancy, the baby, placenta and other Most second trimester abortions are done by conten t s of the womb may be removed piece by dilation and evacuation (D&E). This surgical piece using surgical instruments. This procedure procedure is usually performed in a surgical usually takes less than one hour. center or hospital. Before this procedure, the doctor will prepare the cervix. This process softens and stretches open the cervix and may require one or more visits. The softening and opening of the cervix before performing the D&E helps decrease the risk of tears or lacerations to the cervix. Possible complications or risks of a D&E include:• • Death, in rare cases • Cervical lacerat ion (tears or injury to the cervix) • Hemorrhaging (heavy bleeding) with possib le emergency hysterectomy (removal of the uterus) to end the bleeding Most women will experience some pain with • Perforation of the uterus (a hole in the uterus) this procedure. Before the procedure you may • Injury to the bowe l or bladder, if there is a perforation of the uterus be given pain medicine, a sedative or both. For the procedure, you may receive local or regional anesthesia injected or applied in the area of the cervix . You may also receive general anesthes ia tha t will put you to sleep during the procedure . Your doctor will discuss your options, and any • Abdomina l incision and operation to correct injury • Failure to remove all parts of the baby and other tissue, including the placenta, which may require another procedure risks, for anesthesia. • Increased risk of infertility (the inability to At the beginning of the procedure, the doctor wi ll make sure that the cervix is open. The fluid have a baby), if comp lications occur with the procedure surround ing the baby (amniotic fluid) will be • Embolism (a loose blood clot or amniotic fluid, removed with a suction device placed into the fet al cells, feta l hair or other matter in t he bloodstream that causes sudden blockage of blood flow to the lungs or other organ) uterus. The baby and placenta are removed from the uterus using surgical instruments. Finally, a suction device will be inserted into the uterus at the end of the procedure to remove any fetal tissue that remains. After 14 weeks * Note: Texas law states that abortion may not be performed after the post-fertilization age of 20 weeks or more, which is approximately 22 weeks or more of gestation, as gestation is defined in this booklet. Texas law allows for exceptions when the life of the mother is threatened, serious risk exists of irreversible impairment of a major bodily function [other than a psychological condition) or a severe fetal abnormality is present. 11C/\I\ RSIGHT EXT-18-248-D-000245 Pregnancy and childbirth Birth is a life-changing experience, and each birth brings a new and different set of experience s and feelings. Pregnancy and birth is usually a safe and natural process, although complications can occur. There are complicat ions associated with pregnancy and childbirth . The most common complications of pregnancy include: • Tubal or ectopic pregnancy (where the baby grows outside of the uterus) • High blood pressure problems, including the possible need to treat with an operation , medicine or blood transfusions • Death (very rare - 1.7 in-hospital deaths occurring after delivery per 100 ,000 vaginal deliveries during 2000-2006 xi) • Complicated delivery Cesarean Birth • Premature labor Possible side effects and risks : • Depression • Injury to the bowe l or bladder • Infect ion • Diabet es • Infertility (the inabi lity to have a baby) due to infection or comp lications • Hemorrhaging (heavy bleeding) • Hemorrhaging (heavy bleed ing) You can reduce the risk for prob lems or comp lications in any pregnancy by: • Getting early and regular prenatal care. • Eating a well-balanced diet and gett ing regular exercise. • Avoiding tobacco, alcohol or drugs that your doctor hasn't prescribed for you . During labor, the uterus contracts and pushes to de liver the baby. The baby may be de livered through the woman 's vagina or by a surgical procedure called cesarean section or c-section. Vaginal Delivery • Injury to the tube (uret er) bet ween the kidney and bladder • A possible hysterectomy (remova l of the uterus) due to complications or injuries • Complications from anesthes ia such as respiratory prob lems, headaches or drug reactions • Emergency treatment for any of the above problems , including the possible need to treat with an operation , medicine or blood transfusions • Death (very rare - 12 .7 in-hospit al materna l deaths per 100 ,000 cesarean deliveries occurring during 2000-2006 xi) Possible side effects and risks: • Injury to the bladder or rectum • A hole (fis t ula) between the bladder and ····........ ___ vagina or the rectum and vagina • Hemorrhaging (heavy bleeding) • Inferti lity (the inability to have a baby) due to infection or complicat ions • Emergency treatment for any of the above Texas De artment of State Health Services (DSHS) pVERSIGHT EXT-18-248-D-000246 Postpartum Symptoms The feelings you experience after birth may be the most intense you have ever encountered: great surges of joy and happiness, feelings of contentment and fulfillment. It is not uncommon for women to also experience fears, worries or sadness. Depression can occur after the birth occur up to 1 year after delivery but is typically apparent during pregnancy (SO percent of the time) and about 1-3 weeks after childbirth. PPD is characterized by intense feelings of sadness, anxiety or despair that prevents the new mother from being able function normally on a daily basis. of a baby, and many new mothers experience In rare circumstances you may have a fear of various degrees of it. While depression can occur harming yourself or your baby. You should call your doctor right away and discuss these within days after delivery, it can also appear gradually, and sometimes it doesn't start until a year after your baby's birth. In most cases, mothers have mild symptoms that symptoms. If your doctor is not available, call 9-1-1. Doctors can give you professional help and support during this time. may last only a few days. However, some mothers Women with a history of mental health problems experience severe symptoms that can include are more likely to have mental health problems exhaustion, feelings such as worthlessness or hopelessness, and memory loss. following birth. These women may need additional support. In some circumstances, you may be diagnosed If you have questions or concerns, be sure to talk with postpartum depression (PPD). PPD can with your doctor or other health care provider. EXT-18-248-D-000247 Call the facility or doctor that performed the abortion, or go to the emergency room if: • Heavy bleeding occurs (two or more thick • Pain is severe or not controlled by pain pads per hour for two hours in a row) or if you medication . are concerned about heavy bleeding. • You are disoriented . • You have stomach pain or discomfort, or feel Your doctor will schedule one or more follow- sick (such as feeling weak or having an upset up visits, usually beg inning within two to three stomach, nausea , vomiting or diarrhea), with weeks after t he procedure. Your doctor must or without fever, for more than 24 hours after schedule a follow-up visit within 14 days of a taking misoprosto l for a medical abortion. medical abortion . It is important that you keep all of your appointm ents. • You have a fever (higher than 100.4 degrees Fahrenheit or 38 degrees Celsius). You should also consider seeking counseling if you are experiencing depression, thoughts of • You have difficulty breathing or have shortness of breath. suicide or other psychological dist ress following your abortion. • You have chest pain. 1 Bellieni, C. V. [2012). Pain Assessment in Human Fetus and Infants. The AAPS Journal, 14(3), 456-461. http:lldai.orgl10.1208ls12248 -012 9354 - 5. Last accessed 61612016. • Fetal development citations American Congress of Obstetricians and Gynecologists. ACOG FAQ 156: How Your Baby Grows During Pregnancy Available: http:llwww.acag.org/~lmedia/For%20Patientslfaq156. pdf?dmc =l&ts =20130526T1157139676. Last accessed 611012016. "' Pazo/ K, Creanga AA, Jamieson DJ; Centers for Disease Contra/ and Prevention (CDC). (2015) , Abortion Surveillance - United States, 2012. Maternal Mortality Weekly Review Surveillance Summaries. 64(10):1 40. Available: http:l lwww.cdc.gov/mmwrlpreviewlmmwrhtm/lss64l Ool. htm?s_cid=ss6410o _e. Lost accessed 911012016. 1 • Reardon DC, Coleman PK. Short and long term mortality rates associated with first pregnancy outcome: Population register based study for Denmark 1980 -2004. (2012) Med Sci Monit 2012;18[9):PH 71 - 76. American Congress of Obstetricians and Gynecologists. Your Pregnancy and Childbirth: Month to Month-How Your Baby Grows. [Website]. Available: https:llwww.yourpregnancyandchildbirth.com/month_guide. php. Last accessed 0611012016 . Gissler M, Berg C, Bouvier - Co/le MH, Buekens P. Pregnancy -associated mortality a~er birth, spontaneous abortion or induced abortion in Finland, 1987 -2000. (2004) Am J Ob Gyn:190:422 -427. Carlson BM. Human Embryology and Developmental Biology; 5th ed. Philadelphia, PA: Saunders, an imprint of Elsevier, Inc.; 2014. Cunningham FG,Levena Kl, Bloom SL, et al. Fetal growth and development. In: Cunnigham FG, Levena KL, Bloom SL, et al, eds. Williams Obstetrics. 24th ed. New York, NY: McGraw-Hill; 2014: chap 7. England MA. Life Before Birth. 2nd ed. Tavistock Square, London: Mosby-Wolfe; 1996. Larsen 's Human Embryology. 4th ed. Philadelphia, PA: Churchill Livingstone, an imprint of Elsevier, Inc.; 2009. Moore K, Persaud TVN, Torchio MG. The Developing Human: Clinically Oriented Embryology. 9th ed. Philadelphia , PA: Saunders, an imprint of Elsevier, Inc.; 2011. Large -scale studies of public health records in Denmark and Finland , which provide state -funded abortion, hove shown a higher risk of death . ' Breast cancer citations: Huang, Y., Zhang, X., Li, w.et ol. (2014). A meta -onolysis of the association between induced abortion and breast cancer risk among Chinese females. Cancer Causes Control, 25: 227. Jiang AR, Gaa CM, Ding JH, et al. [2012). Abortions and breast cancer risk in premenopousal and pastmenopousal women in Jiongsu Pravmce of China. Asian Pac J Cancer Prev., 13:33 -35. Karnath R, et al. [2013). A study on risk factors of breast cancer among patients attending the tertiary care hospital in Udupi district. Indian J Community Med, 38(2)95 -99. National Museum of Health and Medicine Human Development Anatomy Center Developmental Anatomy. Developmental Anatomy [Carnegie Stages of Development). http://www.medicalmuseum.mil/ index.cfm?p =callections.hdac.anatamy.index. Last accessed 611012016. Michels KB, Xue F, Co/ditz GA, Willett WC. (2007). Induced and spontaneous abortion and incidence of breast cancer among young women: a prospective cohort study. Archives of Internal Medicine; 167(8):814-820. NIH NLM Medline Plus. Fetal Development. [Website]. Available: http:llwww.nlm.nih.govlmedlinepluslencylorticlel002398.htm. Last accessed 8/2112016. Reeves GK, Kan SW,Key T, et al. (2006). Breast cancer risk in relation ta abortion: results from the EPICstudy. International Journal of Cancer; 119(7):1741-1745. Office on Women's Health . Pregnancy. [Website] . Available: http :// womensheolth.gavlpregnoncylindex.html. Lost accessed 0812112016. O'Rohilly & Muller. The Embryonic Human Brain: An Atlas of Developmental Stages. 1999. Sadler TW, Langman 's Medical Embryology. 12th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2011. Texas De artment of State Health Services (DSHS) pVERSIGHT EXT-18-248-D-000248 ,; •• ;, D&E: Medical abortion: U.S. Food and Drug Administration. Mifeprex Medication Guide. 2016. http:llwww.accessdata.fda.gov/drugsatfda _docs/ label/2016/020687s020lbl.pdf Last accessed 9110/2016. American Congress of Obstetricians and Gynecologists. (2013, reaffirmed 2015). ACOGPractice Bulletin No. 135: Second-trimester abortion. Obstetrics & Gynecology; 121(6):1394 -4 06. Texas Medical Disclosure Panel. (2016) List A. Procedures Requiring Full Disclosure of Specific Risks and Hazards, #13 (Surgical abortion/ dilation and curettage/dilation ond evacuation) and 14 Medical abortion/non-surgical. Available from: http://www.dshs.texas. govlfocilitieslmedical -disclosurellaws -rules.aspx. Last accessed 9/10/2016. TexasMedical Disclosure Panel. (2016) List A, Procedures Requiring Full Disclosure of Specific Risks and Hazards, # 13 (Surgical abortion/ dilation and curettage/dilation and evacuation) and 14 Medical abortion/non-surgical. Available from: http://www.dshs.texas.gov/ facilitieslmedical -disclasurellows -rules.aspx. Last accessed 9110/2016. Texas Medical Disclosure Panel. (2016) List A, Procedures Requiring Full Disclosure of Specific Risks and Hazards, #13 (Surgical abortion/ dilation and curettage/dilation and evacuation) and 14 Medical abortion/non -surgical. Available from: http://www.dshs.texos. govlfocilitieslmedical -disclosurellaws -rules.aspx. Last accessed 9/10/2016. Royal College of Obstetricians and Gynaecologists (RCOG).The care of women requesting induced abortion. London (England): Royal College of Obstetricians and Gynaecologists (RCOG);2011 Nov. 130 p. (Evidence-based Clinical Guideline; no. 7). http://www.rcog.arg.uk/ womens-healthlclinical-guidancelcare-women-requesting -i nduced abartian. Last accessed 6/6/2016. '" Royal College of Obstetricians and Gynaecologists (RCOGJ.The care of women requesting induced abortion. London (England): Royal College of Obstetricians and Gynaecologists (RCOG);201 l Nov. 130 p. (Evidence -based Clinical Guideline; no. 7). http:llwww.rcog.arg.uk/ womens-healthlclinical -guidancelcare -women-requesting -inducedabortion. Last accessed 6/6/2016. Suction cutterage: ' Clark SL, Belfort MA, Dildy GA, Herbst MA, Meyers JA, Hankins GD. (2008). Maternal death in the 21st century: causes, prevention, ond relationship to cesarean delivery. Amer ican Journal of Obstetrics and Gynecology; 199(1):36.e 1-5. Royal College of Obstetricians and Gynaecologists (RCOG). The core of women requesting induced abortion. Landan (England): Royal College of Obstetricians and Gynaecologists (RCOG);2011 Nov. 130 p. (Evidence-based Clinical Guideline; no. 7). http://www.rcog. org.uk/womens-healthlclinical-guidance/care-women-requestinginduced -abortion. Last accessed 616/2016. TEXAS HealthandHumanServices Texas HealthandHuman Services Commission Texas Department ofState HealthServices www.dshs.texas.gov/wrtk Texas Department of State Health Services Publication number 1-450 • Revised December 2016. EXT-18-248-D-000249 To: " Bowman, Matthew (HHS/OGC) " Subject: FW: Update on pregnant UAC? - Request for Addit ional Information Date: 20 17/10/31 22:40 :44 Priority: Normal Type: Note Privileged-legal advice Matt, please advise as to legal issues: Jessica, b)(5) /\MEf ll Al\ pVERSIGHT EXT-18-248-D-000251 (b)(5) From: White, Jonathan (ACF) Sent: Tuesday, October 31, 2017 2:39 PM To: Lloyd, Scott (ACF) Subject: FW: Update on pregnant UAC? - Request for Additional Informa t ion Scott, FYSA,latest update on the currently pregnant UAC at IES LFfacility. From: Brooks, Teresa (ACF) Sent: Tuesday, October 31, 2017 2:34 PM To: Sualog, Jallyn (ACF); White, Jonathan (ACF) Subject: Fwd: Update on pregnant UAC? - Request for Additiona l Information Please see the information in the correspondence below per your request. Thank you, Teresa /\MEf ll Al\ pVERSIGHT EXT-18-248-D-000252 From: "Jessica Martinez" Subject: RE: Update on pregnant UAC? - Request for Additional Information Date: 31 October 2017 12:35 To: "Brooks Teresa (ACF)" , , bl<6l ~,,,.,....----=iest ex.or > 5 Cc: (bl( l iestex.or >, "l(bl<6l ~ieste x.org"' i Good Morning Teresa , As discussed, I apologize for delay , I was at children's program earlier and had not seen your email request. With regards to UAC voicing "TOP", her pregnancy has been confirmed by Dr.~ OB/GYN . UAC's initial OB/GYN appointment took place on 10/27 , UAC verbal~ consented to entire medical exam , including sonogram and 1st trimester lab work. OB/GYN noted minor was approximately 9 weeks' gestation on 10/27/17 . Following the completion of doctor's examination , UAC informed Dr. fbl(6) ~hat she did not want a baby and openly informed Dr. l(bl(6l she is seeking to terminate pregnancy. Dr. l(b)(6) acknowledged UACs statement and responded that she should discuss her options further with care provider. UAC responded to Dr. l(b)(6) Ithat care provider was aware of her wishes , UAC was in the presence of Medical Coordinator and Dr.~stated to Medical Coordinator that his office could provide information regardin~opt ions counseling " and other resources, program Medical Coordinator informed Dr. l(b)(6) that program would elevate minor's reques~ropriate officials and seek further guidance before discussing minor's request. Dr. ~stated he understood and reiterated that should minor undergo procedure he would be prepared to conduct follow-up with her after procedure. At no point in time during initial~ointment were any "options" discussed with UAC, care provider staff and Dr.~ did not issue information or resources to UAC, instead care provider and doctor listened attentively and informed her that her request would be noted . UAC's next OB/GYN appointment in 11/21/17 at 9:00 a.m. I UAC disclosed pregnancy to her mother on 10/26, however she has not disclosed her request for "TOP". In addition , sponsor is not aware of pregnancy or UACs request for 'TOP". At this time, minor has stated she is not willing to inform sponsor of pregnancy and we continue working with UAC with regards to sharing her request for "TOP" with her mother. UAC has requested to meet with ProBAR (legal service provider) follow up with legal service provider is pending. /\MERICAi\ pVERSIGHT EXT-18-248-D-000253 Please be advised at this time care provider has received an incomplete FRA from sponsor (unverified brother in law) . Care provider has received UAC's birth certificate , UAC's adult sister (sponsor 's wife) birth certificate and UAC's mother 's birth certificate . In addition , UAC's mother has provided a notarized letter from home country author izing sponsor to take care and take custody of UAC. However , sponsor has yet to prov ide a copy of his birth certificate and a copy of marriage certificate (to prove formal relationship with UAC). As previously reported , sponsor resides and works in Wendell , Idaho, the nearest fingerprint site is an 8 hour drive, however sponsor stated he would make the necessary arrange ments to travel to site. Sponsor has not returned Authorization for Relapse of Information forms therefore fingerpr int appointment has not been scheduled . Please also note that minor 's adult sister and 1-year-old nephew remain in OHS custody. According to sponsor he has not had communication with his wife (UAC's sister) . Sponsor also has reported he resides in a home with other adult household members , his brother, his brother 's wife and their children. At this time sponsor has not reported any criminal history with the except ion of an immigrat ion arrest. Sponsor disclosed that he and his son (4 years old at the time ) were apprehended approximately 3 years ago upon entering the U.S. without proper documents or inspection . Accord ing to sponsor he is attending immigration proceedings and he is without legal status. Sponsor reported he intends to comply with all immigration hearings . Please also note that UAC has denied a history of abuse , mistreat ment or neglect , there is no known history of trauma and UAC has described her relationship with her mother as "positive". Please advise if further information is needed or if there any further questions or concerns, thank you. Jess ica Mart inez, MA, LCCA Program Director IES Shelter Los Fresnos International Educational Services, Inc . P.O. Box 112 Los Fresnos, TX 78566 Phone: 956-233-5705 ext: 1410 5 Cell: 956{,_ b_ ><_>_ ___. Fax: 956-233-3435 /\MERICAi\ pVERSIGHT EXT-18-248-D-000254 Jessica .martinez@iestex .org >-= small create reflect live serve love CONFIDENTIALITY NOTICE: This message contains information w hich may be confidential or privileged . If you are not the intende d recipient, be aware that any disclosure, copying, dist ribution or use of the contents of this info rmat ion is prohibited. If you have received t his transmission in error, please notify me immed iate ly by telephone and permanently delete the e-mail and any attachments immed iate ly. Thank you. From: Brooks, Teresa (ACF) (mai lto:Teresa.Brooks@ACF.hhs.gov) Sent: Tuesday, October 31, 201 7 9:02 AM To: Jessica Martinez ;l{b)(6) ~iestex .org Cc b)(6) iestex.or >; '1: " Sent Date: 20 17/10/31 22:08 : 14 Delivered Date: 20 17/ 10/31 22:40:44 Message Flags: Unsent /\MERICAi\ pVERSIGHT EXT-18-248-D-000257 rJ~~\l~ f) - RSIGH'I. ·t· TI . • tlpmg ram, ,ts irrvt Ca rrie Gor d on Earll Vice PrC'.Qdcm Govtrmncm .-.~11'\ibhc Pohcy t, I; 1 19 5-ttl 51:H9 f,X\::71? 531EXT-18-248-D-000258 3.\90 focn,On Thcl-.lnuty.com To: "White, Jonathan (ACF) " CC: "White, Laura (ACF) " Subject : RE: Update on minor at SWKCampbellrequestingTOP Dat e: 2018/01/18 07:32:53 Priority: Normal Type: Note Jonathan, Thank you. Two things: }) b)(5) 2) Please have the program I federal staff evaluate whether it has been made clear to her that suppo1t is readily availab le if she chooses to parent the child, or if she decides to offer the baby for adoption. Sometimes adoption is an option that is not well-developed, even in some pregnancy resource settings. If the clinician feels that there has been adequate treatment of these options , no follow up is necessary on that front. 3) Please From: White, Jonathan (ACF) Sent : Wednesday, January 17, 20 18 12:01 PM To: Lloyd, Scott (ACF) Cc: White, Laura (ACF) Subject: Update on minor at SWK Campbell requesting TOP Importance: High Update on minor at SWK Campbe ll in Arizona who is requesting abortion to terminate pregna ncy resulting from rape in home country : • The minor is 16 years of age. She turned 16 on ~ /\MERICAi\ pVERSIGHT 17. EXT-18-248-D-000259 • The minor is pregnant as a result of rape in home country by a group of unknown men. She reports being approached by unknown men in country of origin, who covered her mouth with a piece of cloth, and then then lost consciousness. She woke up later in an unknown location with her clothes off. She was 15 years old at the time of the rape. She denies having had other sexual experiences . • The minor was evaluated by OB/GYN services on January 10, 2018, without concerns . • Gestational development: Based on ultrasound conducted on January 10, the minor was then 10 weeks 1 day. Based on this measurement, gestational age is today 11 weeks 1 day. • ORR has not received any report that there is a medically indicated necessity for abortion for the life of the minor. • The next routine medical appointment is scheduled in two weeks . • On January 11, the minor attended options counseling at Choices Pregnancy Center (CPC), a crisis pregnancy center from the HHS approved list. The minor was provided with information and reported that her questions were all answered. The minor was provided with "appropriate drawings to color and with Bible verses ," per the SIR. • On January 16, a family session was conducted, disclosing to the minor's parents in home countiy her pregnancy and her decision to pursue TOP. The minor ' s clinician was involved. The minor requested that the notification not include the information that that the pregnancy was a result of rape. • The minor spoke with a pastor from her faith tradition on January 15, 2018 . • On January 16, two family sessions were conducted , disclosing to the minor's parent s in home countiy her pregnancy and her decision to pursue TOP. The minor's clinician was involved. A first family session was held with the minor , and the second session the minor asked not to participate. The minor requested that her parents not be informed that the pregnancy is a result of rape, but the family repo1ted that their daughter may have been raped. The minor's father advised that the parents "agreed to end the pregnancy " and expressed that "if minor is requesting to end the pregnancy they supported her." • The SIR addendum for the fami ly notification explains: "On 1/16/2018 at approximately 3:30 p.m., clinician ICblC5l !completed a family session with minor and her father. Minor requested that clinician inform her parents she was pregnant and that she was requesting to end her pregnancy. Minor requested that clinician not disclose how minor became pregnant. Furthermore, clinician informed minor's father that minor was pregnant and requesting /\MERICAi\ pVERSIGHT EXT-18-248-D-000260 to end the pregnancy . Minor's father was notified that minor was taken to the doctor and it was confirmed she is approximately 10 weeks pregnant. Minor's father appeared calm and asked clinician if minor could be reunified with his older daughter. Minor's father requested time to speak to his wife before making a decision on minor 's request to end her pregnancy. On 1/16/2018 at approximately 5 p.m. , clinician Fompleted a family session with minor 's parents. Minor requested not to be present for the second family session . l(b)(B) Clinician spoke to minor 's father who conveyed he had spoken to his wife and decided that they agreed to end the pregnancy. Clinician asked minor's father to clarify what he agreed to. Minor's father stated he and his wife spoke and consider that minor may have been raped on her way to school. Minor 's father shared that in their home town if a woman is raped , the expectation is that she will marry the man that raped her. Minor's father stated that he and his wife are not sure that the pregnancy was a result of minor's choices or of a rape . Minor stated that if minor is requesting to end the pregnancy they supported her. Minor 's father also shared that minor is young and still a child herself to be raising a child of her own. Minor 's father appeared calm and was respectful as he shared the aforementioned ." • At this time the minor continues her request for TOP "due to the pregnancy being a result of sexual abuse." • All steps outlined by the ORR Director have been completed . Parenta l notification has been conducted, in which the family expressed support for the ir daughte r to receive the abortion. The minor has received options counseling from an approved provi der. The minor has received spiritual counseling from a pastor of her faith group (evange lical Christian). • Please advise next steps . Jonathan /\MERICAi\ pVERSIGHT EXT-18-248-D-000261 Jonathan D. White Commander, U.S. Public Healt h Service Deputy Director for Children's Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Hum an Services 330 C Street SW (202) 690-6984 j onathan .white@acf.hhs.gov "White, Jonathan (ACF) "; Recipient: "White, Laura (ACF) " Sent Date: 2018/01/18 07:29:32 Delivered Date: 2018/01/18 07:32:53 Message Flags: Unsent /\MERICAi\ pVERSIGHT EXT-18-248-D-000262 To: "White, Jonathan (ACF) " CC: "White, Laura (ACF) " Subject : RE: Update on minor at SWKCampbellrequestingTOP Dat e: 2018/01/18 16:05:29 Priority: Normal Type: Note Jonathan, I) r l(SJ 2) Please have the program / federal staff evaluate whether the following information has been made adequately clear to the youth , and if not, ask that they offer her the option of receiving more information on these subjects, if they feel they can do so consistent with her mental well being : a. that support is readily available if she chooses to parent the child; b. that support is readily available if she decides to offer the baby for adoption, and that she has been given the opportunity to discuss adoption in depth if she chooses; c. that in some cases , women or minors who have had abortions have expressed regret from having done so, even when pregnancy is the result of sexual assault, and that if she chooses the program can provide for her some written examples of the personal testimony of such women. From: White, Jonathan (ACF) Sent: Wednesday, January 17, 20 18 12:01 PM To: Lloyd, Scott (ACF) Cc: White, Laura (ACF) Subject: Update on minor at SWK Campbell requesting TOP Importance : High /\MERICAi\ pVERSIGHT EXT-18-248-D-000263 Update on minor at SWK Campbell in Arizona who is requesting abortion to terminate pregna ncy resulting from rape in home country : • The minor is 16 years of age. She turned 16 on~17. • The minor is pregnant as a resu lt of rape in home country by a group of unknown men . She reports being approached by unknown men in country of origin, who covered her mouth with a piece of cloth, and then then lost consciousness. She woke up later in an unknown location with her clothes off. She was 15 years old at the time of the rape. She denies having had other sexual experiences . • The minor was evaluated by OB/GYN services on January 10, 2018 , without concerns. • Gestational development: Based on ultrasound conducted on January 10, the minor was then 10 weeks 1 day. Based on this measurement, gestational age is today 11 weeks 1 day. • ORR has not received any report that there is a medically indicated necessity for abortion for the life of the minor. • The next routine medical appointment is scheduled in two weeks. • On January 11, the minor attended options counseling at Choices Pregnancy Center (CPC) , a crisis pregnancy center from the HHS approved list. The minor was provided with information and reported that her questions were all answered. The minor was provided with "appropriate drawings to color and with Bible verses," per the SIR. • On January 16, a family session was conducted, disclosing to the minor's parents in home country her pregnancy and her decision to pursue TOP . The minor's clin ician was involved . The minor requested that the notification not include the information that that the pregnancy was a result of rape. • The minor spoke with a pastor from her faith tradition on Jan uary 15, 2018 . • On January 16, two family sessions were conducted, disclosing to the minor's parents in home country her pregnancy and her decision to pursue TOP. The minor's clinician was involved. A first family session was held with the minor , and the second session the minor asked not to participate. The minor requested that her parents not be informed that the pregnancy is a result of rape, but the family reported that their daughter may have been raped. The minor's father advised that the parents "agreed to end the pregnancy" and expressed that "if minor is requesting to end the pregnancy they supported her." • The SIR addendum for the fami ly notification explains: "On 1/16/2018 at ~ompleted a approximately 3:30 p.m., clinici a n fbl(6) family session with minor and her fathe r. Minor requested that clinician /\MERICAi\ pVERSIGHT EXT-18-248-D-000264 inform her parents she was pregnant and that she was requesting to end her pregnancy. Minor requested that clinician not disclose how minor became pregnant. Furthermore, clinician informed minor's father that minor was pregnant and requesting to end the pregnancy. Minor's father was notified that minor was taken to the doctor and it was confirmed she is approximately 10 weeks pregnant. Minor's father appeared calm and asked clinician if minor could be reunified with his older daughter. Minor's father requested time to speak to his wife before making a decision on minor 's request to end her pregnancy. On 1/16/2018 at approximately 5 p.m., clinician l(b)(6> Fompleted a family session with minor's parents. Minor requested not to be present for the second family session. Clinician spoke to minor's father who conveyed he had spoken to his wife and decided that they agreed to end the pregnancy. Clinician asked minor's father to clarify what he agreed to. Minor's father stated he and his wife spoke and consider that minor may have been raped on her way to school . Minor's father shared that in their home town if a woman is raped , the expectation is that she will marry the man that raped her. Minor's father stated that he and his wife are not sure that the pregnancy was a result of minor's choices or of a rape. Minor stated that if minor is requesting to end the pregnancy they supported her. Minor's father also shared that minor is young and still a child herself to be raising a child of her own. Minor's father appeared calm and was respectful as he shared the aforementioned." • At this time the minor continues her request for TOP "due to the pregnancy being a result of sexual abuse." • All steps outlined by the ORR Director have been completed . Parenta l notification has been conducted, in which the family expressed support for the ir daughter to receive the abortion. The minor has received options counseling from an approved provider . The minor has received spiritual counseling from a pastor of her faith group (evange lical Christian). • Please advise next steps. /\MERICAi\ pVERSIGHT EXT-18-248-D-000265 Jonathan Jonathan D. White Commander, U.S. Public Health Service Deputy Director for Ch ildren's Progra ms Office of Refugee Resett lement Administration for Children and Families U.S. Departm ent of Health and Human Services 330 C Street SW (202) 690-6984 j onathan. white @acf.hhs.gov "White, Jonathan (ACF) "; Recipient: "White, Laura (ACF) " Sent Date: 2018/ 01/ 18 16:05:31 Delivered Date: 2018/ 01/ 18 16:05:29 Message Flags: Unsent /\MERICAi\ pVERSIGHT EXT-18-248-D-000266 From: Bullet in Intell igence To: "HHS@bulletinintelligence .com" Subject: HHS News Briefing for Monday, July 02, 2018 Date: 2018/07/02 07:33 :24 Priority: Normal Type: Note Click to access mobile-optimized /\MERICAi\ pVERSIGHT online version, including download options and an audio reader. EXT-18-248-D-000267 HHS News Briefing TO: THE SECRETARY AND SENIOR STAFF DATE: MONDAY, JULY 2, 2018 7:30 AM EDT Today's Table of Contents Leading the News • Hundreds Of Thousands Protest Administration's Immigration Policy, Separation Of Families . The Secretary in the News /\MERICAi\ pVERSIGHT EXT-18-248-D-000268 • Judge Strikes Down Kentucky's Medicaid Work Rules . Unaccompanied Alien Children • Suit Filed Against HHS Alleges "A Wide Range Of Abuses" Aga inst Unaccompan ied Minors. • House GOP Seeks Answers From Azar About ORR. • Fake Story About HHS Losing Immigrant Children Resulted In Discovery Of Separations At The Southern Border . HHS in the News • HHS' Severino Speaks At National Right To Life Conference. • Several Mid-Leve l HHS Officials Reportedly Emu lating Trump In Tweets. • CMS Looking For Chief Health Informatics Officer. • CMS Releases Payment Data, Reveals Drug And Medical Device Company Contributions. • National Guard Soldiers May Have Sleep Problems After Returning Home From The Battlefield, Research Suggests. • Federal Officials Say Roma ine Lettuce-Linked E. Coli Outbreak Is Officially Over. • Emergency Departments Struggling Through Shortages Of Crucial Drugs. • Amazon's PillPack Deal Unlikely To Impact Drug Costs, Analysts Say. /\MERICAi\ pVERSIGHT EXT-18-248-D-000269 • First Cannabis-Based Prescription Drug Approved By FDA Marks "Watershed " Moment, Industry Members Say. • FDA Commissioner Comments On Efforts To Stem Online Opioid Sales. • FDA Report Suggests Ways To Improve Its Hiring Process. • FDA Policy Limiting Blood Donations From Gay Men Draws Scrutiny. • FDA Warns Pfizer Over "Misleading " Consumer Video. • Op-Ed Touts FDA Allowance Of Off-Label Healthcare Economic Discussions . • Maple Syrup Producers, Beekeepers Oppose FDA's "Added Sugars" Label. • CDC Director Changes Stance On Use Of Condoms To Prevent STDs . • CDC Map Illustrates Incidence Of Pediatric Cancer In Different US Regions . • House Legislators Seek More Transparency From FNIH Concerning Donors . • NCI Research Funding Priorities Following Budget Increases Outlined. • NCI Estab lishes National Clinica l Trials Network Navigator To Augment Access To Cancer Trial Specimens, Data . • NIDOCD Study Indicates Partially-Restored Hearing In Mouse Model Of Inhe rited Deafness . • Senate Committee Considers Addit ional $2 Billion For NIH In 2019. • NIH Recommends Strategies For Older Adults To Avoid Hypothermia /\MERICAi\ pVERSIGHT EXT-18-248-D-000270 In Summer Heat. • Johns Hopkins Tops List Of Leading NIH Grant Recipients In Baltimore Area. Opioid Crisis • Opio id Deaths In Missouri Still On The Rise, But Growth Rate Slow ing Down. • Ohio Auditor 's Report Shows Impact Of Opio ids On Medica id . • New Research Shows How Opioids Are Impacting The Workforce In Kentucky . • Georgia Will Require Doctors To Check Database Before Prescribing Opioids. • Ar izona County Joins Opioid Manufacturer Lawsuit . • Pennsylvania Law Aims To Protect Newborns Affected By Opioid Addiction. • Innovative Program At Kentucky Jail Provides In-House Rehab For Inmates. • Nashville Family Loses Three Loved Ones "To Drugs' Grip." • Media Collaborates To Share Solutions To Opioid Crisis. • Police Using Databases To Crack Down On Opioid Abuse. • Metrohealth Cuts Opioid Prescriptions By 3 Million. • NBC Analysis: France Seems To Have Solution To Its Own Opioid /\MERICAi\ pVERSIGHT EXT-18-248-D-000271 Crisis. Mental Illness • Student Groups On College Campuses May Improve Access To Mental Health Resources, Study Suggests . Healthcare Fraud • Tennessee CEO Indicted In $2.5 Million Medicare Fraud Case. • Dallas Healthcare Center Service Provider Charged In $2.5 Million Medicare Fraud Scheme. Prescription Drug Pricing • Epilepsy Drug's Price Increase Highlighted. • Op-Ed: "American Patients First" Plan Neglects Key Elements Necessary To Reduce Drug Costs. • Editorial: More Policies Requir ing Transparency Of PBMs Are Necessary To Combat Drug Prices. • Op-Ed Crit icizes Pharmacy Benefit Managers. • Op-Ed: State, Federal Laws Should Empower Pharmacists To Help Manage Drug Costs. Health Care &Insurance Reform /\MERICAi\ pVERSIGHT EXT-18-248-D-000272 • Sen. Collins Says She Will Oppose Supreme Court Pick Who Shows "Hostility" To Roe V. Wade. • Medical Advances Have Contributed To Plunging Abort ion Rates. • Iowa Supreme Court Rules Against 72-Hour Abortion Waiting Period. • Opinion: Women Must Speak Up To Defend Abortion Rights. • New Mexico Democrats Push To Repeal State Abortion Law. • Supreme Court Ruling Raises Doubts About Illinois Abortion Law. • Some States Tak ing Action To Support ACA. • House Vote To Repeal Medical Device Tax May Bolster Vu lnerable GOP Lawmaker . • Sen. Durb in Says Trump Seeking Court Nom inee Who Will Overturn Roe, Affordable Care Act. • Trump Adm inistratio n Proposes Cuts To ACA Navigators. • Health Insurers Offering ACA Plans In More States, But At Higher Prem iums. • Obama Told Trump To Take Credit For ACA. • Insurance Premiums Set To Sharply Rise Next Year In New York. • Medica To Add Two More States: Missouri, Oklahoma. • University Of Mississippi Medical Center To Continue Treating Blue Cross Patients As In-Network During Mediation Process. • Opinion: IRS Should Let Workers Spend Pretax Money On Healthcare. /\MERICAi\ pVERSIGHT EXT-18-248-D-000273 • Editorial: Minnesota Helps Bring Insurance Premiums Down, But Faces Funding "Cliff." • Op-Ed: Most Physicians Unaware Of Ways They Can Reduce Healthcare Costs For Patients. Human Services News • HHS Prov ides Maine Group With $200K Grant For Health Work. • July 1 Marks Change In Ar izona Child Welfare Laws . • Distr ict Of Columbia Extends Dead line For Dayca re Workers To Meet New Education Requirements. • Ohio Hasn't Used $SM Designated For At-Risk Youth In 2018. • Maine Governor Vetoes Bills To Increase Reimbursement Rates For Direct Care Workers. Food &Import Safety • Wish-Bone Recalls Salad Dressing For Possible Allerg ens. Nutrition &Obesity • Beverage Industry Scores "Defining Victory" In Banning Soda Taxes In California. Medicare /\MERICAi\ pVERSIGHT EXT-18-248-D-000274 • CMS To Test Medicare Advantage Plans As APMs. Medicaid &CHIP • Sununu Signs Reauthorized Medica id Expansion Bill. • Maine Governor Vetoes Medicaid Expansion Funding. • Idaho GOP Committee Passes Resolution Opposing Medica id Expans ion Initiative. • Iowa's New Private Medicaid Company Has "Troubled Past." • Arkansas Suspends Medicaid Payments To Missouri Nonprofit After Arrest. • Ohio Medicaid Execs Criticized For Defending Pharmacy Middlemen. • Iowa Hospital Association Says State Has No Data To Support Medicaid Savings Claim. • West Virginia Medicaid Waiver Expands Opt ions For Substance Abuse Treatment. • Article Examines Why Tennessee Has Not Expanded Medicaid. Health &Medical News • Scientists Warn On Increased Mortality Risk From Prolonged Sitting. • People Fail To Properly Wash Hands While Cooking 97 Percent Of The Time, Study Finds. • US Evacuates More Americans From China Following Mystery Illness /\MERICAi\ pVERSIGHT EXT-18-248-D-000275 Complaints. • Most People Apply Too Little Sunscreen. • Being Married May Reduce Risk Of Heart Disease, Cardiovascular Death, Review Suggests . • Researchers Developing Artificial Ovary To Help Young Cancer Patients Preserve Fertility . • Immunotherapy "Revolution" Is "Greatest Hope Yet" For Beating Cancer. • FDA Approves First Drug To Reduce Excessive Sweating . • CDC Warns Of Shingr ix Vaccine Shortage. • Police Investigate Elder Abuse Against Comic Book Creator Stan Lee, 95 . • Mississipp i Public Agencies Must Now Cover Increased Share Of Worker Pensions . • Surveys: Financially Independent Millenials Are Happier Than Those With Money Worries . • Retirees Increasingly Becoming Entrepreneurs, Cites AARP Study. • Study Reveals Views On Social Media Bias. • Hospitals Across US Experiencing Shortages Of Beds For Children With Mental Health Illnesses. • Colorado Hospital Sues Patient For Surgery Bill, Highlighting Alleged Price Gouging. • Oklahoma Drafts Rules To Regulate Medical Marijuana Following /\MERICAi\ pVERSIGHT EXT-18-248-D-000276 Successful Legalizat ion. • Many Families Still Live With Arsenic, Lead In Everett, Washington. • Delaware Lawmakers Vote To Ban Powdered Alcohol. • Angelman Syndrome Receives Its Own Medical Code. • California Vaccine Skeptic Put On Probation By State Medical Board. • Opinion: Antibacterial Debate Must Weigh Risks, Benefits. • Woman's Facebook Post Says Menthol Shaving Cream Soothes Sunburns. • AMA President-Elect Profiled. • AARP Dedicates $60 Million To Dementia, Alzheimer's Disease Research Fund. • Ohio, Washington Officials Confirm West Nile Virus-Carrying Mosquitoes . • Michigan's Detroit Area Becoming A "Hotspot" For Vaccination Waivers, Study Suggests. • WPost: Stalling Malaria Fight Could Jeopardize Children's Lives. • Indiana Reside nt Contracts Rare Flu Strain After Exposure To Pigs At Fair. • Op-Ed: New Chemotherapy Study Underscores Importance Inferiority Of Non- Tria ls. • Loved One's Cancer Diagnosis Can Spur Others To Seek Prevent ive Care. /\MERICAi\ pVERSIGHT EXT-18-248-D-000277 • Congress Passes Firefighter Cancer Registry Act. • Amazon's Latest Deal Shows It Plans To Disrupt How Industry Cares For Chronically Ill. • US Judge Rules AbbVie, AndroGel Partner Owe $448 Million In Antitrust Case. • Amazon's PillPack Deal May Provide It With Access To Sensitive Health Data. • WSJournal: Amazon's Pill Pack Deal Will Benefit Consumers, Force Competitors To Improve. • More Suits Filed Against Florida Drugmaker Accused Of Selli ng Contaminated Medicines. • Distr ict Court Extends Indivior's Order Blocking Launch Of US Generic Addiction Treatment. • FDA Cites Mylan For Morgantown Plant Manufacturing Issues. • Report: Nearly All Online Pharmacies Illegal. • Missouri Appeals Court Rejects $55 Million Verdict Against Johnson &Johnson In Talc Powder Suit. • FDA Approves Pulmonx's Valve For Emphysema. • NYC Expands Lead Test ing Program For Children. • Learning To Play Piano May Help Children Build Up Language Skills, Study Indicates. • Tech Company CEO: Children Need To Be Guided Through Technology Thoughtfully. /\MERICAi\ pVERSIGHT EXT-18-248-D-000278 • Factors Behind Lagging Mainstream Adoption Of Telemedicine Examined. • Drivers For Car Services, Ride-Hailing Apps In New York Now Able To Get Coverage For Vision Care. • Scientists' Discovery Is "First Step" To Packaging Insulin In Pill. • Roche Encouraged By Tecentriq Trial Results. • Angela Garbes' New Book " Like A Mother" Discussed. • Hawaii Bans Sale Of Sunscreens Containing Oxybenzone, Octinoxate. Global Health • Britain's NHS To Reduce "Unnecessary Or Risky Procedures." • UK's NHS Making Plans To Ensure Ample Medica l Supplies After Brexit. • Irish Cancer Patients Received Faulty Tests From US-Based Labs. • Global Fund Combating AIDS, TB, Malaria Cancels Funding For North Korean Public Health Efforts. • Novartis, Gilead CAR-T Therapies Both Gain European Panel Recommendation. • AstraZeneca Receives "Speedy Approvals" For Cancer Drugs In Japan. • Ghana Reports HS Bird Flu Outbreaks. • Researchers Warn That Gay Hate Climate In Indonesia Is Fueling HIV Epidemic. /\MERICAi\ pVERSIGHT EXT-18-248-D-000279 • India Celebrates End Of Nipah Virus Outbreak With Music Video. • WTO Upholds Australia's Plain- Packaging Law. • Russians Protest Pension Age Hike. • Son Debates Assisted Dying Amid Mother's Alzheimer's Diagnosis. National News • Trump Predicts Quick Supreme Court Confirmation "If I Pick The Right Person." • Trump Retweets Elder Joke About Reporter Fired Over False MAGA Hat Claim. • Waters: People Want Democrats To Be "More Confrontational" Against Trump. • Todd: Trump Is "Winning," • Ocasio-Cortez: • Duckworth: Democrats Are "Reeling." Democratic Socialism Just "Part Of What I Am." Democrats Can't Go Too Far Left An Win Nationwide. • Portland Police Declare Riot, Revoke Permit As Antifa Disrupts Protest. • NYTimes Analysis: Supreme Court Ruling Against Unions A Blow To Liberal Groups. • Trump Says He Wants To Stay "Uninvolved" In Russia Probe, "At Least For Now." • Judge Extends Program Paying For Hurricane Maria Victims' Hote l Stays. /\MERICAi\ pVERSIGHT EXT-18-248-D-000280 • Private Equity Group Offer High-Interest Loans To Cash-Strapped Americans. • Median Prime For A Single-Family Home In San Francisco Bay Area Is $935,000. • High Schoo ls Clamp Down On Student Journa lists Cover ing Sensitive Subjects. • Seattle Bans Plastic Straws, Utensils In Restaurants. • Murdoch Turning Much Of The Company He Built Over To Disney. • Professors Oppose Stricter Work Requirements For SNAP. • WPost Welcomes Transfer Of Background Checks From OPM To DOD. • WSJournal Cr itic izes Individual, Corporate Tax Hikes In New Jersey. Editorial Wrap-Up • New York Times. • Washington Post. • Wall Street Journal. The Big Picture • Headlines From Today's Front Pages. Last Laughs /\MERICAi\ pVERSIGHT EXT-18-248-D-000281 • Late Night Political Humor. Leading the News Hundreds Of Thousands Protest Administration's Immigration Policy, Separation Of Families. ABC World News Tonight • Video (6/30, lead story, 2:50, Llamas, 4.58M) reported in its lead story that "we begin tonight with the massive nationwide protests against the President 's immigration policy. Tens of thousands of protesters in more than 700 demonstrations, like this one in Chicago, in cities and towns from coast to coast, in every state, urging Presiden t Trump to reunite the families separated at the southern border. Part of the fallout from his zero-tolerance immigration policy." In its lead story, the CBS Weekend News • Video (6/30, lead story, 2:20, Ninan, 2.62M) reported, "Americans across the country are making their vo ices heard this Fourth of July weekend at loud rall ies /\MERICAi\ pVERSIGHT EXT-18-248-D-000282 from coast to coast. They're demanding that thousands of immigrant children be set free and reunited with their parents. And President Trump may have heard. He tweeted th is afternoon that people coming to this country illegally must be escorted out." CBS correspondent Kenneth Craig added, "New York's protest brought an estimated 15,000 to the streets of lower Manhattan over the Trump Administration's zero- tolerance policy on illegal border crossings." Craig also mentioned that HHS said it has custody of more than 2,000 imm igra nt children separated from their parents. NBC Nightly News • Video (6/30, lead story, 2:35, Diaz-Balart, 12.78M) reported in its lead story, "Hundreds of thousands of people in communities across the country mobilized today for [im]migrant families, protesting President Trump 's policy that separated children from their loved ones. Tonight, more than 2,000 of those children remain in detention centers, in a country that's not their own, far from their parents. The White House mostly silent on the issue today." The Washington Post (6/30, Lang, Zauzmer, Natanson, 15.68M) reported that on Saturday, some 750 "'Families Belong Together' rallies were planned throughout the country in every state - from big cities such as Boston, Chicago and New York to t iny ones such as Antler, N.D., which has a popu lation of 27." Organizers said about 50,000 people gathered in Washington, DC, although the Post indicated the total number may have been somewhat less than that. All these protesters had one message: "End President Trump's 'zero tolerance' immigration policy, which has split children from their parents and detained families crossing the southern U.S. border." The article added that whenever "the government, administration" Border Patrol agents or the Trump was mentioned, "the crowd erupted into chants of 'shame, shame, shame."' And "as they passed the Trump International Hotel, protesters booed and chanted 'vote him out."' /\MERICAi\ pVERSIGHT EXT-18-248-D-000283 The New York Times (6/30, Yoon-Hendricks, Greenberg, 19.33M) reported that galvanized "by what they view as the cruel treatment of [im ] migrants seeking refuge in the United States from violence in their home countries, the crowds turned out Saturday bearing homemade signs that read 'Abolish ICE' - the Imm igration and Customs Enforcement agency - and 'Zero tolerance for family separation."' The article said that although "Wash ington was the political epicenter of the protests, similar scenes unfolded in cit ies around the country, including large, border cities like El Paso, state capitals like Salt Lake City and Atlanta, and smaller, inter ior towns like Redding, Calif." The piece added that for the most part, the protests were peaceful, with only a few arrests . USA Toda y (6/30, Hayes, 11.4M) reported on the rallies in all 50 states, but asked, "now what? Will the issue and the outrage fade into the background or help lead to a pivotal moment in the debate over immigration organizations in the U.S.?" A spokesman for MoveOn.org, "one of the behind the nationwide rallies," said, "I've never seen so many people that so deeply care about immigration. This is unlike anything I've seen. It's just a huge amount of opportun ity and we have to ride th is wave to making change." The piece added that "act ivists plan to pressure members of Congress to hold town halls to discuss immigration and force leaders to take a stand when confronted by the ir constituents." The Wall Street Journal (6/30, Raice, Barrett, Duehren, Subscription Publication, 6.13M) reported that protesters said they were angry at President Trump's actions on immigration, and insisted that the world needs to see a d ifferent picture of the US. They carried signs say ing, "No child should be kept in a cage" and "Keep families together" and "Imm igrants make America great." /\MERICAi\ pVERSIGHT EXT-18-248-D-000284 The Arizona Republic (6/30, Carranza, Larson, Steinbach, Janetsky, 1.21M) reported that some "800 people gathered outside the state Capitol building in Phoenix. Many carried signs urging the administration to bring families back together." counterprotesters They encountered "small groups of with megaphones. Some engaged, but the event was mostly peacefu l." Also cover ing the story were the Orlando (FL) Sentinel (6/30, Santana, 593K), the Atlanta Journal - Constitution (6/30, Hansen, 1.09M), the Asbury Park (NJ) Press (6/30, Mikle, 386K), and Newsday (NY) (6/30, Chayes, 1.52M). Trump Administration Accused Of Separating Immigrant Families Who Sought Asylum At Ports Of Entry. The Los Angeles Times (7/1, Esquivel, 4.03M) reports that "the practice of separating families appears to have begun accelerating last year, long before zero tolerance was announced in the spring. Among these cases, according to records and interviews, are many that happened at ports of entry" as imm igrants sought asylum in the US. The article adds, "Administration off icials have said repeatedly that asylum seekers who don't want to be separated from their children should present themselves at a port of entry. Doing so is the legal way to ask for asylum, they said." However, court documents "describe numerous cases in recent months in which families were separated after presenti ng themse lves at a port of entry to ask for asylum." Attorneys contend that this happened even when asylum seekers had identification /\MERICAi\ pVERSIGHT and documents proving they were the children's parents. EXT-18-248-D-000285 DOJ Files Documents Which Indicate Administration Immigrant May Want To Detain Families Longer Than The Current Legal Limit. The Washington Post (6/29, Barrett, 15.68M) reported that the Justice Department on Friday revealed "plans to detain migrant families together in custody rather than release them , according to a new court filing that suggests such detentions could last longer than the 20 days envisioned by a court settlement." The article added that "the filing comes as the Justice Departments seeks to navigate two different court edicts - an injunction issued this week by a federal judge in San Diego that required the government to begin reuniting the roughly 2,000 migrant children still separated from their families, and an older court settlement in federal court in Los Angeles that requires the immigration agencies to release minors in their custody if they are held for more than 20 days." Politico (6/29, Gerstein, 3.51M) reported that only "days after President Donald Trump announced that his administration would ask a federal court to permit detention of immigrant families by modifying a longstanding court settlement, Justice Department lawyers told the Los Angeles-based judge handling the case Friday that no change to the decree may be needed." Attorneys for the government contend that "a separate injunction a federal judge in San Diego issued Tuesday barring family separations effectively wipes out provisions in the decades-old Flores agreement that have been determined to bar detention of most children in imm igration custody for more than 20 days." They wrote, "The rulings work together to permit detention of parents with their minor children with whom they are apprehended." The Hill (6/29, Bowden, 2. 71M) reported that the Administration /\MERICAi\ pVERSIGHT may EXT-18-248-D-000286 seek to "detain migrant families together for months at detention facilit ies as they await prosecution for illega l entry, according to a court filing from the Justice Department." Whi le the filing did not specify the potential length of t ime immigrant fam ilies wou ld be detained, immigration proceedings typically take months. Administration Still Dealing With "Fallout" From Zero Tolerance Policy. The AP (7 /1, Long, Alonso-Zaldivar) testimony, reports that in recent Senate HHS Secretary Alex Azar "could barely conceal his discomfort" as a Democratic senator asked "whether his agency had a role in designing the Trump administrat ion's 'zero to lerance' pol icy that caused" immigrant children to be separated form their parents. Azar responded, "We deal with the children once they're given to us .. .. So we don't - we are not the experts on immigration." The article says separating families "while sidelining the agency responsible for caring for the children was only one example of a communicat ion breakdown in the federal government that left immigrant children in limbo, parents in the dark about their whereabouts and enraged Americans across the country." The Administrat ion "is still dealing with the fallout: It's still not clear how officials will implement the policy or comply with a court order requ iring that families be reun ited within 30 days. Instead, the administration is hoping Congress will fix the mess." Congress Leaves For Recess Without Voting On Bill To End Separation Of Immigrant Families. USA Toda y (6/29, Kelly, 11.4M) reported that "House and Senate leaders had expressed hope that Congress could act quickly this week to pass a narrow bill that would allow migrant children to remain with their parents at detention centers beyond the current 20-day limit," but /\MERICAi\ pVERSIGHT EXT-18-248-D-000287 "both chambers adjourned Thursday without a solut ion. They will return on July 9." Top House Dems Want HHS-OIG, Other Agency Watchdogs To Investigate Administration's Zero Tolerance Policy. The Hill (6/29, Weixel, 2. 71M) reported that "top House Democrats are asking federal agency watchdogs for a broad investigation" Administration's zero-to lerance immigration into the polic ies, "including the separation of children from their parents, as well as the recent executive order intended to partially roll them back ." The lawmakers sent a letter Friday to the inspectors general of HHS, OHS, and the Department of Justice asking for a review of the Administration's process for planning and implementing "entire its immigrat ion plan." The letter was signed by Reps. Elijah E. Cumm ings (D-MD), Jerry Nadler (D-NY), Bennie Thompson (D-MS), Bobby Scott (D-VA), and Frank Pallone, Jr. (D-NJ), the "top Democrats on the House Committees on Overs ight and Government Reform, the Judiciary, Homeland Security, Educat ion and the Workforce, and Energy and Commerce." Dems In Connecticut Denied Access To Immigrant Child Separated From Parents. Vox (6/29, Kirby, 1.66M) reported that on Friday, Sen . Chris Murphy (D-CT), Sen. Richard Blumenthal (D-CT), and Rep. Joe Courtney (D-CT) sought "to visit a child separated from their family who was being housed in a nonprofit facility in Groton, Connecticut." But HHS "denied the lawmakers access, according to Murphy." He tweeted, "The perverse secrecy of child separation should concern us all. " Murphy added, "HHS' excuse was that we need to give 14 days notice .... What?? 14 days of forced separation from your parent can traumatize /\MERICAi\ pVERSIGHT a EXT-18-248-D-000288 kid for life . And we aren't asking to see nuclear codes - we just wanted 10 min to make sure the child is ok." An HHS official "said that a visit from the members had not been approved, and confirmed that HHS requires a two-week notification, at minimum, to make sure tours don't interfere with the care of unaccompanied alien children." Court Documents Allege Border Agent Wished Immigrant Mother 's Day" After Informing Her Of Impending "Happy Separation From Daughter. The Arizona Republic (6/29, Ruelas, 1.21M) reported, "A Guatemalan woman said in a federal complaint filed this week that a Border Patrol agent in an Arizona detention facility, after informing her that her daughter would be taken away, mockingly wished her a happy Mother's Day." The American Civil Liberties Union of Massachusetts is representing the woman in the lawsuit. Attorneys "say they've filed an emergency lawsuit to immediately reunite" the woman "with her daughter, who is only identified in court filings by the init ials S.K. They argue that the continued separation violates the due process rights, as well as the Constitution's Immigrant guarantee of equal protection." Families Still Separated As "Outrage" Over Zero Tolerance Policy Grows. ABC World News Tonight • Video (6/29, story 6, 0:40, Muir, 6.53M) reported that despite the growing "outrage" over the Trump Administration's zero-tolerance policy, imm igra nt children remain separated from their parents. Congress left for recess without passing an immigrat ion bill. The segment mentioned that during her last visit to the border, First Lady Melania Trump was shown "pictures of the sixyear-old boy left alone in the desert, possibly by smugglers." That boy /\MERICAi\ pVERSIGHT EXT-18-248-D-000289 has since been transferred to HHS' custody. Some 2,000 Immigrant Children Remain Separated From Their Parents Despite Judge's Order To Reunite Them. The New York Times (6/30, Correal, 19 .33M) reported that despite "protests being held around the country on Saturday to demand the reunification of parents and children separated at the border, progress on putting families back together has been painfully slow." The article said in spite of "a federal judge's order requiring reunificat ion within 30 days, more than 2,000 children remain scattered across 17 states, including some 300 in New York." The piece added that "their parents too have been sent around the country - to detention centers in Arizona , Colorado and as far away as Washington State ." While HHS "cit[ed] the possibi lity that human traffickers might pose as parents [and] said that the government intends to aggressively 'vet' those who wish to gain custody of children," the Times said officials "declined to say how many children had been reunited with their relat ives since President Trump ended the separation policy with an executive order ." Sponsors, Parents Reportedly Face High Transport Fees, Red Tape Before They Can Be Reunited With Immigrant Children. The New York Times (7/1, Jordan, 19 .33M) reports on the transport fees and red tape facing the sponsors and parents of imm igrant child ren. The art icle mentions that "Brenda, a Salvadoran [im]migrant who was separated from her 7-year - old son Kevin at the border on May 27, was charged $576.20 to cover the boy 's airfare from Miami to Virg inia. His escort collected the money order at Wash ington Dulles airport on Friday upon hand ing over the ch ild to his mother." This is just one of the many "hurdles" sponsors and immigrant parents must /\MERICAi\ pVERSIGHT EXT-18-248-D-000290 overcome in order to be reunited with children . The piece adds that HHS' "Office of Refugee Resett lement, which has official custody of migrant children under detention and establishes conditions for releasing them, has made it clear that the requirements make sure children are not released to traffickers, are intended to and will be well cared for in their new homes." CNN (6/29, 82.6M) featured footage of Brenda 's reunion with her son at Dulles. Advocates In New York Seek To Teach Separated Immigrant Children About Their Legal Rights . The Wall Street Journal (7/1, West, Campo-Flores, Texas, Subscription Publication, 6.13M) reports that advocates in New York are attempting to teach immigrant children separated from their parents about their legal rights. They must use creative methods because many of these children are too young to understand the concept, and some are illiterate. The article mentions that the children are in HHS' custody, wh ile their parents are being held by Imm igration and Customs Enforcement. Guatemalan Girl Reunited With Mother After Two-Month Separation. The Washington Post (7/1, Rozsa, 15.68M) reports on the reunification of a 7-year-o ld Guatemalan girl who was separated from her family for almost two months by US border officia ls. The child's mother, Buena Ventura Martin-Godinez, said, "I'm so happy, so happy .... I didn't know when I would see her again." She added, "She 's happy now, but she /\MERICAi\ pVERSIGHT EXT-18-248-D-000291 wants her daddy," who remains in detention and faces deportation, adding, "She told me she never, ever wants to be away from her fam ily again." The AP (7 /1, Replogle, Kennedy) reports, "The little girl was in the custody of a child welfare agency in Michigan and made heartbreaking calls to her mother, asking when they'd be reunited." Guatemalan Mother Detained In Arizona Begins Road Trip To New York City To Find Her Children. The Arizona Republic (7 /1, Oza, 1.21M) spotlights Yeni Maricela Gonzalez Garcia, a Guatemalan immigrant who spent a month separated from her three children while detained, who is now driving with a volunteer to New York City to find her chi ldren. Children Represent ing Themselves In Immigration Courts. CNN (6/30, Kopan, 82.6M) reported on immigrant children who are coming before imm igration judges to "fight for permiss ion to stay in the country." The article features an immigration attorney whose client was a "crying toddler" that "frazzled" the judge because "she couldn't believe it." CNN added, "Toddlers and infants do, in fact, appear before judges in the system to defend themselves against deportation." piece cites immigration The law experts who "have long opposed the idea of children being able to represent themselves." /\MERICAi\ pVERSIGHT EXT-18-248-D-000292 Immigration Playing "Outsized" Role In Arizona 's Midterms. The AP (7 /1) reports, "The outrage sparked by the sights, sounds and stories of children separated from parents at the U.S.-Mexico border underscores the outsized role immigration wi ll play in the m idterms in Arizona." The article says candidates from both parties are emphas izing immigration as they campaign. The piece adds that for many Arizonans, "the immigration issue is personal," because data indicate "more than 13 percent of Arizona's populat ion as of 2015 were individua ls who were born in another country. " Following Visits To Immigration Detention Centers, It Remains To Be Seen What Action First Lady Will Take . The AP (6/30, Kellman) reported on First Lady Melania Trump's recent visits to the border during which she toured immigrant detention centers. The article said, "Now the question is what she does with that knowledge - and how she meshes it with her dislike for div iding up families and a concurrent belief in strong borders." Stephanie Grisham, a spokeswoman for Mrs. Trump, "says more border v isits or talks with lawmakers are possible, but it's not clear what lessons the first lady took from her visits and what she'll communicate to her husband." Grisham added, "She cares about children deeply .... She also believes in strong border laws and treating everybody equally." Trump Criticizes Dems Who Are Pushing For ICE To Be Abolished. The New York Times (7/1, Coch rane, 19.33M) reports that President Trump is attacking "Democratic lawmakers who have called for abolishing Immigrat ion and Customs Enforcement, seeking to seize /\MERICAi\ pVERSIGHT EXT-18-248-D-000293 political advantage on an issue that has put him on the defensive for weeks and offer a winning message for Republicans facing a forbidding midterm election." During an interview with Fox News' "Sunday Morn ing Futures," Trump said, "You get rid of ICE, you're going to have a country that you're going to be afraid to walk out of your house." The article adds that Trump also urged "Democratic candidates to embrace demands to dissolve the agency, say ing that do ing so would doom the party at the polls. 'They're going to get beaten so badly,"' he said . The Washington Times (7/1, Boyer, 460K) reports Trump "said Sunday that Democrats 'will never win another election' if they keep pushing to abolish Imm igration and Customs Enforcement." In The Face Of Growing Criticism, Trump Defends ICE. On its front page, the Washington Post (6/30, Al, Nakamura, 15.68M) reported that President Trump "opened a new front in the imm igration debate, diverting attention away from his administration's undocumented treatment of immigrants to a broader fight over the federal agency charged with detaining and deporting them ." According to the Post, the President in a pair of tweets "forcefully Immigration defended the performance of and Customs Enforcement and lambasted Democrats for pushing a 'radical left' agenda to abolish it, even though only a handful have publ icly supported doing so." The article mentioned that once immigrant children are separated from their parents , they are turned over to HHS. ICE Acting Director Accused Of Perpetuating Falsehood About Zero Tolerance Policy. /\MERICAi\ pVERSIGHT EXT-18-248-D-000294 The Huffinqton Post (6/29, Fang, 4.32M) reported that on Friday, Thomas Homan, acting director of Imm igration and Customs Enforcement, "perpetuated President Donald Trump's lie that Congress is responsible for the Trump administrat ion's zero tolerance policy of separating young, undocumented immigrant children from the ir parents at the U.S.-Mex ico border." Homan said, "We are enforcing the laws that they enacted .... We're out, doing our sworn oath, enfo rcing the laws that they enacted, and they're going to v ilify us for doing it ." ICE Raids Reported ly Separating Children From Immigrant Parents . The Washington Post (6/30, 15.68M) reported that while the Administration promises "to reunite families separated by Immigration and Customs Enforcement (ICE) at the U.S. border, a similar crisis continues unabated with in the country's interior, where children are separated from their undocumented increasing frequency." parents with little scrutiny and ICE has, in recent months, "carried out the three biggest workplace immigration raids of the past decade , includ ing one on June 5 at a nursery here in rural Ohio, where 114 gardeners, florists and other workers were detained and put into court proceedings for deportation." Many had lived for several years in a nearby "tra iler park of 74 homes known as Little Mexico, where now aid workers estimate that more than 90 children are missing one parent and at least 20 are left with no parent at al l." Advocates Say Separated Immigrant Parents Are Failing Asylum Screenings Because They Are Too Distraught. The Huffinqton Post (6/30, Chapin, 4.32M) reported that advocates say immigrant parents who have been separat ed from their chi ldren "are /\MERICAi\ pVERSIGHT EXT-18-248-D-000295 too devastated to prepare for their court hearings. Instead, they replay the moment their kids were taken away by Border Patrol, worry about their ch ildren's well-being, and ask repeatedly where their sons and daughters are. In some cases, they simply weep." One activist said "over half of the roughly 20 parents she spoke with on Thursday did not pass the ir 'credible fear' interviews - a process that determines a person's asy lum eligibility." She is convinced the parents "are too distressed about the ir children to effectively tell an asylum officer why they fled their country and could be killed upon return ." Some Concerned Immigrant Children Separated From Parents Could Be Put Up For Adoption. The Ar izona Republic (6/29, White, 1.21M) reported , "Since the Trump administration's zero-tolerance border policy led to the separation of more than 2,300 immigrant children from their relatives since early May, some have wondered: Could these kids end up being adopted by American fami lies?" Some immigrants allege they heard border agents say some of the separated children would be adopted after their parents were deported. HHS "has insisted that separated minors will soon be reunited with their relatives. Foster and adoption agencies have said separated children need to be with their families and will never be put up for adoption." However, "there are a number of scenar ios that could complicate that." The Detroit Free Press (6/30, Baldas, 1.21M) reported that Bethany Christian Services in Michigan insists that separated imm igrant parents and children are being reunited. Bethany sa id the more than 50 ch ildren in the state "will not be adopted. These ch ildren have families, and we wi ll cont inue to pursue reunification with the ir fam ilies." /\MERICAi\ pVERSIGHT EXT-18-248-D-000296 Nonprofit Says Its Database Could Help Unite Separated Immigrant Children With Parents. The Dallas Morning News (6/29, Solis, 1.0SM) reported, "A nonprofit has created a database that could help more than 2,000 immigrant children be swiftly reconnected with their parents even as lawyers and advocates become increasingly frustrated about not know ing whe re many of the children are." The art icle said this "database will allow parents and lega l representatives who are trying to locate separated children to submit inquires by phone and ema il," and "from there, the Vera Institute of Justice, a New York-based nonprofit, and its partners hope to connect the families with attorneys to work on the immigrants' legal cases." Experts Say More Central American Children Are Immigrating To The US Because Of Violence, Lack Of Opportunities. The Washington Post (6/29, Schwartz, 15.68M) exam ined why so many children from Central America are coming to the US. Experts attribute this trend to "economic factors and violence and insecurity . The first group includes the lack of economic opportunity, including a lack of jobs or inadequate opportunit ies for educat ion. The second group includes violence and victim ization, not just by gangs, other criminal groups and state security forces but at home as wel I." More Commentary. The New York Times (6/29, 19.33M) said in an editorial that separating families caught illegally crossing the US-Mexico border exemplifies /\MERICAi\ pVERSIGHT EXT-18-248-D-000297 "cruelty &perfidy scarcely paralleled in the most barbarous ages, and totally unworthy the Head of a civilized nation." The Times added, "The Trump administration has committed a gross offense," and urged all Americans to "demand that it promptly reunite these ch ildren with the ir parents." Author and former Border Patrol agent Francisco Cantu wrote in a New Yor k Ti mes (6/30, 19.33M) op-ed that it is crucial "to understand that the crisis of separation manufactured by the Trump administration only the most visibly abhorrent manifestation is of a decades-long project to create a ' state of exception' along our southern border." He added, "The logic of deterrence is not unlike that of war : It has transformed the border into a state of exception where some of the most vulnerable people on earth face death and disappearance and where children are torn from their parents to send the message You are not safe here . In this sense, the situation at the border has reached a point of cris is - not one of criminality but of disregard for human life." Jennifer Rubin wr ites in the Wash ington Post (7/1, 15.68M) "Right Turn" blog that "President Trump is prepared to incarcerate ent ire families for indeterm inate periods of time for what has been traditionally a misdemeanor." treated as She argues, "This is as inhumane as it is wastefu l and dangerous; rather than use resources to go after drug runners and human trafficking and other serious offenses, the adm inistrat ion will be spending resources to stand guard over families. " Alexandra F. Levy, a sen ior staff attorney at the Human Trafficking Legal Center, wrote in a Washington Post (6/29, 15.68M) op-ed about "who stands to gain from the Trump administration's imm igration policies." She said it is not immigrant children or their parents or even the US. Rather, it is the "two largest private prison contractors in the /\MERICAi\ pVERSIGHT EXT-18-248-D-000298 United States, GEO Group and CoreCivic," which "house thousands of immigrant detainees across the country. These corporations now face allegations that they force imm igra nt detainees to perform unpaid labor inside their facilities." Sarah Lustbader, a former public defender, writes in the Washington Post (7 /1, Lustbader, 15.68 M) that the Administration's defense of its family separation policy "boiled down to the following: The child's suffering is the price the parent must pay for breaking the rules. Children are, in essence, collateral damage." Lustbader points out, "Every day, we lock parents up for decades in our prisons regardless of how it will affect their children, and no one bats an eye." She concludes, "We should be demanding more humanity of our system across the board - not just at the border." In an editorial, USA Today (7/1, 11.4M) writes, "Sometime in the nottoo-distant future, the United States could face simultaneous crises, and the word of the White House would be crucial." The editorial goes on to say that "most Americans have come to recognize Trump's long and sordid abuse of facts," and "in recent weeks, his falsehoods have come even faster and with greater vigor." The editorial questions whether the White House will have the requisite credibility when that crisis comes. Anthony Scaramucci, former White House director of communications, writes in USA Today (7/1, Scaramucci, 11.4M) that following the "child separation fiasco, President Donald Trump doesn't have a credibility problem - but his chief of staff and the Democrats do." Scaramucci takes issue with the "messaging" of the policy. He concludes, "The president wants to find common ground, but the 'resistance' is peddling false narratives to avoid making a deal," adding, "the Democrats, not the president, have the real credibility problem." /\MERICAi\ pVERSIGHT EXT-18-248-D-000299 The Secretary in the News Judge Strikes Down Kentucky 's Medicaid Work Rules . The New Yor k Ti mes (6/29, Goodnough, 19.33M) reported that US District Judge James Boasberg on Friday "blocked Kentucky's close ly watched plan to require many Medicaid recipients to work, volunteer or train for a job as a condition of coverage." The Times said the ruling in the Kentucky case "is the first on this issue, but it will almost certainly not be the last; the question may wind up before a more conservative Supreme Court with two Trump appointees." The Trump Admin istration and the state of Kentucky had argued "that Congress gave the health and human services secretary broad discretion to approve Medicaid demonstration projects . Lawyers for the administration also argued that" HHS Secretary Alex Azar "provided plenty of ev idence that working improves health." Judge Boasberg disagreed, saying, "Wh ile the ultimate decis ion whether to grant approva l rests with the secretary, his discretion is not boundless." /\MERICAi\ pVERSIGHT EXT-18-248-D-000300 NPR (6/29, Kodjak, 3.55M) reported that in Friday's ruling, Judge Boasberg "called the Trump administration's Kentucky HEALTH, 'arbitrary and capricious."' approving Kentucky's work requirement approval of the program, He writes "that in proposal, Health and Human Services Secretary Alex Azar 'never adequately considered whether Kentucky HEALTH would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid."' The Washington Post (6/29, Sun, Goldstein, 15.68M) reported that Boasberg's decision "sends the state's program, Kentucky HEALTH, back to the federal Department of Health and Human Services for further review." Bloomberg News (6/29, 4.46M) reported Trump's HHS department "'never adequately considered whether Kentucky Health would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid,' Boasberg wrote." Reuters (6/29, Raymond) reported Kentu cky "was the first of four states to receive approval from the U.S. Department of Health and Human Services (HHS) to require that able-bodied Medicaid recip ients work at least 80 hours a month or lose their benefits." Kentucky "said the judge had blocked the program on the 'narrow basis' that HHS failed to consider its impact on Medicaid coverage, and that the state would work with HHS to address that problem so the program could take effect." Adam Meier, secretary of Kentucky's health department, is quoted saying, "'We will have no choice but to make significant benefit reductions' without implement ing the work requirements." The Wall Street Journal (6/29, Armour, Subscription Publication, 6.13M) reported that Centers for Medicare and Medicaid Services Administrator Verma said, "We are conferring with the Department of Justice to chart a path forward." Verma added, "In the meant ime, we will continue to /\MERICAi\ pVERSIGHT EXT-18-248-D-000301 support innovative, state-driven policies that are designed to advance the objectives of the Medicaid program by improving healt h outcomes for thousands of low-income Americans." The AP (6/29, Beam, Alonso-Zaldivar) reported the national implications of Friday's ruling "could take a while to sort out. Officials in Arkansas have already implemented similar work requirement rules there." The drive "to expand Medicaid in GOP-led states had gotten a boost from the prospect of work requirements, Virginia, work requirements which appeal to conservatives. In are part of a compromise between Democrat ic Gov. Ralph Northam and Republican legislators to expand Medicaid ." The Washington Examiner (6/29, Leonard, 340K) reported the requirements "would have gone into effect Sunday. Republican Gov. Matt Bevin had threatened to discontinue Medicaid expansion in the state, which covers more than 500,000 people, if the requirements were struck down." Additional coverage is provided by CNN (6/29, Luhby, 82.6M), Congressional Quarterly (6/29, Subscription Publicat ion), Forbes (6/29, Japsen, 10.34M), Fortune (6/29, 3.91M), Healthcare Finance News (6/29, 93K), The Hill (6/29, Weixel, 2. 71M), the Huffington Post (6/29, Young, 4 .32M), Kaiser Health News (6/29), Mode rn Healthcare (6/29, Subscription Publication, 239K), the Louisville (KY) Courier-Journal (6/29, 419K), Polit ico (6/29, Pradhan, 3.51M), Vox (6/29, 1.66M), and the Detroit Free Press (6/29, Spangler, 1.21M). /\MERICAi\ pVERSIGHT EXT-18-248-D-000302 Unaccompanied Alien Children Suit Filed Against HHS Alleges "A Wide Range Of Abuses" Against Unaccompanied Minors. USA Today (6/29, Gomez, 11.4M) reported that on Friday, severa l legal groups filed a lawsuit accusing HHS "of mistreating unaccompanied minors in its custody, ordering them to take psychotropic drugs without their relatives' consent and making it overly difficult to reunite them w ith family." The suit was filed on behalf of "five m inors who allege a wide range of abuses at the hands of contractors who run shelters for Health and Human Services ' Office of Refugee Resettlement." the children, "a 12-year-old One of boy from Guatemala who has been in custody since February, has allegedly been admin istered psychotrop ic drugs to treat depression that he developed wh ile in custody." The suit says "the boy refused to continue tak ing the medication because it hurt his stomach, which led shelter officials to transfer him to a psychiatric inst itut ion without consulting his adult sister, who had been trying to w in his re lease ." The Washington Post (6/29, Davis, 15.68M) reported that the lawsuit alleges the 12-year -old boy "went from being calm and cooperative to /\MERICAi\ pVERSIGHT EXT-18-248-D-000303 showing signs of depression brought on by 'be ing kept from his family,"' wh ich had crossed into the US illegally ahead of him. Leecia Welch, an attorney for the Nat ional Center for Youth Law, one of the groups that brought the case, said, "Basic due-process rights" are being "trampled" by the Trump Administration. She added that "parents of children are going through the ringer trying to get their kids out of these detention facilit ies." The Wall Street Journal (6/29, Lazo, Subscription Publication, 6.13M) reported that the suit is seeking class-action status. The five children are from Honduras, Guatemala, El Salvador, and Mexico. It names HHS Secretary Alex Azar and ORR Director E. Scott Lloyd as defendants . The Hill (6/30, Ana pol, 2. 71M) reported that the suit was "fi led Friday in a federal court in California." The five children range in age from 12 to 17, and they all arrived in the US as unaccompanied "alleges that the minors have been held in 'jail-like' minors. The suit conditions and exper ienced 'cruel' pract ices, includ ing being prescribed antidepressants, that may result in lifelong trauma and 'emotional harm."' NBC News (6/30, Mandell, 5. 76M) and Newsweek (6/30, Hutzler, 2.18M) also covered the story. House GOP Seeks Answers From Azar About ORR. /\MERICAi\ pVERSIGHT EXT-18-248-D-000304 The Hill (6/29, Hellmann, 2. 71M) reported that Republicans on the House Energy &Commerce Committee have sent a letter to HHS Secretary Alex Azar asking for answers about the Office of Refugee Resett lement . The article said the lawmakers "asked for answers to a ser ies of questions about ch ildren in ORR custody, including: how many are in ORR custody as a result of being separated from their parents or families; does ORR have the resources to proper ly care for the high number of children being transferred to their custody; what steps is ORR taking to track and address issues of abuse within HHS funded facilit ies and what medications is ORR authorized to administer." The letter stated, "Given HHS' histor ical difficult ies in properly caring for [the children], the committee believes that addit ional scrutiny of ORR is warranted at this time." Fake Story About HHS Losing Immigrant Children Resulted In Discovery Of Separations At The Southern Border . On its website, ABC News (6/30, Pearle, 1.85M) reported that the story about HHS losing almost 1,500 imm igrant children was untrue, yet "it was enough to outrage politicians, stir up journalists and make the public ask questions. Chasing this m islead ing story ... helped uncover a story that many found even more troub ling. And this one was real." The article said that in April, "Steven Wagner, an official at the U.S. Department of Health and Human Services (HHS) who oversees programs that place unaccompanied m inors with families, told a Senate committee that a department office 'was unable to determine with certainty the whereabouts of 1,475 unaccompanied alien children' who had been placed with sponsors living in the United States." In May, /\MERICAi\ pVERSIGHT EXT-18-248-D-000305 Deputy HHS Secretary Eric Hargan "disputed what was becoming a widespread narrative, saying these children were not 'los t ' but had simply been placed with friends and extended family members" who could not be reached. The piece added that while investigating story, reporters uncovered the Trump Administration's this policy of separating immigrant families at the southern border. HHS in the News HHS' Severino Speaks At National Right To Life Conference . The Wichita (KS) Eagle (6/29, Burgess, 316K) reported Roger Severino, who directs the Department of Health and Human Services' Office for Civil Rights, was the featured speaker at the National Rig ht to Life convention Thursday, becoming the first HHS official "in recent memory" to speak at the nation's largest anti-abortion organization. Severino said in his remarks, "Our president is fearless when it comes to life and conscience," adding, "We're just getting started." /\MERICAi\ pVERSIGHT EXT-18-248-D-000306 Several Mid-Level HHS Officials Reportedly Emulating Trump In Tweets. Politico (6/29, Diamond, 3.51M) profiled several "midlevel political appointees at the Health and Human Services Department who have helped shape the agency's communications strategy - even while taking a page out of President Donald Trump's playbook " by emulating his "taunts and gibes" on Twitter. According to Politico, the behavior "suggest[s] that some officials feel empowered to mimic the president even while representing the government to millions of taxpayers and working alongside career federal employees." The article added that the tweeting "also raises questions about whether any officials are violating the Hatch Act, which is intended to ban most federal personnel from bringing politics into the workplace." The piece mentioned officials such as Gavin Smith, "an HHS staffer who identifies himself as deputy communications director," Ximena Barreto, "a deputy communications director who worked on the Trump campaign," and Jon Cordova, "the principal deputy assistant secretary for administration." CMS Looking For Chief Health Informatics Officer. MedCity News (6/29, Dietsche) reported the Centers for Medicare and Medicaid Services "is seeking a chief health informatics officer, according to a job posting on USAjobs.gov ." The individual chosen for the role "will develop requirements and content for health-related information technology with an init ial focus on improving innovat ion and /\MERICAi\ pVERSIGHT EXT-18-248-D-000307 interoperability." CMS Releases Payment Data, Reveals Drug And Medical Device Company Contributions. The Washington Examiner (6/29, King, 340K) reported that the Centers for Medicare and Medicaid Services released its 2017 payment information on Friday. Data show drug and medical dev ice companies provided "$8.4 billion to doctors and teaching hosp itals," that year. Accord ing to the figures, "the biggest amount, $4 . 7 billion, went to research. Coming in second was $2.82 billion for general payments, which include items such as meals, travel to speaking events, and speaking fees." National Guard Soldiers May Have Sleep Problems After Returning Home From The Battlefield , Research Suggests. Reuters (6/29, Weinstock) reported that research suggests "National Guard sold iers may be plagued with sleep problems when they return home from the battlefield." The findings were published online in Sleep Health. Reuters added, "Michael Twery, director of the National Center on Sleep Disorders Research at the National Heart, Lung and Blood Institute ... told Reuters Health by phone that while the study was a /\MERICAi\ pVERSIGHT EXT-18-248-D-000308 small one and needs to be replicated in larger groups of soldiers, it '(lays) a foundat ion to help us design more definit ive studies of sleep in this population."' Federal Officials Say Romaine Lettuce-Linked E. Coli Outbreak Is Officially Over. The Los Angeles Times (6/29, Millman, 4.03M) reported that Federal officials have said the E. coli outbreak tied to Yuma, AZ-grown romaine lettuce is officially over . The CDC has found no "new cases from the outbreak, which started in mid-March and infected people in 36 states." The Times reported, "Dirty irrigation canal water is expected to have caused the outbreak, Food and Drug Administration Commissioner Scott Gottlieb said Thursday, and officials are investigat ing how the bacteria got into the water." Meanwhile, the CDC reported "the last E. coli case from this outbreak June 6." The New York Times (7/1, Jacobs, 19.33M) reports, "Samples of canal water in the Yuma area of Arizona were found to contain the same genetic stra in of E. coli that caused the outbreak, Dr. Scott Gottlieb, commiss ioner of the federal Food and Drug Administration, statement." said in a Dr. Gottlieb said, "More work needs to be done to determine just how and why this strain of E. coli 0157: H7 could have gotten into this body of water and how that led to contamination of romaine lettuce from multiple farms." /\MERICAi\ pVERSIGHT EXT-18-248-D-000309 Emergency Departments Struggling Through Shortages Of Crucial Drugs. The New York Times (7/1, Thomas, 19.33M) reports that emergency departments nat ionw ide are struggling with shortages of "crucial drugs like morphine, which is used to ease the pain of injuries like broken bones , or diltiazem, a heart drug ." The Times adds, "For years, drug shortages have created a behind-the-scenes scramble as pharmacists, doctors and nurses cobble together fixes that are often invisible to patients," but physic ians "around the country say the latest shortages are more directly affecting patient care." A survey of emergency physicians in May by the American College of Emergency Physicians "found that 9 of 10 said they didn't have access to critical medicines, and nearly 4 in 10 said that patients had been negatively affected." FDA Commiss ioner Dr. Scott Gottlieb "acknowledged in an interview that wh ile the agency has made progress, it has not solved the underlying problem," saying, "We are still in the pos ition of trying to put a BandAid on a market that fundamentally hasn't changed." Amazon's PillPack Deal Unlikely To Impact Drug Costs, Analysts Say. The Wall Street Journal (6/29, Rockoff, Walker, Subscript ion Publication, 6 . 13M) reported that Amazon's deal to purchase PillPack may make filling prescr iptions more convenient, but is unlikely to address /\MERICAi\ pVERSIGHT EXT-18-248-D-000310 prescription drug costs, according to industry experts. Those experts suggested that Amazon may be able to negotiate to offer generic versions of medications, but that the main issue with US drug spending is rising cost driven by high-priced biotech therapies, which often must be injected or infused, and which retail pharmacies don't dispense. However, the deal threatens to shift market share from the 64,500 US retail pharmacies, and some analysts suggest Amazon could be looking to take over the role of pharmacy-benefit managers, which currently negotiate drug discounts for insurers and employers. Meanwhile, CNBC (6/29, Lovelace, 4.81M) reported, "FDA Commissioner Scott Gottlieb says Amazon's new push into health care is just fine because anything that makes much needed products, like pharmaceuticals, more accessible to consumers and lowers costs is a positive." In a June 29 interview with CNBC's "Squawk Box," Gottlieb said, "Disruptive competition is a good thing." First Cannabis-Based Prescription Drug Approved By FDA Marks "Watershed" Moment, Industry Members Say. Bloomberg News (6/29, Buckley, 4.46M) reported GW Pharmaceut ica ls has received FDA approval for its medical marijuana treatment " Epidiolex, a prescription drug for children with severe epilepsy," which has been "genetically modified to remove the psychoactive properties." As the "first prescription medicine derived from cannabis permitted to be sold in the U.S.," the drug's approval has been heralded by some industry members as "a watershed event" that the piece said "should help alleviate skepticism among some physicians about the plant's /\MERICAi\ pVERSIGHT EXT-18-248-D-000311 med ical uses ." FDA Commissioner Comments On Efforts To Stem Online Opioid Sales. CNBC's Squawk Box • Video (6/29, 85K) reported on the FDA's summit w ith Facebook, Google, Twitter, and other Internet companies seek ing their help in cracking down on on line opioid sales. In an interview, FDA Commissioner Dr. Scott Gottlieb said, "In 2015, there was data that came out that showed $15 million of on line sales, but we're seeing more and more of the sales being shifted to the online I think as we start to reduce lawful prescribing, so a lot of the medical - a lot of the addiction was people got medically addicted as we see doctors start to prescribe fewer opio ids, we're fearful that more and more of the new addiction is going to sh ift to illic it sources, and a lot of those sales are taking place online." Gottlieb characterized big Internet companies as having "been helpful" and said that "we've been working with them for some period of time now." FDA Report Suggests Ways To Improve Its Hiring Process. Congressional Quarterly (6/29, Siddons, Subscription Publication) reported that the FDA issued a new report that showed that the agency /\MERICAi\ pVERSIGHT EXT-18-248-D-000312 "sees ways that its ability to hire qualified staff could be imp roved, even after Congress granted it new hiring authorities at the end of 2016." The report noted that the new authorities it was granted "included the ability to offer higher salaries for some positions." The report large ly "focuses on ways that the FDA has been implement ing new hire authorities, including which positions it is designating for higher pay scales and how it has sped up its hiring process in several areas." FDA Policy Limiting Blood Donations From Gay Men Draws Scrutiny. The Kansas City (MO) Star (6/29, Randle, 636K) reported an FDA policy from 1983 requiring blood banks "to proh ibit men who have sex with men from donating blood, blood components or plasma" has become "a point of contention for many in the LGBT community who viewed it as archaic and stigmatizing in a time when HIV is less of a threat." The FDA in 2015 "amended its ban to a ' 12 month deferment' policy, allowing men to donate blood as long as they haven't had sex with other men for the past year," but skept ics continue to argue against it. The piece adds that FDA spokeswoman Megan McSeveney said the agency is "fully committed in its actions to facilitate change" and is seeking new means to evaluate blood donors. FDA Warns Pfizer Over "Misleading" Consumer Video . /\MERICAi\ pVERSIGHT EXT-18-248-D-000313 STAT Plus (6/29, Silverman, Subscription Publication, 27K) reported the Food and Drug Admin istration "sco lded" Pfizer "over a consumer video that created a ' misleading impression' of the Estring vag inal ring because there was no risk information." "argued the video 'misleadingly In a June 19 letter, the FDA suggests that patients will experience similar results"' as the person depicted in the video, and the FDA "compla ined this was 'especially concern ing from a public health perspective ' because Estr ing product labeling mentions several ser ious, life-threatening risks, including two forms of cancer." Op-Ed Touts FDA Allowance Of Off-Label Healthcare Economic Discussions. In STAT (6/29, 27K) "F irst Opinion," John Osborn, a senior advisor with Hogan Lovells and a visiting scholar at the UCLA Field ing Schoo l of Public Health and Seth Ray, a senior counsel with O'Melveny &Myers, touted the Trump Administration's issuance of "final guidance that allows drug companies and device makers to provide health care economic and other supporting information committees, to payers and formulary even if the informat ion is outs ide of the FDA approved labeling and was not submitted to the agency in the course of product approval." They suggested that this development "raises the quest ion of whether the agency will take steps to allow companies to provide truthful off-labe l information to phys icians and patients in other contexts." They noted that " in April, FDA Commiss ioner Scott Gottlieb signaled that an expanded safe harbor was coming soon that would provide a 'more robust framework' to allow companies to discuss the value proposit ion and health economic benefits of off-label uses." /\MERICAi\ pVERSIGHT EXT-18-248-D-000314 Maple Syrup Producers, Beekeepers Oppose FDA's "Added Sugars" Label. The AP (7/1) reports that the FDA's "added sugars" labeling is being opposed by maple syrup producers and beekeepers. The agency "has received more than 3,000 comments on its proposal, most of which are from honey and maple syrup producers, the Wisconsin Public Radio reported." The AP reports, "The FDA said that it's look ing forward to 'working with stakeholders to devise a sensible solution," but the "agency said it acknowledges that the feedback from producers indicates that their proposal 'does not provide the clarity that the FDA intended."' CDC Director Changes Stance On Use Of Condoms To Prevent STDs . The AP (6/29, Stobbe) reported that CDC Director Dr. Robert Redfield Jr. "once opposed condoms and needle exchange programs as ways to stop the spread of sexually transmitted diseases." But this week, he said during an interview that "his views have changed." He told the AP that "it has become clear to him that condoms and needle exchanges work as part of comprehensive /\MERICAi\ pVERSIGHT programs to stop the spread of certain EXT-18-248-D-000315 infectious diseases." Redfield was quoted as saying, "One thing I can commit to is CDC is not an opinion organization. It's a science-based, data-driven organization." Speaking about the AIDS epidemic, he added, "We do have the tools to end this epidemic. Let's use them." CDC Map Illustrates Incidence Of Pediatric Cancer In Different US Regions . On its website, NBC News (6/29, 5.76M) reported a new CDC map of cancers in the US indicates pediatr ic "cancer rates are the highest in the Northeast and lowest in the South," that leukemia "is more common in the western states," and "rates of pediatric lymphoma and brain cancer are higher in the Northeast." Lead report author CDC epidemiologist Dr . David Siegel wrote, "Variation in childhood cancer incidence might be related to differences in exposures to carcinogenic chemicals (e.g., air pollution, secondhand smoke, food, or drinking water) or radiation." The piece added, "there might be genetic variations in different populations. Inherited genetics account for about 5 percent of all childhood cancer, the National Cancer Institute says." The NCI was quoted as saying that in adults, certain "gene mutations reflect the cumulative effects of aging and long -term exposure to cancer-causing substances." Health Exec (6/29, Leider) reported the CDC study sourced "data for 2003-2014 from the National Program of Cancer Registries and the National Cancer Inst it ute's Surveillance," a period during which "171,432 cases of pediatric cancer were identified - an incidence rate of 173 .7 cases per one million children." /\MERICAi\ pVERSIGHT EXT-18-248-D-000316 House Legislators Seek More Transparency From FNIH Concerning Donors . Science Magazine (6/29, Mervis, 441K) reported a House appropriations subcommittee Institutes is concerned that the Foundation for the National of Health ( FNIH) may not be adhering to funding disclosure rules dictated by the Public Health Service Act (PHSA). Science said the House report specifically addressed ident ifying donors "who have attached strings to their gift by labeling them as 'anonymous."' However, FNIH senior vice president of research partnerships David Whalley said, "We have the responsibility ... to do these partnerships that support the NIH mission .... And we have always complied with the law." FNIH development office head Julie Wolf-Rodda said, "The lion's share of anonymous gifts are from a relative of someone who was treated at the NIH Clinical Center ... and doesn't want their name listed in the annual report." The piece noted that "NIH Director Francis Collins canceled a $100-mi llion study on the effects of moderate alcohol drinking" following "an investigation found NIH staff had improperly solicited industry directly and shaped the study to satisfy industry interests." NCI Research Funding Priorities Following Budget Increases Outlined. /\MERICAi\ pVERSIGHT EXT-18-248-D-000317 In a paywalled piece, the Cancer Letter (6/29, Ong) reported on the NCI's funding priorities after receiving "a $147 million increase to the Research Grant Project poo l," $60 million for "targeted opportunities," research "a $20 million increase for centers and SPOREs," and "$10 million for the National Clinical Trials Network and the NCI Community Oncology Research Program." With its "$275 million increase over fisca l 2017 levels," NCI has an enacted 2018 budget of $5.66 billion . The piece quoted NCI Director Ned Sharpless as saying, "there was about almost a $40 million increase in taps, benefits, and salaries .... These are things that the NCI has to experience. There's an increase to our [Small Business Innovation Research program] funding, it's a fixed grade of our external budget." NCI Establishes National Clinical Trials Network Navigator To Augment Access To Cancer Trial Specimens , Data. HemOn c Today (6/29, Mishkin, 98K) reported the NCI recently established the National Clinical Trials Network (NCTN) Navigator which aims "to improve the research community's data collected from cancer treatment access to specimens and trials" by providing researchers with "access to specimens donated by adults who participated in published NCI-sponsored phase 3 cancer trials." The piece included an interview with Grace Mishkin, MPH, public health analyst at NCI, who explained, "This init iat ive is designed to align with the goals of NCTN by taking a more network-wide centralized approach to making the specimens from these trials more available to the wider research community," adding, "Ultimately, the goal is to have studies come through the navigator process and evaluate biomarkers that can hopefully be used in future clinical trials." /\MERICAi\ pVERSIGHT EXT-18-248-D-000318 NIDOCD Study Indicates Partially-Restored Hearing In Mouse Model Of Inherited Deafness. The Beck ley (WV) Register-Hera ld (7/1, Holdren, 59K) reports a new study conducted by the National Institutes on Deafness and Other Communication of Health's National Institute Disorders, the University of Iowa, and Iowa City ind icates new understandings of "the molecular mechanism in a form of deafness, DFNA27," and "focused on a smallmolecule drug - the first to preserve hearing in a mouse model of an inherited form of progressive human deafness." Study co-author Thomas B. Friedman, PhD, chief of the Laboratory of Human Molecular Genetics at the NIDCD, explained, "We were able to part ially restore hearing, especially at lower frequencies, and save some sensory hair cells." Andrew J. Griffith, scientific director of the NIDCD, said that by following the genetic indicators, "We find novel and unexpected pathways that can, in cases such as this one, uncover unexpected potential treatment strategies in humans ." Senate Committee Considers Additional $2 Billion For NIH In 2019. In a paywalled piece, the Cancer Letter (6/29, Williams, Ong) reported the Senate Committee on Appropriations /\MERICAi\ pVERSIGHT submitted a fiscal 2019 EXT-18-248-D-000319 spending bill last week which would increase NIH funding by $2 billion, giving it $ 39.1 billion. If the measure is enacted, "federally-funded biomed ical research would get its fourth consecutive increase," and $190 million in new money of the total allocation would "trickle down to NCI." The piece added that the House similarly drafted a bill which "proposes a $1.25 billion increase for NIH, bringing the total to $38.3 billion." NIH Recommends Strategies For Older Adults To Avoid Hypothermia In Summer Heat. The Beck ley (WV) Register-Hera ld (6/29, Holdren, Nelson, 59K) reported, "The National Inst itutes of Health (NIH) is encouraging older adults to take certain precautions this summer to avo id hyperthermia," recommending that older adu lts "stay indoors on particular ly hot and humid days." The NIH also advises staying hydrated, wearing lightcolored and loose-fitt ing clothes, keep ing homes and community centers cool, and visiting air - conditioned locations . Johns Hopkins Tops List Of Leading NIH Grant Recipients In Baltimore Area. The Baltimore Business Journa l (6/29, Sieren, Subscription Publicat ion, /\MERICAi\ pVERSIGHT EXT-18-248-D-000320 823K) reported Johns Hopkins University again leads the list of top NIH grant recipients in Greater Baltimore for 2017 "with a total grant value of $651.8 million last year." The other leading grant recipients include the University of Maryland, Baltimore, the Kennedy Krieger Inst itute, the University of Maryland, Baltimore County, and Profectus BioSciences Inc. Opioid Crisis Opioid Deaths In Missouri Still On The Rise, But Growth Rate Slowing Down. The AP (7/1) reports that while op ioid related deaths "continue to increase in Missouri, the growth rate is slowing down, according to a new report ." The Missouri Department of Health and Senior Services "found that there was a 4. 7 percent increase in opioid deaths from 2016 to 2017, the Columbia Missour ian reported." That rate " is much lower than the 35 percent spike seen from 2015 to 2016 ." /\MERICAi\ pVERSIGHT EXT-18-248-D-000321 Ohio Auditor's Report Shows Impact Of Opioids On Medicaid. The AP (7 /1) reports that a state auditor's report "looking at the impact of the opioid crisis on state Medicaid spending shows the number of Ohio Medicaid recipients with an opioid-related diagnos is quadrupling from 2010 to 2016." The report "recently released by Ohio Auditor Dave Yost shows the number of Ohio Medicaid recip ients with an opioidrelated diagnosis cl imbed 430 percent between 2010 and 2016 ." New Research Shows How Opioids Are Impacting The Workforce In Kentucky . The AP (6/30) reported that new research shows how opioids are affecting the workforce in Kentucky. The research shows "that the state's high use of painkill ing drugs called opioids appears to have reduced the labor pool." In a paper "publ ished by the Federal Reserve Bank of Cleveland, economists Dionissi Aliprantis and Mark E. Schweitzer estimated that partic ipation in the labor force by men in their prime work ing years - ages 24 to 54 - was 4.6 percent less on average in counties with high rates of opioid prescrib ing than in counties with low prescribing rates." /\MERICAi\ pVERSIGHT EXT-18-248-D-000322 Georgia Will Require Doctors To Check Database Before Prescribing Opioids. The Atlanta Journa l-Constitution (6/29, 1.09M) reported that starting July 1, writing a prescr iption for opioid pain med icat ions in Georg ia "will requ ire an extra step ... that lawmakers hope may push health care professionals to make better prescr ibing dec isions." A state law that was passed last year "mandates that doctors, dentists and other prescribers check a database to determine what prescr iptions pat ients have recently filled before doling out certain drugs, including opio id painkillers and benzodiazepines such as Xanax." Arizona County Joins Opioid Manufacturer Lawsuit. The Ar izona Republic (6/30, Wagner, 1.21M) reported that cities and count ies across the US "have joined a nationwide lawsuit against corporat ions that make and distribute opioids, seeking to recoup tax dollars spent fighting America's painkiller -add iction epidemic ." Cochise County in Arizona "became the latest to file suit th is week, joining at least 1,500 local, state and tribal governments that in the past year have filed federal court complaints against Purdue Pharma LP, the manufacturer of OxyCont in, and other companies." /\MERICAi\ pVERSIGHT EXT-18-248-D-000323 Pennsylvania Law Aims To Protect Newborns Affected By Opioid Addiction. The Philadelphia Inquirer (6/29, McCullough, 1.07M) reported the Pennsylvania legislature last week passed a bill "that will dramat ically change the ru les for safeguard ing newborns who go home from the hospital with mothers battling add iction." The overhau l, "effective in October, says any newborn 'affected' by the mother's drug use during pregnancy must be reported by the hosp ital to the county's child protect ive agency, which must 'immediately' assess whether protective custody is needed. The agency has to develop a 'plan of safe care ' for babies who go home." Innovative Program At Kentucky Jail Provides In-House Rehab For Inmates. Fox News (7/1, Kesten, 16.38M) reports that a jail in Kenton County, Kentucky started "an innovative pilot program" back in 2015 that provides in-house rehab for inmates. Today, the program "is so successful that it has a running wait list," and "the vast maj ority of men sign themse lves up." That rehab program, "called Unit 104, houses 70 men," who "have access to alcoholics and narcotics anonymous meetings, along with a daily schedule of classes to prepare for the G.E.D. or future job interviews." /\MERICAi\ pVERSIGHT EXT-18-248-D-000324 Nashville Family Loses Three Loved Ones "To Drugs' Grip." The Ten nessean (7/1, Wadhwani, 513K) reports t hat a family in Nashville has lost three loved ones in drug-related accidents since 2013. Mickey and Tina Baltz's son died in a car accident in 2013 when former 3 Doors Down bassist - hav ing the opioid oxycodone and the muscle relaxant alprazolam in his system - clipped his car on the inte rstate. Then in 2016, their daughter's former boyfriend, Ralph Hardin, 29, "was fatally shot with his own gun in a room at the Red Roof Inn, where the Baltzes say - he had gone to confront" the Baltz's daughter's drug dea ler. And earlier this year, their daughter, Heather Baltz, died "of a heart infection doctors believe originated with a contaminated needle used to shoot heroin. She had turned to heroin after running out of pain pills prescribed for gallbladder surgery in 2014." Media Collaborates To Share Solutions To Opioid Crisis. The AP (6/28, De Groot) reported more than 50 print, digital, and broadcast news organizations "are casting a spotlight on the diverse and sometimes out-of the-ordinary tactics being used to combat the devastating effects of the opioids crisis across Pennsylvania, from the smallest towns to the biggest cities." One goal of the media collaboration was "to make sure communities in every part of the state are aware of strategies, innovations and community efforts that are helping to alleviate the crisis, or at least show promise." /\MERICAi\ pVERSIGHT EXT-18-248-D-000325 Police Using Databases To Crack Down On Opioid Abuse . Politico (6/29, Tahir, 3.51M) reported, "Bolstered by harsh law-andorder rhetoric from President Donald Trump and his aides, police around the country are using electronic databases to unleash a vast crackdown on opioid abusers and the allegedly crooked doctors who sustain them." The databases are helping "to reduce opioid prescriptions, which have fallen by nearly a third since 2011." Metrohealth Cuts Opioid Prescriptions By 3 Million. The Cleveland Plain Dealer (6/29, 1.03M) reported the MetroHealth System "is looking internally to strike the next blow in Ohio's battle against the opioid epidemic." MetroHealth "cut the number of opioid pills prescribed by 3 million, Dr. Akram Boutros, president and CEO of MetroHealth, announced Friday during MetroHealth's annual stakeholders meeting at the Hunt ington Convention Center of Cleveland." During the annual meeting, Boutros "also told the crowd of 700 about a new initiative to address community trauma and shared updated plans for a new 11-story, 270-bed 'hospital in a park' on its main campus off West 25th Street." /\MERICAi\ pVERSIGHT EXT-18-248-D-000326 Modern Healthcare (6/29, Johnson, Subscription Publication, 239K) reported the efforts "resulted in 33% fewer opioid prescriptions compared with the previous 18 months." That includes "a 62% drop in prescriptions for acute pain and a 25% cut in prescriptions for chronic pain." NBC Analysis : France Seems To Have Solution To Its Own Opioid Crisis . NBC Nightly News • Video (7/1, story 9, 3:10, Jackson, 8.26M) reported that France appears to have found a way to "dramatically cut down on the number of people who die from overdosing" on opioids. France, which went t hro ug h it's "own opioid epidemic" in the 1980s and 1990s, began allowing all general practitioners buprenorphine in the mid-1990s. to prescribe In four years, "overdose deaths dropped by 79 percent, and even now, 64 percent of hero in and other opioid substance abusers are on the treatment. Under France's universal health system, it's free." NBC's Dr. John Torres said buprenorphine "works and saves lives" but isn't being used in the US because it's not covered in all states, and doctors who would prescribe it would need "special training." /\MERICAi\ pVERSIGHT EXT-18-248-D-000327 Mental Illness Student Groups On College Campuses May Improve Access To Mental Health Resources, Study Suggests . The Huffington Post (6/30, Pajer, 4.32M) reported that some college students "are taking action" to improve access to mental healthcare and "address the culture that makes their peers reluctant to seek help." The article said some students "have formed clubs and support groups," wh ile "others educate fellow students about mental health offerings on campus." A new study which examines such groups across 12 California schools found that "students' efforts are working," and said that the presence of these groups on campus "was found to foster an increase in general knowledge and posit ive attitudes about mental health," according to the article. Healthcare Fraud /\MERICAi\ pVERSIGHT EXT-18-248-D-000328 Tennessee CEO Indicted In $2.5 Million Medicare Fraud Case. The Tennessean (6/29, Kelman, 513K) reported in cont inuing coverage about a "nationwide health care fraud takedown" that "led to hundreds of arrests in a host of unconnected cases across the nation." The article said "Brenda Montgomery, 70, of Camden, the owner of CCC Medical, Inc., has been charged with conspiracy and bribery, according to a federal indictment that was unsea led Thursday." The Tennessee company "sold knee, wrist and back braces. " According to the piece, "Montgomery was identified as [the] leader of the alleged Tennessee bribery conspiracy, which prosecutors say spanned six years before being discovered in January . Federal prosecutors also charged four others: Beau Jones, 50, of Loudon; and Sarah Dacus, 36; Greg Lawson, 42; and Josh Wiley, 35; all of Knoxville." Dallas Healthcare Center Service Provider Charged In $2.5 Million Medicare Fraud Scheme. The Dallas Morning News (6/29, Coello, Reporter, 1.05M) reported that the operator of a Dallas healthcare practice was arrested Thursday and "faces a fraud charge after a record-break ing enforcement action by the Medicare Fraud Strike Force." A federal complaint alleges that Nehaj Rizvi, 29, who operated Life Spring Housecall Physicians, "used a physician's signature stamp to sign certifications and orders for supposedly homebound patients who did not actually need the endorsed /\MERICAi\ pVERSIGHT EXT-18-248-D-000329 treatments," accord ing to the art icle. Life Spring distributed orders and certifications physician "to over 100 home hea lth agencies, allowing them to charge Medicare about $2.5 million in false billings, according to the complaint." Prescription Drug Pricing Epilepsy Drug's Price Increase Highlighted. CNN (6/29, Drash, For, 82.6M) highlighted the case of Trevor Foltz, a teen who lives with infantile spasms, a rare form of ep ilepsy. The treatment needed for his survival, Acthar (repos itory corticotropin), increased in price from $1,600 per dose to "more than $23,000," and his family "wrestled with the ir insurance" to get him treated "at a cost of more than $125,000 ." The family had to fight for another round of treatment more than a year later, meaning another cost of $125,000. The drug, first invented in the 1930s, cost $40 per vial back in 2001 and now costs $39,000 per vial. Ult imately, the steep price hike "resulted in a $ 100 million settlement between the government and the drugmaker - as well as revelations that Medicare has spent nearly $2 billion covering Acthar prescript ions for seniors wh ile the drugmaker paid millions to prescrib ing doctors." /\MERICAi\ pVERSIGHT EXT-18-248-D-000330 Op-Ed: "American Patients First" Plan Neglects Key Elements Necessary To Reduce Drug Costs. Hagop Kantarjian, MD, health policy fellow at Rice University's Baker Institute for Public Policy, and Vivian Ho, PhD, Baker Institute chair in health economics and director at the Center for Health and Biosciences, write in an op-ed for The Hill (7 /1, 2. 71M) that the Trump Administration "should reconsider thoughtfully" the "American Patients First" drug pricing proposa l released in May by the Department of Health and Human Services because it "is unlikely" the plan will yield the changes necessary to cut drug costs. According to the authors, a successful plan "must address controlling drug prices through reducing the launch price of new drugs; prohib it ing unjustified annual increases of prices, and protecting patients from excessive out-of-pocket expenses." However, they conclude, the "'American Patients First' road map ignores all three." Editorial: More Policies Requiring Transparency Of PBMs Are Necessary To Combat Drug Prices. In an editorial, the Columbus (OH) Dispatch (7/1, 399K) argues for increased transparency /\MERICAi\ pVERSIGHT regarding the role of pharmacy benefit EXT-18-248-D-000331 managers (PBMs) play in drug pricing. The Dispatch says PBMs "were once hailed as an answer to provide needed cost controls through claims management for insurers and payers," but now "have been revealed as lining their pockets" in their contracts with prescription-drug manufacturers and payers. The editorial applauds the implementation of state contracts requiring transparency about pricing from "two of the nation's largest PBMs, CVS Caremark and Optum Rx," which took effect Sunday, and calls for "Medicaid administrators, legislators, office holders and would-be office holders ... [to] continue demanding more transparency until we can all be assured that consumers and taxpayers are being treated fairly." Op-Ed Criticizes Pharmacy Benefit Managers . In an op-ed in STAT (6/29, 27K), Scott Knoer, PharmD, the chief pharmacy officer of the Cleveland Clinic, argued that pharmacy benefit managers engage in "financial shenanigans" rather than helping "control costs for payers and lower out-of-pocket costs for plan membe rs." Knoer contended that PBMs have been able to do this for so long because they "closely guard their complicated processes to avoid scrutiny, and require pharmac ies to sign confidential agreements that shield them from visibility." And, since just three PBMs "control 73 percent of the market," there are often "abuses" of the system. Knoer detailed five ways in which PBMs "make the ir unparalleled high profits" - processing of claims, negotiation of rebates, the spread, or "differe nce between what a pharmacy benefit manager collects from the payer (such as Medicaid) for medications and the amount it pays the pharmacy that dispenses it," as well as by "forcing patients to use specific pharmac ies," and via remuneration fees . /\MERICAi\ pVERSIGHT EXT-18-248-D-000332 Op-Ed: State, Federal Laws Should Empower Pharmacists To Help Manage Drug Costs . In an op-ed in The Hill (6/29, 2. 71M), Lucinda L. Maine, PhD, RPh, the Executive Vice President and CEO of the Amer ican Association of Colleges of Pharmacy, argued that "pharmacists are in a good position to assist" with the challenges of medication costs, "if state and federal laws would allow ." She pointed out that when "pat ients elect not to fill a prescript ion or use only a few doses w ithout finish ing the course," this can increase healthcare costs . She pointed out that "the American Association of Colleges of Pharmacy has long advocated for legislative and regulatory changes to professional practice that would he lp some 200 million Americans better manage their chronic diseases so that more lives could be saved." Among the changes she suggested is "increasing public access to and coverage for pharmacists' medication management services." Health Care &Insurance Reform /\MERICAi\ pVERSIGHT EXT-18-248-D-000333 Sen. Collins Says She Will Oppose Supreme Court Pick Who Shows "Hostility " To Roe V. Wade. The Washington Post (7 /1, Long, 15.68M) reports Sen. Susan Collins (R-ME) is a "key swing vote on President Trump's next Supreme Court pick" and she said she will not support "any judge who would overturn Roe v. Wade." Collins said Sunday on CNN's State of the Union, "I would not support a nominee who demonstrated hostility to Roe v. Wade." The New York Times (7 /1, Fandos, Cochrane, 19.33M) reports that Sen. Collins is "among the few remaining voices of centrism in the Republican Party," and "is one of two Republican senators who have supported abortion rights and, in the past, have shown themselves willing to break with their party." The AP (7 /1, Yen, Thomas) reports Sen. Collins explained that any judge with such hostility to precedent "would not be acceptable to me because that would ind icate an activist agenda." The AP adds, "Republicans hold a narrow 51-49 majority in the Senate, and it's even closer because of the absence of ailing Sen. John McCain of Arizona." CNN (7 /1, Watkins, 82.6M) reports Collins "said when she met with President Donald Trump to discuss the vacancy created by the retirement of Justice Anthony Kennedy, she encouraged Trump 'to broaden his list beyond' his standing list of 25 potential choices." She said, "The President really was soliciting my views on the type of /\MERICAi\ pVERSIGHT EXT-18-248-D-000334 nominee that I was looking for," adding, "I emphasized that I wanted a nominee who would respect precedent, a fundamental tenet of our judicial system." Collins also said, "I want a judge who will apply the law to the facts of the case with fidelity to the Const itut ion" and "Roe v. Wade is a constitutiona l right that is well established, and no less an authority than Chief Just ice Roberts said that repeatedly at his confirmation hear ing." Bloomberg News (7/1, Niquette, Condon, 4.46M) reports Collins said of the president's process, "I got the feeling that he was still deliberat ing and had not yet reached a decision, and that this was genuine outreach on his part ." She added, "There are people on that list whom I could not support." The Washington Examiner (7/1, Ayers, 340K) reports Sen. Collins pointed out that Just ice Neil Gorsuch wou ld likely not overturn Roe v. Wade. She explained, "I had a very long discuss ion with Justice Gorsuch in my office and he pointed out to me that he [is] the co-author of a whole book on precedent," adding, "So someone who devotes that much t ime to writing a book on precedent, I think, understands how important a principle that is in our judic ial system." Also reporting are Reuters (7/1, Dunsmuir), the Was hington T imes (7/1, Richardson, 460K) and Politico (7/1, Kullgren, 3 .51M) . Most Americans Do Not Want To Overturn Roe V. Wade, Poll Says. Congressio nal Qua rte rly (6/29, Raman, Subscription Publication) /\MERICAi\ pVERSIGHT EXT-18-248-D-000335 reported according to a survey released Friday , only 29 percent of Americans support overturning Roe v. Wade. The poll was conducted before Supreme Court Justice Anthony Kennedy announced he was retiring. Among Republicans, 53 percent want the case overturned, wh ile 81 percent of Democrats and 73 percent of independents do not. The Hill (6/29, Hellmann, 2 . 71M) reported, "Sixty - eight percent of women and 65 percent of men said they want the decision to remain the law of the land." The poll was from the Kaiser Family Foundation. The Hill added, "Forty-percent of adults sa id they are more like ly to vote for a cand idate who supports access to abortion services, while 30 percent said a candidate who supports abort ion restrictions is more likely to get their vote." Politico (6/29, Diamond, 3.51M) reported the po ll found 67 percent of Americans "oppose rolling back constitutional protections for access to abortion." The poll also showed that "67 percent of Democrats oppose the Trump administration's going to organizations proposal to prohibit federal funding from that provide abort ion services, while Republicans are nearly split" with 46 percent in support and 48 in opposition. The Washington Examiner (6/29, Leonard, 340K) also reports. Trump Judicial Adviser Claims None Of Top Supreme Court Candidates Have A "Clear Posit ion" On Roe V. Wade. The Washington Examiner (7/1, Williams, 340K) reports Leonard Leo, a "top Trump judicial adviser" and vice president of the Federalist Society, /\MERICAi\ pVERSIGHT EXT-18-248-D-000336 "none of the reportedly top individuals on the administration's shortlist of candidates to replace retiring Supreme Court Justice Anthony Kennedy have a clear position on whether to overturn" the Roe v. Wade hold ing. Leo said, "Prospective nominees li ke Brett Kavanaugh, and Amy Barrett, and Raymond Kethledge, and Tom Hardiman are people who have not specifically said they oppose Roe v. Wade, and their writings and their work show that they are very fair." He added, "They look at arguments from both sides all the time and they analyze them very carefully, and when they take a position, they then say these are what the other peop le have said about this and here's why I don't agree with them." Advocacy Groups Plan To Spend Millions On Supreme Court Nomination Battle. NPR (7/1, Overby, 3.SSM) reports both sides of the upcoming battle over President Trump's nomination to the Supreme Court are "expected to spend tens of millions of dollars." NPR adds, "the Judicial Crisis Network, wh ich pledged $10 million to win confirmation for Just ice Neil Gorsuch last year, is gearing up again" and so are "plenty of other groups," including "the Koch brothers' Americans for Prosperity, which said it's 'prepared to commit seven figures,' the anti - abort ion Susan B. Anthony Fund, Heritage Action and others." The article says, "Some liberal groups say this won't be like other confirmation fights, and they hope to put the future of the Affordable Care Act, or Obamacare, at the center." Opinion: Ending Abort ion Is The Beginning, Not The End. Kimberly Ross wrote in the Washington Examiner (6/29, Ross, 340K) that "Abort ion has reached a near-sacramental /\MERICAi\ pVERSIGHT status in the Left's EXT-18-248-D-000337 political religion" and "to encroach upon this holy ground is tantamount to war." Ross added, "One day, we hope to look back on abortion as we now do slavery and wonder how a nation built on freedom ever permitted and celebrated such a daily horror." She concluded, "While there may be a potential victory on the horizon, pro-lifers should not trick themselves into believing such a thing means our mission is accomplished." Opinion: Antiabortion Groups Are "Laying Low" About Overturning Roe. Jennifer Rubin wrote in the Washington Post (6/29, 15.68M) in its "Right Turn" blog that "pro-life activists are trying to lay low" about being "on the brink of achieving their dream of a 5-4 court ready to reverse Roe v. Wade." Rubin criticized their "different tune" and says, "pro-life activists should have the power of their convictions," noting, "they have spent their lives saying they want to eradicate abortion and that the American people were with them. Now is the time to have that fight." Opinion: People Need To Mobilize Against Trump's Supreme Court Pick. EJ Dionne Jr. writes in the Washington Post (7/1, Dionne, 15.68M) that Sen. Elizabeth Warren (D-MA) was correct when she called the replacement of Supreme Court Justice Anthony Kennedy the "fight of our lives." Dionne says, "There is no choice but to mobilize." He adds, "The future of abortion rights is central to the coming battle. But so are civil rights, corporate power and our democratic capacity to correct social injustices." /\MERICAi\ pVERSIGHT EXT-18-248-D-000338 Medical Advances Have Contributed To Plunging Abortion Rates. The New York Times (7/1, Al, Belluck, Hoffman, 19.33M) reports on its front page that "America even without legal abortion would be very different from America before abortion was legal." The article explains, "a full-fledged return to an era of back-alley, coat-hanger abortions seems improbable" because "a burst of scientific innovat ion has produced more effective, simpler and safer ways to prevent pregnancies and to stop them after conception - advances that have contributed to an abortion rate that has already plunged by half since the 1980s." Iowa Supreme Court Rules Against 72-Hour Abortion Waiting Period. The AP (6/29, Pitt) reported the Iowa Supreme Court on Friday ruled 52 that a state law requiring a 72-hour waiting period for abortions is unconstitutional, saying that "autonomy and dominion over one's body go to the very heart of what it means to be free." The court determined the restriction was not "narrowly tailored to serve a compelling interest of the state." Reuters (6/29, Goldberg) reported that there is a "separate challenge pending" over another provision of the law "that outlaws abortion after /\MERICAi\ pVERSIGHT EXT-18-248-D-000339 a fetal heartbeat is detected." Also reporting were The Hill (6/29, Wise, 2.71M) and the Washingto n Examiner (6/29, King, 340K). Opinion: Women Must Speak Up To Defend Abortion Rights. Cindi Leive, former editor in chief of Glamour and Self, wrote in the New Yor k Times (6/30, 19.33M) that as Justice Anthony Kennedy, "whose vote has helped protect abortion rights over his 30 years on the Supreme Court, prepares to retire, we are faced with the very real prospect of a court that would overturn Roe, at a t ime when states across the country are already restricting abortion rights." Leive emphasized the importance of women who have had an abortion sharing their stories if they feel comfortable with doing so because "silence ... allows menacing myths about abortion to thrive ." Leive said the right to abortion "is under greater threat than it has been in my adult lifetime," and concluded that "just as women decades ago shared their stories en masse in an effort to change inhumane laws, it's time for those of us who feel we can share to do so once again." New Mexico Democrats Push To Repeal State Abortion Law. /\MERICAi\ pVERSIGHT EXT-18-248-D-000340 The Albuquerque (NM) Journal (6/29, McKay, 215K) reported that Democratic lawmakers in New Mexico are renewing efforts to repeal a state law that makes it a crime for an abortion provider to end a women's pregnancy, except in narrow circumstances. "in part because the retirement The push comes of U.S. Supreme Court Justice Anthony Kennedy will allow President Donald Trump to nominate his successor," according to the article. Supreme Court Ruling Raises Doubts About Illinois Abortion Law. The Chicago Tribune (7 /1, Lourgos , 2.37M) reports the Supreme Court's recent decision to back anti-abortion pregnancy centers is raising doubts about an Illinois law that says "medical providers must inform patients about all available medical options, including abortion and contraception, even if the nurse or physician has faith-based or moral objections." Some States Taking Action To Support ACA. The Washington Post (7 /1, Goldstein, 15.68M) reports on efforts by state governments to buttress the protections of the Affordable Care Act /\MERICAi\ pVERSIGHT EXT-18-248-D-000341 against efforts by the federal government discusses individual mandate requirements to "erode the ACA." The Post passed in New Jersey, Vermont, and DC, as well as state efforts to erect "barriers aga inst rules the Trump administration is writing to promote short-term health plans." The Post explains how "taken together, the moves mean the nation is starting to revert to the insurance landscape of a decade ago - a hodgepodge that created the political pressures that culminated in the sweeping 2010 law" - where each state had different insurance requ irements . House Vote To Repeal Medical Device Tax May Bolster Vulnerable GOP Lawmaker . The Hill (7 /1, Sullivan, 2. 71M) reports that the House is planning to vote this month on legislation that would repeal the Affordable Care Act's medical device tax, which would "satisfy industry leaders and boost the reelection prospects for the bill's sponsor," Rep. Erik Paulsen (R- MN), whose seat is "vulnerable." Several dev ice makers are based in Paulsen's district. Repealing the tax is "absolutely district," popu lar in this according to Larry Jacobs, a political science professor at the University of Minnesota. Sen. Durbin Says Trump Seeking Court Nominee Who Will Overturn Roe, Affordable Care Act. /\MERICAi\ pVERSIGHT EXT-18-248-D-000342 The Washingto n Times (7/1, Richardson , 460K) reports Senate Minor ity Whip Dick Durbin said President Trump is seeking to nominate a just ice to the Supreme Court who will overturn Roe v. Wade and the Affordable Care Act . Du rbin said, "The president is looking for someone who will overturn Roe versus Wade .... But even equally important, he's looking for someone on the court who will make sure that they ru le that the Affordable Care Act's protection of those with preex isting conditions is unconstitutional." Trump Administration Proposes Cuts To ACA Navigato rs. The Hill (6/29, Sullivan, 2. 71M) reported the Trump Administration has proposed cutting the fund ing for Affordable Care Act navigators from $36 million last year to $ 10 mi llion this year. The Administration cut the funding from $63 million to $36 million in 2017. While a spokeswoman for the Department of Health and Human Services "did not respond to a request for comment," but sources "say that proposa l now cou ld be walked back, and it is possible fund ing could remain the same as last year, but it is unclear where the final number will end up ." Health Insurers Offering ACA Plans In More States , But At Higher Premiums . /\MERICAi\ pVERSIGHT EXT-18-248-D-000343 The Washingto n Examiner (7/2, Leonard, 340K) reports that even though health insurers are planning to expand their participation under the Affordable Care Act, the "trend is coming at the expense of higher premiums for certain customers." The "entrance by insurers into Obamacare is a reversal from years of exits." The Examiner reports that Oscar Health is expanding into three new states; Centene "has fi led in North Carolina and Tennessee;" and Well mark Blue Cross and Blue Shield, Molina, and Medica are also adding states. Obama Told Trump To Take Credit For ACA . The Hill (6/29, Sullivan, 2. 71M) reported former President Barack Obama revealed Thursday that he told President Trump, "Just change the name and claim that you made these wonderful changes and I would be like, 'You go."' Obama added, "Because I didn't have pride of authorship, I just wanted people to have health care." Newsweek (6/29, Touchberry, 2.18M) reports that "Obama reite rated Thursday that he did not take up the issue of health care because he wanted to preserve his legacy or receive credit." Obama said, "The idea that I somehow took on health care just because I thought it was fun or it would somehow burnish my legacy is nuts," adding, "Because we knew going [into] 2008 that every president since Teddy Roosevelt had fai led to do what every other advanced democracy in the world has done ." /\MERICAi\ pVERSIGHT EXT-18-248-D-000344 Insurance Premiums Set To Sharply Rise Next Year In New York. News day ( NY) (7/1, Polsky, 1.52M) reports that insurance premiums in New York state are positioned to "rise sharply in January, as measures to undercut the Affordab le Care Act start to take effect." The 14 insurers in the state "are ask ing for a weighted-average hike of 24 percent, with individual requests ranging from an actual rate cut to up to a 38.6 percent increase." Newsday adds, "The highest rate was requested by Fidelis Care, which has the highest percentage of individual enrollment in 2018, with 41 percent of enrollees with qualified health plans." Medica To Add Two More States : Missouri , Oklahoma. The Min neapolis Star Tribun e (6/29, Snowbeck, 1.16M) reports hea lth insurer Medica is planning on expanding next year into individua l insurance markets in Missouri and Ok lahoma . The growth brings the insurer's tota l to eight states. The Star Tribune points out, "Wh ile many health insurers over the past two years have f led red ink in the indiv idual market under the federal Affordable Care Act (ACA), Medica has grown from its base in Minnesota, North Dakota and Wiscons in into Iowa, Kansas and Nebraska." /\MERICAi\ pVERSIGHT EXT-18-248-D-000345 University Of Mississippi Medical Center To Continue Treating Blue Cross Patients As In-Network During Mediation Process . The Jackson (MS) Clarion Ledger (6/29, Wolfe, 287K) reported the University of Mississippi Medical Center has agreed to continue treating patients with insurance from Blue Cross &Blue Shield as "in-network" whi le the two attempt to resolve a contract dispute. Both sides have agreed to meet with a "professional mediator." Opinion: IRS Should Let Workers Spend Pretax Money On Healthcare. Regina Herzlinger, a Harvard Business School professor, and Joel Klein, chief policy and strategy officer at Oscar Health, writes the Wall Street Journal (7/1, Subscription Publicat ion, 6.13M) that healthcare is becoming an unsustainable expense as the Milli man Medical Index estimates that insurance for an American family of four was $28,000 this year . They propose a solution to have the Internal Revenue Service permit workers to buy health insurance using pretax dollars, like employers . /\MERICAi\ pVERSIGHT EXT-18-248-D-000346 Editorial: Minnesota Helps Bring Insurance Premiums Down, But Faces Funding "Cliff." The Minneapolis St ar Tribun e (6/30, 1.16M) editor ialized that insurers in Minnesota are proposing rate decreases on the individual market by 7 to 12 percent . The editorial explained that the state legislature's "reinsurance" program "played a played a lead role in keeping rates down." The piece adds, "A different and far more daunting hea lth care cha llenge looms : a tower ing state funding cliff that could weaken Minnesota's health-care-driven economy and underm ine coverage for 982,000 Minnesotans rely ing on public programs." Op-Ed: Most Physicians Unaware Of Ways They Can Reduce Healthcare Costs For Patients. Hussain Lalani, resident physician in Dallas, Texas, wr ites in a column for the Dall as Mornin g News (6/29, 1.0SM) that as one of more than 30,000 new physicians beginn ing medical residency July 1, he is "concerned that we will contribute to the $750 billion epidemic of excessive hea lth care spending ... and risk financially hurting our pat ients if we do not know the cost of what we prescribe. " Lalani exp lained, "Most pat ients want their doctors to talk about costs of care with them . . . . Yet, most docto rs don't know the specific costs of what they prescribe ." He noted t hat often, t here are "cheaper, equa lly effective alternatives" /\MERICAi\ pVERSIGHT physicians can use to minimize hea lthcare costs. EXT-18-248-D-000347 Human Services News HHS Provides Maine Group With $200K Grant For Health Work. The AP (7 /1) reports that the Department of Health and Human Services has provided a $200,000 grant to help the Aroostook County, Maine Action Program "connect more residents with health services." Sens. Angus King (I-ME) and Susan Collins (R-ME) "say the action program plays an important role in linking residents of far northern Maine to services." July 1 Marks Change In Arizona Child Welfare Laws. The Ar izona Republic (7 /1, 1.21M) reports that July 1 marked a change /\MERICAi\ pVERSIGHT EXT-18-248-D-000348 in Arizona's child-welfare proceedings. As of that date, "except in emergency situations, child welfare workers will no longer be able to remove a child from her home to protect against abuse or neglect without first getting a court's permiss ion." While critics hope the change w ill end what they refer to as the "warrantless seizures" of children, "the experience of other states, and the expectations of the lawmakers who championed the legis lation, suggests it will have a more subtle effect on the number of child removals." District Of Columbia Extends Deadline For Daycare Workers To Meet New Education Requirements. The Washington Post (6/29, Stein, 15 .68M) reported that Washington, DC's government has extended a deadline for the city's "daycare emp loyees to meet str icter education requirements after workers in the field argued that the new rules were unrealistic to complete." Two years ago, the city enacted some of the "most advanced educat ion requ irements for childcare workers" in the US, but faced "a backlash, w ith cr itics arguing that childcare workers are often paid min imum wage and there is little incentive for them to obtain higher degrees." On June 29, the city announced it would provide "employees an additional one to four years to complete certification or degree requirements." The AP (6/30) reported that "lead teachers in child care centers now have until December 2023 instead of 2020 to earn an associate's degree," while "requirements for assistant teachers, home caregivers and associate home caregivers were pushed back from 2018 to 2019 ." /\MERICAi\ pVERSIGHT EXT-18-248-D-000349 Ohio Hasn't Used $SM Designated For At-Risk Youth In 2018. The AP (7 /1) reports that so far, Ohio has not spent any of the $5 million it has designated in 2018 "for services for troub led youth on the cusp of being removed from their homes or at risk of entering the justice or foster-care stabilization systems." Money from the so-called "crisis fund" was earmarked "to help pay for support groups, child care, transportation and other expenses," and "county Family and Children First councils were given the task of making local plans to administer the funds ." Child welfare advocates argue that "stipulations attached to the federally funded program have caused roadblocks." Maine Governor Vetoes Bills To Increase Reimbursement Rates For Direct Care Workers . The Portland (ME) Press Herald (6/29, Pols, 157K) reported that on the evening of June 29, Gov. Paul LePage (R-ME) vetoed two measures that would have boosted "reimbursement rates for the agencies that hire direct care workers who provide key support for adults with intellectual disab ilities, as well as those who care for the elderly in nursing homes." Last week, the Legislature unanimously passed a measure affect ing workers who care for "intellectually disable d adults," and supporters hope they will be able to gather "the two-thirds /\MERICAi\ pVERSIGHT major ity necessary to EXT-18-248-D-000350 override the governor's veto when lawmakers return on July 9." The current veto, however, means pay rates reverted to 2017 levels as of Ju ly 1, and workers were set to "face an immediate 12 percent pay cut," according to Maine Association for Community Service Providers Executive Director Lydia Dawson, to a pay level of $9.17 per hour, less than the minimum wage. Food &Import Safety Wish-Bone Recalls Salad Dressing For Possible Allergens. The Knoxville (TN) News Sentinel (7/1, 252K) reports, "Pinnacle Foods Inc. is recalling 7,768 cases of Wish-Bone House Italian salad dressing distributed nationwide after learning from a customer that some bottles were mislabeled," according to the FDA. The voluntary recall pertains to "15-ounce bottles which may not list milk or egg, potential allergens, as ingredients," and impacts products with a "Best If Used By" date of Jan. 13, 2019. The New Orleans Times-Picayune (7/1, Krueger, 521K) reports, /\MERICAi\ pVERSIGHT EXT-18-248-D-000351 "According to the company, 7,768 cases of the recalled product was distributed." Nutrition &Obesity Beverage Industry Scores "Defining Victory" In Banning Soda Taxes In California. The Washington Post (6/30, Dewey, 15.68M) reported that the beverage industry "scored a defining victory" in its battle aga inst soda taxes last week when California lawmakers voted to bar future local taxes on sugary drinks. According to the Post, "under the fast-moving ban introduced June 23 and signed into law five days later, no new food or beverage taxes can be passed in the state until 2031 at the earliest." The article said that the law "represents a significant, if long anticipated, shift among the nation's soda makers, who have prev iously fought taxes, city by city, and expended millions of dollars in the process." Fortune (6/29, Mukherjee, 3.91M) examined how such a measure /\MERICAi\ pVERSIGHT EXT-18-248-D-000352 seems unlikely in a state known for progressive policies and attributed to passing of the leg islat ion to a "successful, no-holds-barred campaign by the beverage industry and its supporters to nix even the possibility of local soda taxes in exchange for stand ing down on a controversial tax-related ballot measure. " In commentary published by The Hill (7/1, 2 .71M) , Larry Cohen, the executive director of the nonprofit Prevention Inst itute, maintains that the "new law bann ing soda taxes in California is a setback." But when teenage health advocates from Stockton "urged lawmakers to stand with commun ities like the irs and put people's health over corporate profits," the "other side was conspicuously quiet" so, we "won't give up on reigning in the soda industry." Also reporting were Kaiser Health News (6/29, Young) and U.S. News &World Report (6/29, Lard ieri, 1.97M). Medicare /\MERICAi\ pVERSIGHT EXT-18-248-D-000353 CMS To Test Medicare Advantage Plans As APMs . Modern Healthcare (6/29, Dickson, Subscription Publica t ion, 239K) reported the CMS "wants to launch an experiment that allows doctors in Medicare Advantage plans to qualify as participating in an alternative pay model." Clinicians in Medicare Advantage plans "have urged the CMS to consider those plans as APMs since some are offering r isk-based contracts." Medicaid &CHIP Sununu Signs Reauthorized Medicaid Expansion Bill. The AP (6/29) reports Republican Gov. Chris Sununu "has signed a bill to continue New Hampshire 's expanded Medicaid program for another five years." The current program "uses Medicaid funds to purchase private health plans for about 50,000 low-income residents. It would have expired this year if lawmakers didn't reauthorize it." The bill "also changes its structure to a more cost-effective /\MERICAi\ pVERSIGHT managed care model." EXT-18-248-D-000354 The New Ham pshire Union Leader (6/29, 122K) quoted Sununu saying, "This is probably the biggest single piece of landmark legis lation I have been invo lved with as governor." The Nashua ( NH) Teleg rap h (6/30, 44K) reported that the law "still needs federal approval for some of the waivers it is seeking, such as for the work requirement for able-bodied, childless adults." Maine Governor Vetoes Medicaid Expansion Funding. The Portla nd {ME) Press Heral d (6/29, 157K) reported Maine Gov. Paul LePage "vetoed a $60 million Medicaid expansion funding bill Friday, an expected move that sets up a veto override vote by lawmakers when they return on July 9." LePage "said in a statement Friday evening that he vetoed the bill, passed by the Legislature last week, because lawmakers acted in a fisca lly irresponsib le manner." The AP (7 /1, Villeneuve) reported Maine "is the only state whose voters have approved expanding Medicaid to low-income res idents, but expansion originally set for Monday is in limbo as a lega l batt le between the fiscally conservative governor and advocates continues." Maine's Medicaid Program To Cover Chiropractic Exams . /\MERICAi\ pVERSIGHT EXT-18-248-D-000355 The AP (6/30) reports Maine's Medicaid program "will start covering chiropractic exams under a new law," which is expected to require "about $67,000 from Maine's general fund and $122,000 in federal funds." Idaho GOP Committee Passes Resolution Opposing Medicaid Expansion Initiative . The Idaho Press Tr ibune (6/29) reported the Idaho Republ ican Party's resolutions comm ittee "approved a resolution th is morning opposing the Medicaid expansion ballot initiative, in one of the first resolutions to gain support during the 2018 GOP convention, reports Bryan Clark of the Idaho Falls Post Register ." The resolution, "drafted and submitted by the Bonneville County Centra l Committee, passed on an overwhelming voice vote in the committee, though there was a small group of dissenters." The AP (6/29, Krues i) reported the resolution - wh ich "st ill needs to win approval from delegates during Saturday's genera l session - warns 'the current Medicaid program is already cannibalizing dollars for schools and roads by growing at a faster rate than other major programs and expans ion w ill further erode support for other critica l spending needs."' /\MERICAi\ pVERSIGHT EXT-18-248-D-000356 Iowa's New Private Medicaid Company Has "Troubled Past. " The Des Moines {IA) Register (7 /1, Clayworth, 292K) reports that an invest igation shows that "the corporation selected to help manage Iowa's controvers ial privatized Medica id system has faced serious charges of mismanagement resulting in at least $23.6 million in penalties in more than a dozen states ." Iowa Total Care, a subsid iary of Centene, "was awarded a state Medicaid contract in May by the Iowa Department of Human Services despite scoring nearly 14 points lower on its evaluation than when it had applied and was rejected in 2015, public records show." But with "only two companies bidding for the work, Iowa Tota l Care won a spot managing Iowa's annual $4.8 billion Medicaid program." Arkansas Suspends Medicaid Payments To Missouri Nonprofit After Arrest. The AP (6/30) reports authorities in Arkansas "have suspended Medicaid payments to a Missouri nonprofit after a former executive with the agency was arrested as part of a scheme to improperly bill almost $2.3 million in claims for mental health se rvices." Citing the Arkansas Democrat -Gazette , the AP reports that the suspension Friday of Medicaid payments "comes a day after Robin Raveendran, formerly executive vice president for Preferred Family Healthcare, was arrested on two counts of Medicaid fraud." /\MERICAi\ pVERSIGHT EXT-18-248-D-000357 Ohio Medicaid Execs Criticized For Defending Pharmacy Middlemen. The Columbus (OH) Dispatch (7/1, 399K) reports that criticism "rained down" on Ohio Medicaid executives during a legislative hearing last week as they "reported on findings by a consultant who delved into practices of pharmacy benefit managers, which play t he role of middlemen between Medicaid's managed care outfits and Ohio pharmacies." Iowa Hospital Association Says State Has No Data To Support Medicaid Savings Claim. The Cedar Rapids (IA) Gazette (7/1, Ramm, 146K) reports the Iowa Hospital Association said Iowa Medicaid Enterprises Director Michael Randol has no data to back up his claim that the state's managed-care model is saving money. The IHA says the state is saving money "bec ause the Medicaid insurance companies are not adequately reimbursing health care providers for their services," according to the article. /\MERICAi\ pVERSIGHT EXT-18-248-D-000358 West Virginia Medicaid Waiver Expands Options For Substance Abuse Treatment. The Exponent Telegram (WV) (7/1, Snoderly) reports that the second phase of a Medica id waiver in West Virgin ia has been "rolled out" which w ill focus "more on intensive services for individuals with substance use disorders, accord ing to Bureau of Medica l Serv ices Commissioner Cindy Beane." The waiver allows the state to sidestep the Institutions for Mental Diseases Medicaid exclusion that "prohibits the use of federal funds for care prov ided to patients in mental health facilities with more than 16 beds. " West Virginia was "awarded the waiver in October 2017 , making it the fifth state to receive the approval." Article Examines Why Tennessee Has Not Expanded Medicaid. The Tenne ssean (6/29, Allison, 513K) featured an article that exam ined why the state has not been among those to expand Medicaid. The piece highlighted a way to cover Tennessee's 10% share of Medicaid expansion cost, and how it could lower insurance premiums. /\MERICAi\ pVERSIGHT EXT-18-248-D-000359 Health &Medical News Scientists Warn On Increased Mortality Risk From Prolonged Sitting. NBC Nightly News • Video (6/29, story 12, 0:20, Holt, 6.8M) reported American Cancer Society scientists warn that sitting for at least six hours a day can "lead to a nearly 20 percent higher risk of death, compared with people who sat for just three hours." They said, "Spending all that time sitting was linked to 14 diseases." People Fail To Properly Wash Hands While Cooking 97 Percent Of The Time, Study Finds. USA Toda y (6/29, Molina, 11.4M) reported, "Ahead of Fourth of July grilling, the U.S. Department of Agriculture is offering a reminder to wash our hands" proper ly . TIME (6/30, Ducharme, 19.27M) reported, "People fail to properly wash /\MERICAi\ pVERSIGHT EXT-18-248-D-000360 their hands wh ile cooking 97% of the time, potentially opening them up to food-borne illnesses such as salmonella, norovirus and E. coli," research indicated. The findings came from a US Department of Agriculture's Food Safety and Inspect ion Serv ice study. US Evacuates More Americans From China Following Mystery Illness Complaints . The Wall Street Journal (7 /1, Chen, Subscription Publication, 6.13M) reports that at least nine Americans have been med ically evacuated from the Chinese city of Guangzhou following complaints of abnormal aural sensations similar to those experienced by US diplomats in Cuba last year. To date, only one American in China has been confirmed as hav ing symptoms and clinical findings consistent with those experienced by U.S. diplomats in Cuba, according to the Journal. However, US embassy staff were told in June that the evacuations of the Americans were not all connected to the mysterious symptoms. The New York Times (6/30, Myers, 19.33M) said the State Department " evacuated at least 11 Amer icans from China" after abnormal sounds or sensations were reported by government employees at the US Consulate in Guangzhou. /\MERICAi\ pVERSIGHT EXT-18-248-D-000361 Most People Apply Too Little Sunscreen . The Wall Street Journal (6/29, McGinty, Subscription Publication, 6.13M) reported that many people do not apply enough sunscreen, and dermatologists sometimes have difficulty explaining how much should be used. Sandy Walsh, a spokeswoman for the FDA, said, "The amount of sunscreen applied for each consumer will be based on their specific attributes including body size, the amount of body hair and sensitivity to the sun." The article also pointed out that a study published earlier this year in t he Journa l of the American Academy of Dermatology indicated that using sunscreens that have an SPF that is higher than 50 is beneficial. Being Married May Reduce Risk Of Heart Disease, Cardiovascular Death, Review Suggests. The New York Times (6/29, Bakalar, 19.33M) reported that a review suggests "being married may reduce the risk of heart disease and cardiovascular death." The find ings were published in the BMJ. Researchers Developing Artificial Ovary To Help Young Cancer Patients Preserve Fertility. /\MERICAi\ pVERSIGHT EXT-18-248-D-000362 On its website, CNN (7/1, Scutti, 82.6M) reports a group of Danish researchers developing an artificial ovary "have eng ineered a 'scaffold' on which early-stage cells can develop into functional ovarian follicles," wh ich could help younger cancer patients preserve their "fert ility from the impact of cancer treatments, experts say." Researchers will present the study Monday at the European Society of Human Reproduction and Embryology annual meeting in Barcelona, Spain. lmmunotherapy "Revolution" Is "Greatest Hope Yet" For Beating Cancer . The Telegraph ( UK) (7 /2, Vonderhe ide, 976K) reports that new cancer treatments "that harness the pat ient's immune system mark the 'end of the beginning' of the fight against cancer." The story of immunotherapy drugs "has rad ically altered how we treat some of the most common and dead ly cancers - and our work applying those approaches to tackle even more of them." FDA Approves First Drug To Reduce Excessive Sweating. The AP (6/29, Johnson) reported that on June 29, the Food and Drug /\MERICAi\ pVERSIGHT EXT-18-248-D-000363 Adm inistration "approved the first drug developed specifically to reduce excessive sweat ing," Qbrexza (glycopyrronium), manufactured by Dermira. The drug will be " inside a cloth wiped over the skin daily to block sweat glands from activating." The drug will start being avai lable in October. Reuters (6/29, Mishra) reported, "Currently, Allergan's (AGN .N) Botox injection is used to treat" excessive sweating, and "other treatments include antiperspirants and costlier alternatives such as laser therapy, as well as localized surgery like liposuction to remove sweat glands." Cowen analysts have estimated the drug could have "sales of $250 million to $300 million by 2023 ." Newsweek (6/29, Spear, 2.18M) reported that "in one study, 53 percent of patients said Qbrexza reduced sweat production by roughly half, versus 28 percent in a comparison group using a non-med icated cloth, the drug company reported." Also covering the story were Forbes (6/30, Lee, 10.34M) and TIME (6/30, Ducharme, 19.27M). CDC Warns Of Shingrix Vaccine Shortage . CBS News (6/29, 6. 78M) reported on its website that the Centers for /\MERICAi\ pVERSIGHT EXT-18-248-D-000364 Disease Control and Prevention has warned about a shortage of the Shingrix shingles vaccine. On "CBS This Morning" on June 30, Dr. David Agus said, "It's a really potent, excellent vaccine. I got it myself. And this is a vaccine where the old vaccine worked 30, 40 percent of the time. Th is is 97 percent of the time." He offered advice for people attempting to find the vaccine, adding, "Call ahead to a pharmacy. Make sure they have it. You can get it at a pharmacy, your doctor's office." The Philade lph ia Inquirer (6/29, Schaefer, 1.07M) reported on the high demand for the Shingrix vaccine, pointing out that "a quick check of some pharmacies in the Philadelphia region found the vaccine was still available, but not at all locations." The Inquirer reported that Shingrix's maker, GlaxoSmithKline, "has recommended that people who need the second of the two-dose series of the vaccine get priority." Police Investigate Elder Abuse Against Comic Book Creator Stan Lee, 95. The AP (6/30, Dalton) reported that, after the death last July of Joan, "his wife of 69 years and partner in all th ings, " comic book creator Stan Lee, 95, "has found himself in the middle of a fight over his finances and legacy that has led to lawsuits, a restraining order and a police investigation of elder abuse." The article used Lee's case to make the larger point that "Lee's status as a celebrity in declining mental health and vulnerable to exploitation has many precedents and may become increasingly common as a wave of wealthy baby boomers reaches old age." A restraining order against a memorabilia collector alleged that /\MERICAi\ pVERSIGHT EXT-18-248-D-000365 the collector "isolated him from associates, friends and relatives, which is considered a form of elder abuse." Mississippi Public Agencies Must Now Cover Increased Share Of Worker Pensions. The AP (6/29, Amy) reported, "Public agencies in Mississippi will have to contribute another $100 million toward worker pensions beginning July 1, 2019, after a vote by the state Public Employees Retirement System's board." Employe rs will now be required to provide 17.4 percent of a worker's salary, up from 15.75 percent, while workers will continue to contribute 9% of the ir own paychecks. The state's retirement system currently has 61 percent of the assets needed to cover future benefits. approved changes indicate that the state's retirement plan will be 100 percent funded by 2047, although that remains heavily reliant on the projected rate of investment returns. Surveys : Financially Independent Millenials Are Happier Than Those With Money Worries . CNBC (7 /1, 4.81M) reports on its website that a decade-long study by the National Endowment for Financial Education found that financ ially independent millen ials tended to be more confident and happ ier overall. /\MERICAi\ pVERSIGHT EXT-18-248-D-000366 NEFE Chief Executive Off icer Ted Beck said that the path to financial independence beg ins long before college, urging parents to have regu lar discussions with the ir children on financial responsibility. Similarly, a recent survey from T. Rowe Price found that "young adults who discussed money with their parents are more likely to have a budget, more likely to have an emergency fund, more likely to put 10 percent or more of the ir income toward savings and more like ly to have a retirement account." Retirees Increasingly Becoming Entrepreneurs, Cites AARP Study. As part of a series, "S ilver Linings," on the issues of New Hampshire's aging population, the New Hampshire Union Leader (7/1, Bake r, 122K) reports the rising number of retirees starting businesses as entrepreneurs. The article cites Sma ll Business Administrat ion data that the number of people aged 62 and older who are self-employed is "rising" nationwide. It also cites a 2015 AARP survey that "only" 10 percent of New Hampsh ire res idents aged 50 and older plan to retire and never return to work. Study Reveals Views On Social Media Bias. The Washington Times (6/29, Sabes, 460K) reported that a new Pew /\MERICAi\ pVERSIGHT EXT-18-248-D-000367 Research Center poll of about 5,000 people found that 85 percent of Republicans believe social media sites tend to bias what they show, and 72 percent of Americans believe social media sites censor political views. Younger adults tended to trust social medias sites more than older respondents, with 67 percent of those 18 to 29 years of age saying that the websites censor views, while 81 percent of "seniors" believe that they do. Hospitals Across US Experiencing Shortages Of Beds For Children With Mental Health Illnesses . NBC Nig ht ly News • Video (6/29, story 8, 4:05, Holt, 6.8M) reported on a "growing crisis" in American hospitals: "there are simply not enough beds to accommodate kids who need to be hospitalized" for mental illnesses. According to NBC News, "the crisis is nationwide, with nearly a 40-percent increase in psychiatric visits to emergency rooms." One hospital in Kansas said it turned away 2,000 children last year alone, NBC added. Colorado Hospital Sues Patient For Surgery Bill, Highlighting Alleged Price Gouging. The Denve r Post (6/29, Osher, 755K) reported on a patient in Colorado /\MERICAi\ pVERSIGHT EXT-18-248-D-000368 who underwent spinal-fusion surgery at the nonprofit St. Anthony North Health Campus and was later sued by the hospital for $229,112.13 for unpaid medical bills. The article said the case highlights "a growing conflict over skyrocketing health care costs pitting employer-based, self-funded insurance plans against hospitals," and added that "a growing number of employers are refusing to pay the full amount of the hospital bills of their workers due to alleged price gouging by the hospitals." The piece continued, "As justification, they point to data that consultants have unearthed showing wide disparities in hospital billing." Oklahoma Drafts Rules To Regulate Medical Marijuana Following Successful Legalization. The AP (6/30) reported that Oklahomans voted to legalize medical mar ijuana Tuesday "via State Question 788, which passed with about 57 percent support in an election with unusually high turnout." Now, the state health department is circulating draft rules to regulate medical marijuana licenses for patients, caregivers, and businesses in a move to tighten the new legislation that the AP said is "broad." The proposed rules would ban "dispensaries near schools, indoor smoking in public places and psychoactive gummy bears," and "lay out guidance for doctors interested in recommending marijuana, patients who want to use it and businesses looking to grow, process or sell it." /\MERICAi\ pVERSIGHT EXT-18-248-D-000369 Many Families Still Live With Arsenic, Lead In Everett, Washington . The AP (6/30) reported that "nearly three decades" after Washington state discovered large amounts of arsenic and lead in properties surrounding a former smelter site in Everett, "about 150 homeowners are still waiting for the contamination to be cleaned up." So far, about 350 properties have been cleaned up using a $34 million settlement, but the fund only has enough to remediate 20 more propert ies in 2019. Delaware Lawmakers Vote To Ban Powdered Alcohol. The AP (6/30, Chase) reported that Delaware lawmakers gave final approval to a bill "outlawing the manufacture, sale and use of powdered alcoholic beverages." Enactment of the legislation would make Delaware the 37th state to ban "powdered substances that form alcoholic drinks when reconstituted with liquid." According to the AP, "the American Medical Association has called for a nat ionwide ban on powdered alcohol, which critics say carries the risk of more potent drinks and harmful overconsumption." Angelman Syndrome Receives Its Own Medical Code. /\MERICAi\ pVERSIGHT EXT-18-248-D-000370 The Atlant ic (6/29, Yong, 3.08M) reported t hat Angelman syndrome has been granted its own medical code, Q93.51, under the International Classification of Diseases. The article said the medical standard allows researchers "to interrogate large databases and find out how many patients have a particular disorder, what secondary problems they experience, what treatments they typically receive, how many times they're admitted to the hospital, and more. Insure rs use them to decide what treatments should be reimbursed." California Vaccine Skeptic Put On Probation By State Medical Board . The Los Angeles Times (6/29, Karlamangla, 4.03M) reported that the Medical Board of California has ordered 35 months' probation for Dr. Bob Sears, "an Orange County pediatrician well-known for being sympathetic to parents opposed to vaccines." According to the Times, "Sears can keep practicing medicine but will be required to take 40 hours of medical education courses a year, as well as an ethics class, and also be monitored by a fellow doctor." In addition, he "must notify all hospital and medical facilities where he practices of the order and is not allowed to supervise physician assistants or nurse practitioners." Opinion: Antibacterial Debate Must Weigh Risks, Benefits . /\MERICAi\ pVERSIGHT EXT-18-248-D-000371 Bloomberg View (6/29, 4.46M) opinion columnist Faye Flam wrote about the safety concerns surrounding the antibacterial chemical triclosan, and highlighted recent evidence which showed the chemical can have negative side effects. Flam wrote, "There's only one rational way out of this bind: to think about safety not as a black or white issue, but to consider risk-benefit ratios." Flam said "the FDA did consider both sides of the equation in 2016, when it required companies to phase triclosan out of soaps and body washes, citing safety concerns and lack of evidence for any benefit." Woman's Facebook Post Says Menthol Shaving Cream Soothes Sunburns. TODAY (6/29, Murray, 1.19M) reported that in a Facebook post, a woman discusses her " trick to getting rid of sunburn," which is "applying menthol shaving cream on the burn, which the poster said 'takes the heat out' and soothes skin." However, "dermatologists say it's no magic solution for sunburns, although it might provide some relief." AMA President-Elect Profiled. /\MERICAi\ pVERSIGHT EXT-18-248-D-000372 The AP (7/1, Severino) profiles Patrice Harr is, MD, who "will become the 174th president of the AMA in June 2019, and is now serv ing as president-elect." Dr. Harris "was elected to the post earlier this month." The AP adds, "In her vision for the AMA, Harris said she wants to improve the education of up and com ing medical profess ionals." The article also points out that Dr . Harris "served on the American Psych iatric Association board and was later named by the APA as a delegate to the AMA." AARP Dedicates $60 Million To Dementia, Alzheimer 's Disease Research Fund. Healt h IT Analytics (6/29) reported the AARP's Brain Health Fund has vowed to "invest $60 million in the Dementia Discovery Fund (DDF) to accelerate the development of innovative treatments for dementia and Alzheimer's disease." The research is considered "vital for dementia treatment as the condition becomes more and more prevalent," the piece said, adding, "NIH also recently convened a group of leading experts to discuss how to best foster a collaborative environment research and use precision medicine to ultimately discover a cure for these chronic, degenerative conditions." Ohio , Washington Officials Confirm West Nile Virus-Carrying Mosqu itoes . /\MERICAi\ pVERSIGHT EXT-18-248-D-000373 Newsweek (6/29, Spear, 2.18M) reported Ohio and Washington healt h officials "are urging people to protect themselves against mosquitoes after insects in these states tested positive for the West Nile virus." Data from the Ohio Department of Health showed "mosquitoes near Alexandria, Johnstown and Harrison Townsh ip in Ohio had the virus," while Washington officials "d iscovered a pool of mosquitos that tested positive for the virus in Benton County." The article added that the National Institutes of Health says severe cases of West Nile virus in humans can "affect the nervous system, and trigger conditions including meningitis, and inflammation of the brain called encephalitis." Michigan's Detroit Area Becoming A "Hotspot" For Vaccination Waivers, Study Suggests. The Detroit News (7 /1, 710K) reports that according to health researchers, a growing number of "parents choosing not to vaccinate their children for non-medical reasons" has led to the rise of "'hotspots' across the country and in Metro Detroit." The piece says that since 2009, "the number of kindergarten-age children enrolling in school with non-medical waivers has climbed in 12 of 18 states that allow the exemptions, according to a peer-reviewed study published June 12 in the Public Library of Science journal PLOS Medicine." Cities including "Troy, Warren and Detroit were among the areas in Michigan where more than 400 kindergartners exemptions, /\MERICAi\ pVERSIGHT had received the non-medical vaccination according to the PLOS report." EXT-18-248-D-000374 WPost: Stalling Malaria Fight Could Jeopardize Children 's Lives. The Washington Post (7 /1, 15.68M) editorial says that while the number of malaria cases and deaths have declined steadily for a decade and a half as "global public-health officials have been at war" with the disease, the "battle shows signs of stalling." In 2016, "the number of malar ia cases went up to 215 million, from 210 million the year before," the Post says, adding that malaria "kills more than 445,000 people annually, about 70 percent of them children under 5 years old." The Post adds that the fight against malaria will be won "by action on many fronts. A stall, after so much promise, would be terrible and costly." Indiana Resident Contracts Rare Flu Strain After Exposure To Pigs At Fair. The Indianapolis Star (7/1, Fittes, 477K) reports health officials are warning Indiana residents "to take preventative measures this fair season, after an Indiana resident caught the influenza virus following a visit to a county fair." In what is "the first human case of the H3N2 influenza in the Indiana since 2013, and first case reported nationwide this year, according to the Centers for Disease Control and Prevention," a resident has been sickened with a flu strain "commonly associated with contact with pigs, the Indiana State Department of Health and Indiana Board of Animal Healt h said in a statement Friday." /\MERICAi\ pVERSIGHT EXT-18-248-D-000375 Op-Ed: New Chemotherapy Study Underscores Importance Of NonInferiority Trials . Contributor Dr. Conor Lavelle wrote for Quartz (6/29, 788K) that a study published in New England Journal of Medicine assessing the effectiveness of "c hemotherapy for a specific, common variant of breast cancer ... found that thousands of women may not actually need to undergo the intensive, painful treatment." Dr. Lavelle considers this "ano ther important victory for something called a 'non-inferiority trial, 111 which "is arguably our most powerful weapon in the war against unnecessary or harmful pharmaceuticals - and it starts with putting people first." Loved One's Cancer Diagnosis Can Spur Others To Seek Preventive Care. U.S. News &World Report (6/29, Howley, 1.97M) examined the impact of watching a loved one endure cancer treatment, hyper-focusing noting it "can have a effect for many people." The article spotlighted the case of one woman who was diagnosed with breast cancer and whose daughter after determining that the family had a history of "known breast-cancer causing mutation" on their BRCA2 genes. The ordeal caused the daughter to undergo genetic testing, finding that she "tested /\MERICAi\ pVERSIGHT EXT-18-248-D-000376 positive for the same mutation as her mother" and prompt ing her to undergo a double mastectomy. Cancer Institute The piece noted that the National reports "about 69 percent of women who inherit a harmful BRCA2 mutation will develop breast cancer by the age of 80." Congress Passes Firefighter Cancer Registry Act. The Springfield (MA) Republican (6/29, Flynn, 412K) reported Congress has passed the Firefighter Cancer Registry Act, wh ich "allows the Cente rs for Disease Cont rol and Prevention under the Secretary of Health and Human Services to create a voluntary and inclusive national registry that wou ld allow scientists and others to track job-related cancer incidence for both career and volunteer firefighters ." The legislat ion also "authorizes $2.5 million for each of the fiscal years 2018 through 2022 to carry out th is broader collection of data to help improve measures to protect firefighters." National Institute The piece added that the for Occupational Safety and Health in 2010 "began a five -year study of near ly 30,000 firefighters" wh ich found they "have a greater number of cancer diagnoses and cancer-related deaths," wh ich helped spur the creation of the legislation. Amazon's Latest Deal Shows It Plans To Disrupt How Industry Cares For Chronically Ill. /\MERICAi\ pVERSIGHT EXT-18-248-D-000377 STAT Plus (6/29, Ross, Subscription Publication, 27K) reported that Amazon's acquisition of the home delivery pharmacy PillPack makes clear the company's ambitions to "not only fundamentally treatment change of U.S. patients, it wants a large chunk of the $370 billion market for selling and distributing their prescr iption drugs." The PillPack deal "gives Amazon the infrastructure to become a national seller of prescription drugs," noting that "PillPack is already an in-network pharmacy for all the largest pharmacy benefit managers." STAT Plus adds, "To turn the corner in the pharmacy business - and lower costs within its own ranks - Amazon will need to figure out how to improve services for the chronically ill population." US Judge Rules AbbVie, AndroGel Partner Owe $448 Million In Antitrust Case. Reute rs (6/29, Raymond) reported that on June 29, US District Judge Harvey Bartle in Philadelphia ruled "that pharmaceutical company AbbVie Inc. used sham litigation to illegally prevent generic versions of testosterone replacement drug AndroGel from getting to market and ordered the drugmaker and its partner to pay $448 million." The ruling was for an antitrust suit filed in 2014 by the FTC against both AbbVie and partner Besins Healthcare. The FTC had alleged AbbVie and Besins filed "baseless patent infringement lawsuits in 2011 against generic drugmakers Teva Pharmaceutical Industries Ltd and Perrigo Company to delay the launch of their generic versions of AndroGel." /\MERICAi\ pVERSIGHT EXT-18-248-D-000378 Amazon's PillPack Deal May Provide It With Access To Sensitive Health Data. The Wall Street Journal (7 /1, Stevens, Terlep , Subscription Publication, 6.13M) reports that Amazon's acquisition of PillPack will provide it with information about people's prescriptions, a move into t he health and med ical records space which the Journal describes as much more detailed than Amazon's previous efforts to track customers' purchases of things such as movies or toiletries. The Journal reports that an Amazon spokeswoman said the company plans to comply with regulations, includ ing HIPAA. WSJournal: Amazon's PillPack Deal Will Benefit Consumers , Force Competitors To Improve. The Wall Street Journal (6/29, Subscription Publication, 6.13M) editorialized that Amazon's acquisition of online pharmacy PillPack will enable the company to grow rapid ly to compete with drugstore industry giants. The combination will help patients get drugs faster and cheaper and will force competitors to improve service, the Journal adds. The article concludes Amazon's decisio n to enter the drug delivery industry is welcome, and could benefit consumers in the long run. Similarly, a Forbes (6/29, 10.34M) column written by Christopher /\MERICAi\ pVERSIGHT EXT-18-248-D-000379 Walton suggested that Amazon's entry into the industry will likely have an impact on CVS and Walgreens. Meanwhile, for Bloomberg View (6/29, 4.46M), Faye Flam wrote, "If Amazon's move to disrupt health care is going to make Americans any healthier, the improvement is most likely to take place in the business of getting prescription drugs to patients more reliably." More Suits Filed Against Florida Drugmaker Accused Of Selling Contaminated Medicines. The South Flor ida Sun Sentinel (6/29, Hurt ib ise, 601K) reported that more suits have been filed against South Florida drugmaker PharmaTech LLC and its principals and distributors. The company is now facing seven suits "on behalf of patients said to have been sickened or killed, includ ing three infants who reportedly died after being given a liquid stool softener made by the company." The company vacated its Davie, FL plant in June 2017 following FDA inspection reports in August 2016 and May 2017 that "identified deficienc ies in its manufacturing numerous quality control processes," the Sentinel reported. The latest suit, filed in June in Broward County Circuit Court, identified the victim of an outbreak of water-borne bacteria "as Londyn Simone Manuel, who was born with a congenital heart defect in December 2016, and died before turning 8 months old after being given liqu id docusate" made by the company. /\MERICAi\ pVERSIGHT EXT-18-248-D-000380 District Court Extends lndivior's Order Blocking Launch Of US Generic Addiction Treatment. Reuters (6/29, Varghese) reported that on June 29, the US Court for the District of New Jersey "extended a restraining order blocking" Mylan NV and Dr. Reddy's from launch ing a gener ic version of Indivior's Suboxone (buprenorph ine and naloxone) Film, an op ioid add iction treatment that generates around 80% of Indiv ior's revenue. "Ind iv ior said its temporary restraining order (TRO) issued on June 15 had been extended for another 14 days, during which time the U.S. court for the District of New Jersey will consider the app licat ion and issue a ruling on the injunction." FDA Cites Mylan For Morgantown Plant Manufacturing Issues. The Pittsburgh Post-Gazette (6/29, Sabatini, 507K) reported that on June 28, Mylan announced the FDA cited it in April for manufacturing issues at its Morgantown, WV plant. Among the issues an FDA inspection report cited were "numerous instances of a lack of appropriate oversight by the quality unit," along with problems related to "cleaning procedures used to prevent cross-contaminat ion of drug ingredients." In a statement, Mylan said, "The company has submitted a comprehens ive response to the agency and committed to a robust improvement /\MERICAi\ pVERSIGHT plan ." EXT-18-248-D-000381 Report : Nearly All Online Pharmacies Illegal. Newsweek (7 /1, Hugo, 2.18M) reports that "if you buy drugs from an online pharmacy, there 's a good chance that exchange is illegal - or worse ." In a report on darknet opioid sales, the Center for Safe Internet Pharmacies "found that people on both the darknet and surface web sell drugs like opioid painkillers through on line 'pharmacies,' 97 percent of wh ich operate illegally, according to the FDA." Many of these online " pharmacies" are actually "drug-dealing websites set up to look like they simply sell prescription pills to those in need , and some cla im to offer prescriptions." CSIP Executive Director Marjorie Clifton "said that some non-opioid-selling pharmacies are lega l, if they follow certain rules," such as having "br ick- and - mortar locations," as well as being "licensed in every state that they sell to." Missouri Appeals Court Rejects $55 Million Verdict Against Johnson &Johnson In Talc Powder Suit. Reuters (6/29, Bellon) reported that on June 29, a Missouri appeals court "threw out a $55 million verdict against Johnson &Johnson in a lawsuit by a woman who claimed she developed ovarian cancer after using talc - based products, including J&J's baby powder." The appeals court's decis ion to dismiss the 2016 verdict cited "a 2017 U.S. Supreme /\MERICAi\ pVERSIGHT EXT-18-248-D-000382 Court decision that limits where companies can be sued for personal injuries" and that found that "state courts cannot hear claims against companies that are not based in the state or when the alleged injuries did not occur there." In a statement, J&J "said it was extremely pleased w ith the court's decision to recognize that the trial should have never occurred." FDA Approves Pulmonx's Valve For Emphysema. Reuters (6/29, Mitra) reported that on June 29, the Food and Drug Administration "approved Pulmonx Inc.'s valve to treat" emphysema. The valve works by being "permanently implanted using a catheter in the affected part of a patient's lung," then regulating "the airflow to the healthier parts" of the lung. The average patient "may need four valves and depending upon the severity of emphysema, the cost of treatment could go up to $10,000 per patient." Mass Device (6/29, Perriello) reported that the FDA "granted premarket approval under its breakthrough devices designation," upon "a 190-patient study comparing treatment with Zephyr, plus standard medical management and pu lmonary rehabilitation, treatment based to with standard medical management and rehab only." The trial benchmark "was at least a 15% improvement in pulmonary function score," and around "47.7% of patients in the Zephyr arm met that mark, compared with 16.8% of the control arm, according to the FDA." /\MERICAi\ pVERSIGHT EXT-18-248-D-000383 NYC Expands Lead Testing Program For Children. The New York Times (7/1, A18, Ferre - Sadurnf, 19.33M) reported that in New York City, "the exact number of ch ildren residing in public housing poisoned by lead was never disclosed." This past weekend, however, "the city department of health offered a number," saying that "820 children younger than 6 were found to have elevated levels of lead in their blood between 2012 and 2016." AM New York (7/1, Cook, Trangle, 591K) reports on its webs ite that on July 1, New York City Mayor Bill De Blasio's Adm inistrat ion anno unced an expansion to a program to test lead levels in children. The city now w ill start "environmental investigations for all children younger than 18 who test above a blood lead level (BLL) of 5 micrograms per deciliter," an adjustment from the previous level of "10 micrograms per deciliter." The city health department has already started " investigations for children at NYCHA developments and will implement the new r ules for the rest of the city by the end of the year, according to the mayor's office." The news follows the "day after a Daily News report that revealed the city knew of more than 800 children living in NYCHA apartments between 2012 and 2016 who had blood lead levels between 5 and 9 micrograms per deciliter ." The New York Post (7 /1, Hicks, 4.46M) reports, "As many as 820 child ren in the city's housing projects tested for elevated levels of lead, but hea lth officials failed to follow up and inspect their apartments, Hall admitted Saturday." Despite the CDC in 2012 implementing /\MERICAi\ pVERSIGHT City a EXT-18-248-D-000384 recommendat ion "that authorities take action if children test positive for hav ing more than 5 micrograms of the compound in their blood," New York City "health officials cont inued to use the CDC's old 10-microgram standard, meaning these 820 posit ive tests would not have been forwarded by city health officials to the New York City Housing Authority and would not have triggered a home inspection - potentially allowing the exposure to continue." Learning To Play Piano May Help Children Build Up Language Skills, Study Indicates. TIME (7/1, Ducharme, 19.27M) reported research indicates learning to play the piano may help children "build up their language skills." As youngsters' "ears become trained to distinguish between different pitches and tones at the piano ... they also seem to get better at parsing subtle differences between spoken words, a key element of language acquisition," the study revealed. The findings were pub lished online in the Proceedings of the Nationa l Academy of Sciences . Tech Company CEO: Children Need To Be Guided Through Technology Thoughtfully. In an opinion piece in USA Today (6/30, Ingram-Cauchi, /\MERICAi\ pVERSIGHT Contributor, EXT-18-248-D-000385 11.4M), Pete Ingram-Cauchi, "CEO of iD Tech Camps, a STEM education company based in" California, wrote that even though "technology has its downsides ... it holds untold promise and it is not going away." Children "just need to be guided through it thoughtfully and led to a place of creativity and passion." Factors Behind Lagging Mainstream Adoption Of Telemedicine Examined. CNBC (6/30, Farr, 4.81M) examined factors behind lagg ing mainstream adoption of telemedicine. The primary and "most important" factor "is that many U.S. consumers are still not aware they have the option to chat with their doctor over the phone or via video." In addition, patients who have "heard of telemedicine apps often fear the expense, especially if it's unclear whether they can use their health insurance." What's more, clinicians "who are willing to work with app makers are inexperienced, or low-quality." Many clinicians "are afraid of liability, as it's possible to miss something during a remote visit," and "reimbursement questions" remain . Drivers For Car Services, Ride-Hailing Apps In New York Now Able To Get Coverage For Vision Care. /\MERICAi\ pVERSIGHT EXT-18-248-D-000386 The AP (6/29, Matthews) reported that starting July 1 in New York, "drivers for car services and ride-hailing apps like Uber and Lyft" will "now be able to get coverage for vision care as well as phone or video appointments with doctors, industry representatives announced." This "coverage for an estimated 43,000 drivers statewide will be paid for by the Black Car Fund, a workers' compensation fund for car-service drivers that is funded by a 2.5 percent surcharge on each ride." Scientists' Discovery Is "First Step" To Packaging Insulin In Pill. The Boston Globe (7/2, 945K) reports that two developments - "a newly released study and the publication of new clinical trial data" describe "advances toward an alternative management: approach" to diabetes "the delivery of blood-sugar-regulating hormones in a pill, long regarded as the 'holy grail' of diabetes treatment." The study, "by Universi ty of California Santa Barbara and Harvard University scientists, demonstrated a technical breakthrough in the oral delivery of insulin, a hormone produced in the pancreas that allows the body to absorb and store sugar from the blood." This discovery "is the first step in a longer process to package insulin in a pill that could take many years." Enclosing insulin "in a particular ionic liquid, aptly named CAGE, has the dual benefit of protecting the hormone from stomach acid and promoting its absorption through lay ers of mucous and the intestinal wall. That could help it reach the liver." One prom ising note, "experts say, is that the two ingredients of CAGE, choline and geranic acid, are generally regarded as safe by the Food and Drug Administration." /\MERICAi\ pVERSIGHT EXT-18-248-D-000387 Roche Encouraged By Tecentriq Trial Results. Reuters (7 /2) reports Swiss drug maker Roche "said on Monday that a trial showed its immunotherapy Tecentriq plus the chemotherapy Abraxane significantly reduced the risk of disease worsen ing or death in people with metastatic triple negat ive breast cancer." The company, "citing its 1Mpassion130 study, said it also recorded an encourag ing overall surv ival benefit for the PD- L1 positive populat ion, whose tumors express a protein that help them evade immune system detection, at interim analysis." Angela Garbes ' New Book "Like A Mother" Discussed. ABC's Good Morning America (7 /2, Kindelan, 4.2M) discusses mother of two and author Angela Garbes' new book, "Like a Mother: A Feminist Journey Through the Science and Culture of Pregnancy," wh ich GMA says "gives women straight talk on pregnancy, their bodies and life after giving birth." One topic the book covers is "lack of post-delivery care for new moms." Garbes' interest in post-delivery care for moms "stemmed from hip pain she suffered after giving birth ." The piece adds that the American College of Obstetricians and Gynecologists " recently launched an initiative to address the issue of postpartum care for new moms called 'the fourth trimester. /\MERICAi\ pVERSIGHT 111 EXT-18-248-D-000388 Hawaii Bans Sale Of Sunscreens Containing Oxybenzone, Octinoxate. NPR (7 /2, Fulton, 3.SSM) reports Hawaii's governor David Ige is expected "to sign the world's first ban on the sale of sunscreens containing the chemicals oxybenzone and octinoxate this week." The state is "banning the products because of concerns they may be harming one of the state's biggest attractions - coral reefs." Both chemicals "have had the Food and Drug Administration's decades, but in recent years, some environmental OK for research has suggested octinoxate can contribute to coral bleaching and that oxybenzone exposure leads to the death of baby coral." Global Health Britain's NHS To Reduce "Unnecessary Or Risky Procedures." /\MERICAi\ pVERSIGHT EXT-18-248-D-000389 The AP (6/30) reported that Britain's NHS has proposed cutting back on operations including breast reduct ions and ant i-snoring treatments as part of plans to save money and reduce "unnecessary or risky procedures." NHS medical director Stephen Powis said the agency "could save an estimated 200 mil lion pounds ( $264 million) a year by tightening the criteria for treatments where the risks could outweigh the benefits." According to the AP, "the list of 17 treatments under consideration to be halted or reduced includes tonsil remova ls and procedures for carpal tunnel , hemorrho ids and varicose veins." UK's NHS Making Plans To Ensure Ample Medical Supplies After Brexit. The AP (7 /1) reports that Britain's National Health Service "is making plans to ensure that medica l supplies will be available if Britain leaves the European Union without a trade deal." NHS chief Simon Stevens said Sunday there is "significant planning" underway to make sure the NHS "can cope with a no-deal Brexit without a disruption in services ." Stevens explained that Britain's health agency and other governmental departments are working to make sure supplies of medicine and medical equipment can still be accessed under var ious Brexit scenarios , according to the AP. Reuters (7/1) reports that Stevens said the NHS is "working with pharmaceutical companies to make sure there will be no breakdown in supply if there is no deal with the EU." /\MERICAi\ pVERSIGHT EXT-18-248-D-000390 Irish Cancer Patients Received Faulty Tests From US-Based Labs. The CBS Evening News • Video (6/29, story 7, 2:45, Glor, 5.29M) reported American laborator ies Quest Diagnostics and Clinical Pathology Laborator ies (CPL) "are coming under scrutiny because of faulty cancer tests in Ire land," where hundreds of women "were told they tested negative, only to find out years later they had cancer all along." Correspondent Roxana Saberi reported that Quest and CPL along with "an Irish lab processed smear tests for Ireland's health service. A government review four years ago found that the labs mistakenly cleared more than 200 women ... who were later diagnosed with cervical cancer." Since that time, "18 of those women have died. But most of the women affected were never told until one of them ... discovered a page from that review in her medical file." Global Fund Combating AIDS , TB, Malaria Cancels Funding For North Korean Public Health Efforts. Science Magazine (6/29, Stone, 441K) reported The Global Fund to Fight AIDS, Tuberculosis and Malaria announced that effective June 30, it will revoke its grants to North Korea, a revelation which "leaves the isolated nation with about 1 year to line up a new source of medic ines and diagnostics to combat a deepening [tuberculosis] crisis." Medical researchers say they have "not gotten any clarity on why they are doing /\MERICAi\ pVERSIGHT EXT-18-248-D-000391 this," adding that the fund's financial contributions of more than $100 million to TB and malaria control in the country "has been the biggest outside investment ever in public health in North Korea." Novartis, Gilead CAR-T Therapies Both Gain European Panel Recommendation. Reuters (6/29, Miller) reported that rival cancel therapies from Gilead Sciences and Novartis both won recommendations from the European Medicines Agency's Committee for Medicinal Products for Human Use. The committee recommended both Gilead's Yescarta (axicabtagene ciloleucel) and Novartis' Kymriah (tisagenlecleucel) for diffuse large B cell lymphoma, while it also recommended Yescarta for primary med iastinal B cell lymphoma and Kymriah for B cell acute lympho blastic leukemia. Both of the CAR-T therapies are single-use treatments "in which immune cells are removed from patients, genetically engineered in the laboratory using disarmed virus to target their blood cancers, and then re-infused." Both drugs range in price in the US from between $373,000 and $47 5,000, depending on the cancer being treated. Fierce Pharma (6/29, Sagonowsky) reported that both treatments received US approval several months ago. One reason for the high cost of the drugs " is their unique, patient-specific manufacturing, " as "CAR-T drugs are made of re-engineered T cells collected from each patient, which are then infused back into the patient to attack cancer." Gilead recently said it will build "a CAR-T manufacturing plant at the Amsterdam airport in an effort to cut down on logistics and manufacturing /\MERICAi\ pVERSIGHT turnaround time." EXT-18-248-D-000392 AstraZeneca Receives "Speedy Approvals " For Cancer Drugs In Japan. Reuters (7 /2) reports AstraZeneca has won "rapid regulatory approval for new uses of two of its important cancer drugs in Japan, less than six months after the first global approvals in Western markets." The decisions by the Japanese Ministry of Health, Labour, and Welfare " reflect an increased urgency by officials in the country to access modern medicines , afte r many years of slow adoption." Ghana Reports HS Bird Flu Outbreaks. Reuters (6/29, Trompiz) reported that Ghana announced two outbreaks of "highly pathogenic HS bird flu" on farms in the country. According to Reuters, "one of the outbreaks killed 5,431 birds out of an 11,000strong flock on a farm in Boankra in the Ashant i region, while the other killed 5,935 out of 13,188 birds on a farm in Nkawkaw in the Eastern region." /\MERICAi\ pVERSIGHT EXT-18-248-D-000393 Researchers Warn That Gay Hate Climate In Indonesia Is Fueling HIV Epidemic. The AP (7 /2, Wright) reports on an "out-of-contro l but litt le- acknowledged epidem ic of HIV among gay men in Indonesia that researchers say is being fueled by a gay hate climate whipped up by the country's conservative politica l and relig ious leaders." A Human Rights Watch report released Monday explained that "highly publicized police raids targeting gay men and a vicious outpouring of ant i-LGBT rhetoric from officials and other influential figures since early 2016 have caused significant disruption to HIV awareness and testing programs." TIME (7/2, Haynes, 19.27M) reports Kyle Knight, an LGBT rights researcher at Human Rights Watch and author of the report, said, "What's shifted in the last two years is that the government and police have made it abundantly clear that it's perfectly okay to hate LGBT people and to act on it." He cautioned, "Unless certain steps are taken to dial back on these raids, to create safe spaces for those to gather to gain information, to get safety, sense of dignity, community and privacy, this will spin out of control not just from a human rights perspective, but also from a public health perspective." TIME adds, "Combined with the crackdown and heightened discr imination against LGBT peop le, the impending health crisis threatens to force the commun ity into total retreat." /\MERICAi\ pVERSIGHT EXT-18-248-D-000394 India Celebrates End Of Nipah Virus Outbreak With Music Video . NPR (7/1, Thiagarajan, 3.SSM) reports India's Nipah virus outbreak " in May had all ingredients of an-edge-of-the-seat medical thriller" as the nation battled "one of the most lethal pathogens of our times." The article says, "Three weeks after Nipah had been identified as a cause of the outbreak, on June 10, Kera la's Minister for Health, K.K. Shylaja, declared that the state was Nipah-free. Of the 19 cases, two patients have recovered." After the outbreak was declared over, "a group of musicians and filmmakers decided to make a video to celebrate." WTO Upholds Australia's Plain-Packaging Law. Fortun e (6/29, Meyer, 3.91M) reported in continuing coverage that the WTO last week ruled in favor of Australia's plain-packaging laws and said the country "is free to continue selling cigarettes in drab, olivecolored packaging without no brand ing beyond the manufacturer's name in small print, and with large and graphic health warnings dominating the packaging." The article said the WTO's decision "will likely have major ramifications around the world." Bloomberg View (7/1, 4.46M) columnist David Fickling says "the wor ld's ugliest cigarette packets aren't going away." Fickling says claims that Australian plain packaging does not make much of a difference do not "stand up to a lot of scrutiny: Studies supporting that claim have either been based on non-public data that can't be checked, or commissioned /\MERICAi\ pVERSIGHT EXT-18-248-D-000395 by the industry, or both, according to a 2016 analysis by Australia's Department of Hea Ith." Russians Protest Pension Age Hike. Reuters (7 /1) reports that although "thousands of Russians protested on Sunday over a government decis ion to increase the retirement age ... there were no demonstrations in the cities hosting the World Cup because of secur ity restr ictions in force dur ing the tournament." Published photos of the protest featu red indiv iduals with signs saying "Raise the pension, not the pens ion age!" and "Hands off our pensions!" A "close ally of President Vladimir Putin" last month stated "that the government wanted to raise the ret irement age for men by five years, to 65 from 60, and for women by eight years, to 63 from 55," which supposed ly is "to ease intense pressure on state coffers," per Reuters, wh ile "critics say the retirement expectancy." age in many regions is higher than life Some polls reported Putin's approval rat ing dropped from 75 to 69 percent following the announcement . Son Debates Assisted Dying Amid Mother's Alzheimer's Diagnosis. Bernard Lyall writes in The Guardian (UK) (7/1, 4 .03M) about his mother's Alzheimer's diagnosis, saying that "she who has lived entirely /\MERICAi\ pVERSIGHT EXT-18-248-D-000396 by her wits has now lost them" to a word carrying "the ring of finality." Lyall says despite several emotional "blows," his mother retained "her inst inct to put on a brave face, try to ignore it and muddle through regardless," which "was the way her generat ion coped," but has proved "disastrous" for her carers, because "whenever we hoped she'd understand some new limitation, or accept a new level of care, we had to choose between complicity in a face-saving but ultimately pointless pretence and provoking unreasoning anger." While "Kath had argued for the right to die, has a living will, and would have been horrified to see herself like this," now Lyall says that as "the power to let her go has fallen to me, it's not so simple." Lyall wonders whether someone's "younger self" should "be allowed to make such decisions about the person they are now." National News Trump Predicts Quick Supreme Court Confirmation "If I Pick The Right Person." During an interview Sunday with Fox News' Sunday Morning Futures IN Video (7 /1, Bartiromo, 1. 79M), the President vowed he would "pick somebody who is outstanding" /\MERICAi\ pVERSIGHT to replace retiring Supreme Court Justice EXT-18-248-D-000397 Anthony Kennedy. He also predicted that while Democrats would work to resist his choice, "I think it wi ll go quickly if I pick the right person." The Washingto n Examiner (7/1, Chaitin, 340K) reports the President also predicted a "big week" ahead, declaring in a tweet Sunday he will be focused on decid ing who he will nominate to succeed Kennedy. Media reports, however, cast the President as ready for a fight with Democrats over his pick. On ABC World News Tonight • Video (7/1, story 4, 2:50, Llamas, 14.63M), for example, Tara Palmer i said Trump is "preparing for battle ton ight over his highly anticipated Supreme Court pick." Trump: "It's probably going to be vicious because the other side, all they can do obstruct and resist . You know, their whole thing is res ist." NBC Night ly News • Video (7/1, story 6, 2:00, Jackson, 8.26M) reported, "A vicious but fast fight. That's what President Trump says he expects once he announces the second Supreme Court nominee of his Adm inistration" next week under "his self- imposed deadline." Kelly O'Donnell said the President, who is "on the trail this week, is already touting the influence of his high court selection to rally his own base." The CBS Weekend News • Video (7/1, story 4, 2:40, Quijano, 5.32M) reported that while Trump "voiced confidence that his yet -to-be announced Supreme Court nominee will be confirmed soon," his choice "needs the back ing of nearly all Senate Republicans." According to the Wall Street Journal (7/1, Armour, Nicholas, Subscription Publication, 6.13M), White House officials are also meeting with Democrats, including the three who voted last year for Justice Neil Gorsuch: Sens. Joe Manchin, Heidi Heitkamp and Joe Donne lly. USA Today (7/1, Estepa, 11.4M) reports that while Trump said he is "going to pick someone who is outstanding," the "eventual nominee already faces a hurd le: Republicans hold a slim 51-49 majority in the /\MERICAi\ pVERSIGHT EXT-18-248-D-000398 Senate, and Sen. John McCain is out as he battles brain cancer . That means the pres ident needs to cater to senators on both sides of the aisle if he hopes to get a majority to vote in favor of his pick." Reports also continue to cast the issue of abortion as likely to be a focal point of the eventual nominee's confirmation hea rings. Breitb art (7 /1, Key, 1.28M) says Trump "hinted at the possible overturning of Roe v . Wade" during his interview with Fox News, say ing the legality of abortion "could very well end up with states at some point." Asked if abortion rights should be decided by the states, Trump said, "Well, maybe someday it will be to the states. You never know how that's going to turn out. That's a very comp lex quest ion. The Roe v. Wade is probably the one that people are talking about in terms of having an effect. But we will see what happens. But it could very well end up with states at some point ." TI ME (7/1, Langone, 19.27M) reports that in the interv iew with Fox News, "Trump acknowledged that the status of Roe v. Wade is one of the key issues in the public's mind," but Newsweek (7/1, Fearnow, 2.18M) says he "hesitantly added, however, that he's not going to be 'so specific with the questions' used to query" candidates . Yahoo! News (7/1, Walsh, 12.44M) reports Trump, however, told Fox News, "They're all saying, 'Don't do that. You don't do that. You shouldn't do that.' But I'm putt ing conservat ive people on and I'm very proud of Neil Gorsuch. He's been outstanding. His opinions are you know so well written, so brilliant . And I'm going to try and do something like that but I don't think I'm going to be so specific in the questions I'll be asking. And I'm actually told I shouldn't be." NJ News (7 /1, Salant, 1.17M), however, notes that Trump "has pledged to nominate justices who w ill overturn Roe v. Wade," and "said he /\MERICAi\ pVERSIGHT EXT-18-248-D-000399 would choose from a list of people vetted by the Federalist Society, a conservat ive legal group that opposes abortion. So he already knows how anyone on the list will vote on abortion, meaning he doesn't have to ask their views on the issue." The Washington Free Beacon (7/1, Kugle, 67K) notes that "all four names Leo mentioned are on Trump's list of potential Supreme Court justices," but when asked if they are the front runners, Leo said, "No, I don't think it 's fair to say that, and here's why. The president is really in the driver's seat along w ith the assistance of White House counsel Don McGahn. Those are people who are under very serious consideration." Sen . Richard Blumenthal said on CBS' Face the Nation • Video (7 /1, Brennan, 3.28M), "The President has said that he will appoint someone only if he or she would 'automatically overturn Roe v. Wade."' He added, "This decision will shape the Court for years to come and it could lead to criminalizing reproductive rights, as they were prior to Roe v. Wade when women were prosecuted and women died ." The AP (6/30, Harrisburg (PA), Patriot-News), meanwh ile, reports that "some evangelical leaders are downplaying their fortune on an issue that has defined their movement for decades." Jerry Falwe ll Jr. told the AP, "What people don't understand is that if you overturn Roe v. Wade, all that does is give the states the r ight to decide whether abort ion is legal or illegal. My guess is that there'd probably be less than 20 states that would make abortion illegal if given that right." Sources: White House Officials Eyeing Exits Likely To Stay Through /\MERICAi\ pVERSIGHT EXT-18-248-D-000400 Confirmation. ABC News (7/1, Palmeri, 1.85M) reports on its website that "top White House officials worn out from the chaos of the Trump administration and eyeing the exits in the coming weeks are now considering staying on through the confirmation of a Supreme Court justice, three White House officials and two outside advisors" say. White House Counsel Don McGahn, Legislative Affairs Director Marc Short and Domestic Policy Director Andrew Bremberg "have told colleagues in the days following Supreme Court Justice Kennedy's retirement announcement that they plan to stay on staff through the confirmation process." Cantwell: Wrong Vote On Nominee Could Be "Career-Ending Move." The Washingto n Times (7/1, Richardson, 460K) reports Sen. Maria Cantwell (D-WA) "warned her colleagues Sunday that a wrong decision" on President Trump's nominee could become a "career-ending move." Cantwell told NBC's Meet the Press, "I th ink that my colleagues on both sides of the aisle know that this vote could be one of the key votes of their entire career. And they know that no matter what spin comes out of the White House, if they vote for somebody who's going to change precedent, it could be a career-ending move." T he Hill (7/1, Birnbaum, 2. 71M) also reports Cantwell's comments. A Washington Times (7 /1, McLaughlin, 460K) analysis, meanwhile, says "red-state Democrats seeking re-election th is fall were already facing the difficult task of navigating between their own virulently anti-Trump national party and the Republican-leaning voters needed to win back home. But that narrow path has become even more of a tightrope now that incumbents will be asked to take sides" on the President's nomination. The Times says if Republicans "hold firm, the Senate is likely to vote on a Supreme Court nominee just as the midterm /\MERICAi\ pVERSIGHT EXT-18-248-D-000401 campaign season hits full stride." But it "also means vulnerable Democrats in states such as West Virgin ia and North Dakota w ill have to choose between a pres ident who easily won their states in 2016 and a frenzied liberal base intent on blocking anyone he chooses." Seung Min Kim of the Washington Post said on CNN Inside Politics • Video (7 /1, 733K), "For Senate Democrats, this is the ir one chance to really get their base to care about the Court. What we've seen last several years, perhaps the last decade is that conservatives are better at the court issue than Democrats in terms of just getting the base involved, getting their base excited," but "now with potentially the future of Roe v . Wade on the line, Democrats, this is their chance to really get their voters excited and that's why you're seeing the Democrat ic messaging on the Supreme Court already focusing on not only abortion, but future of the Affordable Care Act ." Michael Shear of the New York Times said on CNN Inside Politics • Video (7/1, 733K), "I th ink one of the things you're going to see is that the Democrats are going to try to make the case that to their base" that abortion and the Affordable Care Act are "something that you have to be united on ... because what the Democrats need is to hold their entire - all 49 and then they only have to peel off one Republican." Toomey: Special Counsel Investigation Should Not Prevent Trump Nomination. Sen. Pat Toomey (R-PA), asked on CBS' Face the Nation • Video (7/1, Brennan, 3.28M) about the question of the Special Counsel investigation and the probability of the justice Trump appoints ruling in the case, said, "I think that is a r idicu lous argument that is made as just an /\MERICAi\ pVERSIGHT EXT-18-248-D-000402 attempt to make way for the real position, which is that President Trump should never be able to confirm a vacancy." He added, "I don 't remember hearing the Democrats mak ing that argument when President Bill Clinton was in fact personally under investigation vacancy occurred. My understanding when a is that President Trump is not himself personally the subject of the investigation even. I think that is a non-argument." Trump Retweets Elder Joke About Reporter Fired Over False MAGA Hat Claim. The New York Post (7 /1, Perez, 4.46M) reports that President Trump on Sunday retweeted "a tweet by conservat ive rad io host Larry Elder ... which poked fun at a newspaper reporter who lost his job after he falsely claimed that the Capital Gazette shooter wore a 'Make America Great Again' hat during the massacre." Elder sent the tweet, wh ich read, "BEWARE! #TrumpDerangementSyndrome can be career ending," in response "to an article published by The Hill, which covered the res ignation of Conor Berry, a former reporter at The Republican in Springfield, Hemingway: Mass." Press Sought To Tie Trump To Maryland Newspaper Shooting. Mollie Hemingway of The Federalist said on Fox News MediaBuzz lN Video (7/1, 1.61M), "It's very difficult when something li ke this happens. You are desperate for information /\MERICAi\ pVERSIGHT and speculation runs EXT-18-248-D-000403 rampant. I think it's important for journalists to make sure they are not speculating without evidence. It wasn't just bad that people started try ing to tie President Trump to the shooting. It was that after the news came out showing that the shooter had a longstanding grudge against the publication dating back to 2011, many journalists kept say ing that they thought this was somehow the respons ibility of President Trump." Waters: People Want Democrats To Be "More Confrontational" Against Trump . Breitbart (7 /1, Key, 1.28M) reports that Rep. Maxine Waters to ld MSNBC AM Joy • Video Sunday that weekend protests over the President's immigration policies show that "the people" want Democrats to be "more forceful" and "more confrontational" in their opposition. Waters said, "Well, let me just tell you this, first of all, the people of th is country, no matter Republican or Democrat, do not like the idea that children have been separated. Republicans are making a mistake thinking they can hold on to that const ituency, that so- called belongs to Donald Trump. On th is issue, Republicans and Democrats, Independents alike are opposed to what is going on. And yes, people do want to see us being stronger and more forceful and to confront them on these policies." Fox News (7/1, Chamberla in, 16.38M) reports on its webs ite that Waters said she was "surprised" by crit icism from Democratic leaders over her call for people to "push back" against members of the Adm inistration . Waters said • Video , "One of the things I recognize, being an elected official, is in the final analysis, leadersh ip ... will do /\MERICAi\ pVERSIGHT EXT-18-248-D-000404 anything that they think is necessary to protect their leadersh ip and so what I have to do is not focus on them." Waters added, "I was blessed with courage. And I was blessed with the kind of strength that does not allow me to be intimidated by the likes of Donald Trump .... Let him call me whatever he wants to call me. Let him say whatever he wants to say. He will not stop me." The Hill (7/1, Wise, 2.71M) also reports on Waters' comments. Todd : Trump Is "Winning ," Democrats Are "Reeling." Bre itbart (7 /1, Key, 1.28M) reports that Chuck Todd, host of NBC's Meet the Press • Video , said Sunday that President Trump is "winning" Democrats are "reeling." Todd said, "The announced retirement and of Supreme Court Justice Anthony Kennedy this week helped make one political reality clear: Despite his overall unpopularity, President Trump is winning, and the Democrats right now are ree ling .... How about the Republican Party? The president's approval rating among Republicans is around 90 percent. Elected Republicans fear criticizing him, and the party has become a cult of personality: his." Todd continued, "Still, much of Mr. Trump's success is superficial. While he's more popular among Republicans, the party overall is shrinking. His trade war, North Korea, or the Mueller investigation all could turn against him and, frankly, turn against him now like North Korea has. But if the Democrats' reaction to the Kennedy retirement proved anything, it's that the Democratic Party has not figured out how to succeed in the Trump era." /\MERICAi\ pVERSIGHT EXT-18-248-D-000405 Ocasio-Cortez: Democratic Socialism Just "Part Of What I Am." The Washington Times (7/1, Richardson, 460K) reports that in an interv iew with NBC's Meet the Press • Video Sunday, Alexandria Ocasio-Cortez, who defeated Rep. Joe Crowley in last week's primary in NY14, "downplayed ... her affiliation with democrat ic socialism," saying, "It's part of what I am. It's not all of what I am. And I think that that's a very important distinction ... . I'm an educator, I'm an organizer . ... And I believe that what we're really see ing is just a movement for health care housing and education in the United States." Ocasio-Cortez added, "Democrats are a big tent party .... I'm not trying to impose an ideology on all severa l hundred members of Congress, but I do think that once again it's not selling an -i sm or an ideology or a label or a color. It's about selling our va lues." The New York Post (7 /1, Moore, 4.46M) reports that Ocasio-Cortez "faulted Crowley, a 10-term incumbent, for not being more closely connected to the community," saying, "I do think there was certain ly a lack of presence, and that was a big part of my win .... There was a lack of listening on the ground. A lack of going to the grocery store and saying 'Hey, how you doing?' That is an important work of representation ." Ocasio -Cortez also "said the Democrats must have a unified message that people can rally around, especially in the fight over President Trump's nominee to the Supreme Court." She said, "This Supreme Court seat is extremely serious. There is a federa l invest igation going on with direct implications to the presidency and that presidency is ta lking about nominat ing a Supreme Court pick that is going to essentially hear this case out." /\MERICAi\ pVERSIGHT EXT-18-248-D-000406 Duckworth: Democrats Can't Go Too Far Left An Win Nationwide. The Washington Examiner (7/1, Ayers, 340K) reports that Sen. Tammy Duckworth warned Sunday that the Democratic Party should not move further to the left if they want to win the presidency. Following the surpris ing defeat of Crowley by Ocasio-Cortez, an "avowed Democratic socialist," Duckworth told CNN's State of the Union • Video Sunday that "she doesn't foresee that being a winning strategy in the Midwest. " Said Duckworth, "I think that you can't win the White House without the Midwest .... And I don't think you can go too far to the left and still win the Midwest - coming from a Midwestern state." Duckworth urged dia logue with the "industrial Midwest," and said, "You need to listen to the people there in order to win an election nationwide." The Washington Post (7/1, Scherer, 15.68M) says Democratic leaders are "scrambling to keep the political outrage they'd counted on to fuel m idterm election wins from becoming a liab ilit y for the party." Internal debates "have broken into public view over maintain ing civility and the usefu lness of liberal slogans like 'abolish ICE,' which some Republicans have embraced to argue fa lsely that Democrats oppose immigration enforcement." Meanwhile, "liberal activ ists have begun to argue for more radical measures to counter the pres ident, who they assert presents an immed iate threat to the republic." Rachel Bade of Politico said on CNN Inside Politi cs • Video (7/1, 733K) that Ocasio-Cortez's primary win over Crowley "was a clear message to the top of Democrat ic leadership in the House that Democrats want change in their hierarchy and they want the establishment /\MERICAi\ pVERSIGHT out, they EXT-18-248-D-000407 want new blood at the top and they are ready to see somebody else lead beyond Pelosi." John King said on CNN Ins ide Politics • Video (7/1, 733K), "If there's a giant blue wave and Democrats win the House by 20 seats, Nancy Pelosi will be okay. She still is the party's premier fundraiser. She still has a lot of loyalty in the caucus. However, if they just squeak by and a whole bunch of candidates promised in their TV ads I won't vote for her, she's going to have to negotiate either a temporary speakership ... or she may have to go." Portland Police Declare Riot, Revoke Permit As Antifa Disrupts Protest. Breitbart (7/1, Huston, 1.28M) reports that Portland, Oregon police "revoked a permit for a pro -Amer ica march and declared the scene a riot when counter-protesters erupted in violence on Saturday." The permit had been "secured by the Patriot Prayer group that had planned a march entitled the 'Freedom and Courage' rally . But a large number of members of a local vio lent, black-clad Antifa group also gathered along the march route and began a series of confrontations with the marchers." According to The Oregonian, the Antifa group " initiated hostilities by throwing eggs, bott les, and other items at the Patr iot group, the paper noted ." ABC Wor ld News Tonight • Video (7/1, story 9, 0:20, Llamas, 14.63M) /\MERICAi\ pVERSIGHT EXT-18-248-D-000408 reported that according to police, at least four people were hurt "when right-wing demonstrators and counter-protesters broke out in brawls, " and "at least nine people [are] facing charges." The CBS Weekend News • Video (7/1, story 9, 0:20, Quijano, 5.32M) reported that officials "say they seized knives, clubs, and chemical sprays." NYTimes Analysis : Supreme Court Ruling Against Unions A Blow To Liberal Groups. The New York Times (7 /1, Scheiber, 19.33M) reports that the Supreme Court's ruling "striking down mandatory union fees for government workers" wi ll "hit hard at a vast network of groups dedicated to advancing liberal policies and cand idates ." Groups that "work for immigrants and civil rights," or "produce economic research" or "turn out voters or run ads in Democratic campa igns, " have "benefited from tens of millions of dollars a year from public-sector unions - fund ing now in jeopardy because of the prospective decline in union revenue." According to liberal activists, cutting off that funding "was a cruc ial goal of the conservat ive groups that helped bring the case, known as Janus v. American Federation of State, County and Municipal Employees," and conservat ives "have acknowledged as much .... Even President Trump took notice of the just ices' ruling, declaring on Twitter that it was a ' big loss for the coffers of the Democrats!"' /\MERICAi\ pVERSIGHT EXT-18-248-D-000409 Trump Says He Wants To Stay "Uninvolved" In Russia Probe, "At Least For Now." President Trump was asked in an interv iew that aired on Fox News Sunday Morning Futures • Video (7/1, Bartiromo, 1.79M) about Russia invest igation. Trump said, "So, I have this country running like a top, Mike Pompeo is doing great." He sa id, "We have a great group of people" and "the one thing I want to stay uninvolved in at least for now I may get involved but I have been to ld by so many people don't get involved." He said, "There's no collus ion with me .. . honestly it is a disgrace but I purposely said I'm not getting involved" and "you know, they found nothing." He said, "By the way, th is is the most transparent thing ever done with the White House ... I think I gave them a million 400,000 documents I told them don't even read them; there's no Russia ment ioned or anything like that ." Judge Rules Rosenstein 's Order Gives Mueller Wide Investigative Latitude. The Washington Times (7/1, Scarborough, 460K) reports that understanding the reason special counsel Robert Mueller has expanded his invest igation beyond the 2016 pres idential race "may require perusing a federal judge's opinion on June 26 in the Paul Manafort case." District Court Judge T.S. Ellis III "dissected Deputy Attorney General Rod Rosenstein's May 2017 appointment order to Mr. Mueller," and "concluded that the prosecutor is empowered to look at virtually any Russian contact." According to Ellis, Rosenstein 's gu idelines " state that Mr. Mueller is to investigate any links between the Russian government and Trump campaign associates," which means "indirect links" or "potential links, " giving Mueller "wide latitude when deciding whether to target a Trump person ." /\MERICAi\ pVERSIGHT EXT-18-248-D-000410 Judge Extends Program Paying For Hurricane Maria Victims' Hotel Stays . The CBS Weekend News • Video (7/1, story 11, 0:30, Quijano, 5.32M) reported that Hurr icane Maria evacuees living in hotels have gotten a "s hort reprieve " as a federal judge "temporarily extended the program that's been paying for the ir stay." The program was "set to expire at midn ig ht Sunday, but will now end on Tuesday." Private Equity Group Offer High-Interest Loans To Cash-Strapped Americans. The Washington Post (7 /1, Whoriskey, 15.68M) reports that the company Marine r Finance "enables some of the nation's wealthiest investors and investment funds to make money offering high-interest loans to cash-strapped Americans." The company "is owned and managed by a $11.2 billion private equity fund controlled by Warburg Pincus, a storied New York firm," whose president is Timo thy F. Geithner, "who, as treasury secretary in the Obama administration, condemned predatory lenders." The Post says the market for '"consumer installment loans,' which Mariner and its competitors serve, has grown rapidly in recent years, particularly as new federal regulations have curtailed payday lending, according to the Center for /\MERICAi\ pVERSIGHT EXT-18-248-D-000411 Financial Services Innovation, a nonprofit research group. Private equity firms, with billions to invest, have taken significant stakes in the growing field." Mariner "stands out for the frequent use of mass-mailed checks, which allows customers to accept a high-interest loan on an impulse - just sign the check." Median Prime For A Single-Family Home In San Francisco Bay Area Is $935,000. The CBS Weekend News • Video (7/1, story 8, 2:10, Quijano, 5.32M) reported that "a recent report says the median price for a single-family home in the [San Francisco] Bay area is $935,000. In the city it's even higher." CBS (Strassmann) added that market "is fueled by thousands of well-paid tech workers who have driven up the median price of a San Francisco home to $1.6 million, the highest in the country. And while housing prices are ris ing faster than incomes nationwide, nowhere is it more evident than in the Bay area, where home values have soared a staggering 64% over the last five years." High Schools Clamp Down On Student Journalists Covering Sensitive Subjects. The New York Times (7/1, Peiser, 19.33M) reports that high schools /\MERICAi\ pVERSIGHT EXT-18-248-D-000412 across the nation have been push ing back against student journal ists "who have reported on sensitive subjects, like the reaction to school shootings and adolescent sexuality." Since a 1988 Supreme Court ruling "that a Missouri school district had acted lawfully in removing a twopage spread on divorce and teenage pregnancy from a student newspaper, administrators have been able to censor work in school publications that they consider poorly written or 'inconsistent with the shared values of a civ ilized social order."' The Times cites a number of examples but also notes that in some places, "student reporters have delved into difficult subjects without interference or complaint from administrators." Seattle Bans Plastic Straws, Utensils In Restaurants. NBC Night ly News • Video (7/1, story 8, 2:30, Jackson, 8.26M) reported that Seatt le on Sunday joined "the growing list of cities banning plastic straws and plastic forks and knives in local restaurants. They're almost never recycled, meaning they end up in landfills, creating more of a pollution problem." NBC (Fryer) added that "28 cities around the country that have banned or limited plastic straws or are consider ing it . Californ ia and Hawaii are even exploring statewide policies." Murdoch Turning Much Of The Company He Built Over To Disney . /\MERICAi\ pVERSIGHT EXT-18-248-D-000413 The Washingto n Post (7 /1, Ellison, 15.68M) reports that 21st Century Fox and News Corp. founder and co-executive chairman Rupert Murdoch is "selling the bulk of the company to Disney." It is " a seminal moment for Murdoch, who is turn ing over the power to run the company he has spent his career building." The Post adds that w ith President Trump's election, Murdoch is "at the height of his political influence in the United States, a position he has long sought . Murdoch has a direct line to Trump and close re lationsh ips with several Fox News personalities who act as unoffic ial advisers to the White House. " Murdoch and the President "talk weekly and sometimes daily, according to people close to both men." Moreover, with "former Fox News executive and Sean Hannity confidant Bill Shine ... expected to take the job of White House deputy chief of staff in charge of communications," it "on ly adds to the personal connections between Trump and the Murdoch-contro lled news network ." In an editorial, the New York Times (7 /1, 19.33M) questions the speed w ith which the Just ice Department approved the Disney - Fox deal, saying it took "about half the time that regulators usually need to evaluate deals of this size." Noting that the Department "spent nearly two years investigating an ultimately AT&T's acquisition of Time Warner and bringing unsuccessfu l lawsuit against the deal," the Times says that while the Administration "has den ied that politics plays a role in its antitrust enforcement decisions," it is "hard not to be skept ical of the possible motivat ions behind the Justice Department's approa ch to these dea ls." /\MERICAi\ pVERSIGHT EXT-18-248-D-000414 Professors Oppose Stricter Work Requirements For SNAP . In an op-ed for the New York Times (7/1, 19.33M), Sarah Bowen, Sinikka Elliott And Annie Hardison-Moody, professors who have conducted a study on child hunger, write that the nation's policies "have long reflected, imperfectly, the moral imperative that children deserve adequate food. Unt il now." Although SNAP already inclu des work requirements for able-bodied adults without children, the House-passed farm bill "an even harsher policy and extends it to parents of school-age children. It would require that most adults provide monthly proof that they are working or enrolled in at least 20 hours of work force training per week in order to receive support" or risk being locked out of the program for three years. They note that the Senate version does not include the requiremen t "that will leave more kids hungry," and argue that while President Trump "offered his support," for stricter work requirements, the program "should not be restricted" but "expanded, so that fewer families - and especially kids - are hungry." WPost Welcomes Transfer Of Background Checks From OPM To DOD. In an editorial, the Washington Post (7 /1, 15.68M) says the Administration's investigations Department proposal to transfer responsibility for background for security clearances from the OPM to the Defense is change that is "a long time coming." The Post cites criticism of OPM's "slow processing of background checks" as well as "security concerns" stemming from the agency's handling of the investigations /\MERICAi\ pVERSIGHT and says the "transfer of security-clearance EXT-18-248-D-000415 responsibilities Department makes sense." Howeve r, the Post says Defense must "address these concerns and ensure that the background-check process is efficient, secure and accurate going forward." WSJournal Criticizes Individual, Corporate Tax Hikes In New Jersey . A Wa ll Street Journa l (7/1, Subscription Publication, 6.13M) editorial criticizes New Jersey Gov. Phil Murphy and State Senate leader Steve Sweeney for agreeing to increase New Jersey's state's income tax on residents making more than $5 million and the corporate rate on companies with more than $1 million in income, givin g the state the fourth highest income tax rate on individua ls and the second highest corporate rate in the nat ion . Editorial Wrap-Up /\MERICAi\ pVERSIGHT EXT-18-248-D-000416 New York Times . "Your Credit Card Will Pay For The Next Recession." The New York Times (7/1, 19.33M) says in an editorial that Federal Reserve forecasters' "median prediction is that the federal funds rate is headed to 3 .4 percent by the end of 2020 from the current 1. 9 percent," meaning consumers will be "paying more to get a mortgage, a new-car loan or to carry a balance on your credit card. How much more? Possibly enough to absorb whatever extra income you might be enjoying from lower tax rates or higher wages." The Fed's job of keeping " inflation in check by raising rates," has been "made more urgent by the Repub licans' $1.5 trillion tax giveaway to the wealthy and corporat ions." Now, "Trump supporters who benefited the least from the Republican tax cut ... will now have to pay the bulk of the bill to mitigate the damage it caused to the economy." "The Disney-Fox Deal Sails Through, A Bit Too Easily." In an editorial, the New York Times (7 /1, 19.33M) questions the speed w ith which the Just ice Department approved the Disney-Fox deal, saying it took "about half the time that regulators usually need to evaluate deals of this size." Noting that the Department "spent nearly two years investigating an ultimately AT&T's acquisition of Time Warner and bringing unsuccessfu l lawsuit against the deal," the Times says that while the Administration "has den ied that politics plays a role in its antitrust enforcement decisions," it is "hard not to be skept ical of the possible motivat ions behind the Justice Department's approach to these deals." /\MERICAi\ pVERSIGHT EXT-18-248-D-000417 Washington Post. "This Piece Of Trump's Federal Shake-Up Coming. Get It Right." Has Been A Long Time In an editorial, the Washington Post (7/1, 15.68M) says the Administration's proposal to transfer responsib ility for background inv estigations for security clearances from t he OPM to the Defense Department is change that is "a long time coming." The Post cites criticism of OPM's "slow processing of background checks" as well as "security concerns" stemming from the agency's handling of the investigations and says the "transfer of security-clearance responsibilities Department makes sense." However, the Post says Defense must "address these concerns and ensure that the background-check process is efficient, secure and accurate going forward." "The Malaria Fight Stalls As Children Die By The Hundreds Of Thousands." A Washington Post (7/1, 15.68M) editorial says that while the number of malaria cases and deaths have declined steadily for a decade and a half as "g lobal public-health officials have been at war" with the disease, the "battle shows signs of stalling." In 2016, "the number of malaria cases went up to 215 million, from 210 million the year before." The Post says that the fight against malaria will be won "by action on many fronts. A stall, after so much promise, would be terrible and costly." /\MERICAi\ pVERSIGHT EXT-18-248-D-000418 "What Are The Park Police Hiding?" A Washington Post (7/1, 15.68M) criticizes the "epic stonewalling campaign" by US Park Police concerning Park Police officers' fata l shooting of Bijan Ghaisar, "a young accountant in Northern Virginia who appeared to pose no threat to them or anyone else." The Post says "it has been 225 days - and counting" and the Park Police response "has been characterized by brazen arrogance and in-your-face unaccountab ility on a grand scale ." The Post concludes that "after so many months of official nonresponsiveness, there is one overarching question the public is entitled to ask: What are the police trying to hide?" Wall Street Journal. "The War On Admissions Testing." In an editorial, the Wall Street Journa l (7/1, Subscr iption Publication, 6.13M) takes issue with a growing movement to eliminate he ACT and SAT tests for college admiss ions. The Journal argues that although no test is ideal, the ACT and SAT are good pred ictors of how a student will perform in college. " New Jersey 's Tax Gift To Florida." A Wall Street Journal (7/1, Subscription Publication, 6.13M) editoria l criticizes New Jersey Gov. Phil Murphy and State Senate leader Steve Sweeney for agreeing to increase New Jersey's state's income tax on residents making more than $5 million and the corporate rate on /\MERICAi\ pVERSIGHT EXT-18-248-D-000419 companies with more than $1 million in income, giving the state the fourth highest income tax rate on individuals and the second highest corporate rate in the nation. "North Korea Keeps Enrich ing Uranium." A Wa ll Street Journal (7/1, Subscription Publication, 6.13M) editoria l says evidence of North Korea's continuing nuclear-fue l production suggests Pyongyang intends to drag out open-ended talks with the US for as long as possible in hopes of extracting new concessions along the way . The Journal says if President Trump does not call Kim Jong - un out on these activities, then Kim will conclude that he can get away with this behavior. The Big Picture Headlines From Today's Front Pages. /\MERICAi\ pVERSIGHT EXT-18-248-D-000420 Wall Street .Journal: Trump Cites Threat Of Auto Tariffs As His Biggest Leverage Facebook Gave Firms Special Access To Users' Personal Data North Korea Expands Key Missile-Manufacturing Plant Taiwan's Technology Secrets Come Under Assault From China New York Times: Supreme Court Defeat For Unions Upends A Liberal Money Base Bulwark Against An Abortion Ban? Medical Advances In Denmark, Harsh New Laws For Immigrant 'Ghettos' Leltist Wins Mexico Presidency In Landslide With Mandate To Reshape Nation As Bolton Says North Korea Could Disarm In A Year, Reality Lags /\MERICAi\ pVERSIGHT EXT-18-248-D-000421 Promises Behind Lincoln Center's Wh ite Travertine Facade: Infighting And Indecision Washington Post: Unsolicited Checks Can Be A Lifeline - And An Albatross Trump Stays Firm On Trade As Foreign Tariffs Kick In Democrats' Bad Week Highlights A Big Rift Two Bristols, Two Fiscal Realities Mexico Turns Left In Election Emails Reveal Ties Between Top EPA Aides And Lobbyists Financial Times: Arnio Seals Comfortab le Victory In Mexico Election /\MERICAi\ pVERSIGHT EXT-18-248-D-000422 EU Warns Of $300BN Hit To US Over Car Import Tariffs Alphabet Adds To Transport Bets With Scooter Deal Activ ist Loeb Demands More Urgency At 'Complacent ' Nestle Washington Times : Sw ing-Vote Collins Keeps Open Mind On Trump's Supreme Court Pick Despite Left ist Pressure Political Pickle: Supreme Court Vacancy Puts Red-State Democrats In A Big Campa ign Quandary Trump's 'Down The Road' Deadline To Lift North Korea Sanctions Frustrates Nations Eager For Trade Trump's Pressure Against Regime Adds Strength To Iran's Largest Dissident Group Judge: Rosenstein's ' Any Links' Mandate Empowe rs Mueller To Look At Virtually Any Russian Contact After Trump Yields On Family Separation, Immigration Activists Demand End To Detentions, ICE /\MERICAi\ pVERSIGHT EXT-18-248-D-000423 Story Lineup From Last Night's Network News: ABC: Severe Weather; Bahamas-Boat Explosion; Idaho-Man Goes On Stabbing Spree; Trump-SCOTUS Pick; France-Murderer Mexico-Elections; Australia-Shark Escapes Prison; India-Bus Accident; Oregon-Police Shooting; Bites Woman; Portland-Protest Road Collapses; Reagan National Airport-United Becomes Riot; ChinaExpress Flight Forced To Deplane; Food Recall-Wishbone Italian Dressing; Best Buy Stops Selling CDs; Police Lip Sync. CBS: Severe Weather; Wildfires; Bahamas-Boat Explosion; TrumpSCOTUS Pick; Reagan National Airport-United Express Flight Forced To Deplane; Maryland-Capita l Gazette Memorial; US-Russia Relations; Mexico-E lections; San Francisco-Housing Market; Portland-Protest Becomes Riot; Thailand-Missing Boys' Soccer Team; Puerto Rico- Hurr icane Maria Evacuees; Long Island -Father Son Sock Business. NBC: Idaho-Man Goes On Stabbing Spree; Severe Weather; Weather Report; Wildfires; Bahamas-Boat Explosion; Trump-SCOTUS Pick; Mexico-E lections; Plastic Straw Bans; Opioid Crisis-France's Solution; France-Murderer Network Escapes Prison; Family's Monster Truck Business. TV At A Glance: Severe Weather - 7 minutes, 35 seconds /\MERICAi\ pVERSIGHT EXT-18-248-D-000424 Trump-SCOTUS Pick - 7 m inutes, 30 seconds Bahamas-Boat Explosion - 4 minutes, 50 seconds Mexico-E lections - 3 minutes, 0 seconds Story Lineup From This Morning's Radio News Broadcasts: ABC: Trump-SCOTUS Pick; Idaho-Man Goes On Stabbing Spree; NBA News . CBS: Idaho-Man Goes On Stabb ing Spree; Severe Weather; Wildfires; Mexico-E lect ions; NBA News. FOX: NBA News; Congress -SCOTUS Pick; Mexico-Elections. NPR: Trump-SCOTUS Pick; Idaho-Man Goes On Stabbing Spree; Guatemala-Volcano-Health /\MERICAi\ pVERSIGHT Issues; Canada-Tariffs On US. EXT-18-248-D-000425 Last Laughs Late Night Political Humor. John Oliver: Supreme Court Justice Anthony Kennedy's retirement " is obviously huge news, and for anyone who believes that the Constitution protects things like reproductive and LGBT rights, this is bad. And we know it's bad because Donald Trump Jr. was happy, tweet ing 'OMG just when you thought this week couldn't get more lit, I give you Anthony Kennedy 's retirement from #scotus.' And I'm afra id I'm going to have to disagree with Mr. Junior on th is, because I personally don't think this was lit at all. I mean, it's obvs cray af. No one is deny ing that, fam. But I would argue that this news was neither lit nor on fleek. Nor was it three fire emojis . Now, granted, I am still a little shook , jsyk , but I persona lly believe Kennedy's retirement is super werpt. And I'm happy to announce that, in say ing that, all the slang words I just used are now officially dead forever . And that includes 'werpt, ' a term that doesn't even exist, but wh ich I have preempt ively ruined just in case. " /\MERICAi\ pVERSIGHT EXT-18-248-D-000426 John Oliver: "The big question here is, who is going to replace Kennedy? And the Adm inistration has made their plans pretty clear, with Mike Pence tweeting, 'Thank you to justice Anthony Kennedy for your long career of service. Trump will nominate a strong conservat ive in the tradition of the late Justice Scalia.' Which is a little weird . You don't genera lly stand up at someone's ret irement party and say, 'Thank you for everything you did for this company, Robert, and rest assured that we will replace you with someone exactly like that other guy who used to work here that we always liked much more than you."' John Oliver: "There's a fundamental problem there, and that is that Republicans have 51 seats in the Senate, and they need 51 votes to confirm the new justice. So unless Democrats can convince their entire party to oppose the nomination and persuade a number of Republicans over to their side, they are ... out of luck, meaning it's t ime for Democrats' favorite game: 'Hope Susan Collin Flips And Be Disappointed When She Doesn't!' It's America's most depressing game show." John Oliver: "I'm happy to say, there is some good news. It turns out there's a /\MERICAi\ pVERSIGHT EXT-18-248-D-000427 constitutional loophole that allows Democrats to - I'm obviously lying here. There's no good news. Everything is terr ible now." John Oliver: "Barring some massive screw-up from Trump, the only thing anyone can really do is vote. And there are actually two key elections you should really try and vote in: One in 2016 and one in 2014. Because that is what got us into this mess." Copyright 2018 by Bulletin Intelligence LLC Reproduction or redistribution without permission prohibited. Content is drawn from thousands of newspapers, national magazines, national and local television programs, radio broadcasts, social-media platforms and additional forms of open-source data. Sources for Bulletin Intelligence audience-size estimates include Scarborough, GfK MRI, comScore, Nielsen, and the Audit Bureau of Circulation. 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We can be found on the Web at Bulletinintelligence.com, or called at (703) 483-6100. /\MERICAi\ pVERSIGHT EXT-18-248-D-000428 Sender: Bulletin Intel ligence Recipient: "HHS@bulletin intell igence.com " Sent Date: 2018/07/02 07:30:14 Delivered Date: 2018/07/02 07:33:24 /\MERICAi\ pVERSIGHT EXT-18-248-D-000429 HHS NEWS BRIEFING PRODUCED BY BU LLETIN INTELLIGENCE WWW.BULLETININTELLIGENCE.COM/HHS TO: THE SECRETARY AND SENIOR STAFF DATE: MONDAY, JULY 2, 2018 7:30 AM EDT TODAY'S Leading the News Hundreds Of Thousands Protest Administration 's Immigration Policy, Separation Of Families ....... .4 The Secretary in the News Judge Strikes Down Kentucky's Medicaid Work Rules .. .................................................................9 Unaccompanied Alien Children Suit Filed Against HHS Alleges "A Wide Range Of Abuses" Against Unaccompanied Minors ........... 9 House GOP Seeks Answers From Azar About ORR ..... ............................................................. 10 Fake Story About HHS Losing Immigrant Children Resulted In Discovery Of Separations At The Southern Border ................................................ 10 HHS in the News HHS' Severino Speaks At National Right To Life Conference ........................................................ 10 Several Mid-Level HHS Officials Reportedly Emulating Trump In Tweets .............................. 10 CMS Looking For Chief Health Informatics Officer .. 11 CMS Releases Payment Data , Reveals Drug And Medical Device Company Contributions ........... 11 National Guard Soldiers May Have Sleep Problems After Returning Home From The Battlefield , Research Suggests ........................................... 11 Federal Officials Say Romaine Lettuce-Linked E. Coli Outbreak Is Officially Over ......................... 11 Emergency Departmen ts Struggling Through Shortages Of Crucial Drugs ....................... ....... 11 Amazon's PillPack Deal Unlikely To Impact Drug Costs, Analysts Say . ......................................... 11 First Cannabis -Based Prescription Drug Approved By FDA Marks "Watershed" Moment , Industry Members Say ... ................................................. 12 FDA Commissioner Comments On Efforts To Stem Online Opioid Sales ...... .................................... 12 FDA Report Suggests Ways To Improve Its Hiring Process ....... ............................................ .......... 12 EDITION FDA Policy Limiting Blood Donations From Gay Men Draws Scrutiny .......................................... 12 FDA Warns Pfizer Over "Misleading" Consumer Video ................................................................. 12 Op-Ed Touts FDA Allowance Of Off-Label Healthcare Economic Discussions .. ................. 12 Maple Syrup Producers, Beekeepers Oppose FDA's "Added Sugars " Label. ...................................... 12 CDC Director Changes Stance On Use Of Condoms To Prevent STDs .............................. 13 CDC Map Illustrates Incidence Of Pediatric Cancer In Different US Regions . ................................... 13 House Legislators Seek More Transparency From FN IH Concerning Donors .................................. 13 NCI Research Fund ing Priorities Following Budget Increases Outlined ............................................ 13 NCI Establishes National Clinical Trials Network Navigator To Augment Access To Cancer Trial Specimens, Data ............................................... 13 NIDOCD Study Indicates Partially-Restored Hearing In Mouse Model Of Inherited Deafness ............ 13 Senate Committee Considers Additional $2 Billion For NIH In 2019 ................................................. 14 NIH Recommends Strategies For Older Adults To Avoid Hypothermia In Summer Heat. ............... 14 Johns Hopkins Tops List Of Leading NIH Grant Recipients In Baltimore Area ............................ 14 Opioid Crisis Opioid Deaths In Missouri Still On The Rise, But Growth Rate Slowing Down .............................. 14 Ohio Auditor's Report Shows Impact Of Opioids On Medica id ..... ....................................................... 14 New Research Shows How Opioids Are Impacting The Workforce In Kentucky ............................... 14 Georgia Will Require Doctors To Check Database Before Prescribing Opioids ........... .................... 14 Arizona County Joins Opioid Manufacturer Lawsuit.14 Pennsylvania Law Aims To Protect Newborns Affected By Opioid Addiction ............................ 15 EXT-18-248-D-000430 Innovative Program At Kentucky Jail Provides InHouse Rehab For Inmates ................................ 15 Nashville Family Loses Three Loved Ones "To Drugs' Grip." ...................................................... 15 Media Collaborates To Share Solutions To Opioid Crisis .... ............................................................. 15 Police Using Databases To Crack Down On Opioid Abuse ... ............................................................. 15 Metrohealth Cuts Opioid Prescript ions By 3 Million. 15 NBC Analysis: France Seems To Have Solution To Its Own Opioid Crisis ......................................... 15 Medica To Add Two More States: Missouri, Oklahoma ............. ............................... ............. .20 University Of Mississippi Medical Center To Continue Treating Blue Cross Patients As InNetwork During Mediation Process . .................20 Opinion: IRS Should Let Workers Spend Pretax Money On Healthcare ....................................... 20 Editorial: Minnesota Helps Bring Insurance Premiums Down, But Faces Fund ing "Cliff." ....20 Op-Ed : Most Physicians Unaware Of Ways They Can Reduce Healthcare Costs For Patients .....20 Mental Illness Human Services News Student Groups On College Campuses May Improve Access To Mental Health Resources, Study Suggests . ................................................ 15 HHS Provides Maine Group With $200K Grant For Health Work . .....................................................20 July 1 Marks Change In Arizona Child Welfare Laws .................................................................. 20 District Of Columbia Extends Deadline For Daycare Workers To Meet New Education Requirements ....... ............................... ............. .20 Ohio Hasn 't Used $SM Designated For At-Risk Youth In 2018 ....................................................21 Maine Governor Vetoes Bills To Increase Reimbursement Rates For Direct Care Workers .... ........................................... ..............21 Healthcare Fraud Tennessee CEO Indicted In $2.5 Million Medicare Fraud Case . ...................................................... 16 Dallas Health care Center Service Provider Charged In $2.5 Million Medicare Fraud Scheme . .......... 16 Prescription Drug Pricing Epilepsy Drug's Price Increase Highlighted ............. 16 Op-Ed: "Ame rican Patients First" Plan Negle cts Key Elements Necessary To Redu ce Drug Costs ... 16 Editorial: More Policies Requiring Transparency Of PBMs Are Necessary To Combat Drug Prices.16 Op-Ed Criticizes Pharmacy Benefit Managers ......... 16 Op-Ed : State, Federal Laws Should Empower Pharmacists To Help Manage Drug Costs ... .... 17 Food & Import Safety Wish-Bone Recalls Salad Dressing For Possible Allergens ........................................................... 21 Nutrition & Obesity Beverage Industry Scores "Defining Victory " In Banning Soda Taxes In California ...... ......... .....21 Health Care & Insurance Reform Medicare Sen . Collins Says She Will Oppose Supreme Court Pick Who Shows "Hostility " To Roe V. Wade ... 17 Medical Advances Have Contributed To Plunging Abortion Rates .... .............................................. 18 Iowa Supreme Court Rules Against 72-Hour Abortion Waiting Period .................................... 18 Opinion: Women Must Speak Up To Defend Abortion Rights .................................................. 18 New Mexico Democrats Push To Repeal State Abortion Law ..................................................... 19 Supreme Court Ruling Raises Doubts About Illinois Abortion Law ..................................................... 19 Some States Taking Action To Support ACA . ......... 19 House Vote To Repeal Medical Device Tax May Bolster Vulnerable GOP Lawmaker .................. 19 Sen. Durbin Says Trump Seeking Court Nom inee Who Will Overturn Roe, Affordable Care Act. .. 19 Trump Administration Proposes Cuts To ACA Naviga tors .. ....................................................... 19 Health Insurers Offering ACA Plans In More States, But At Higher Premiums ..... .............................. 19 Obama Told Trump To Take Credit For ACA ...... .... 19 Insurance Premiums Set To Sharply Rise Next Year In New York ... ................................ .................... 19 CMS To Test Medicare Advantage Plans As APMs.21 Medicaid & CHIP Sununu Signs Reauthorized Medicaid Exp ansion Bill ......................................................................21 Maine Governor Vetoes Medicaid Expansion Funding ...... .......................................................22 Idaho GOP Committee Passes Resolution Opposing Medicaid Expansion Initiative ...........22 Iowa's New Private Medicaid Company Has "Trouble d Past." ................................................22 Arkansas Suspends Medicaid Payments To Missouri Nonprofit After Arrest. ......................... 22 Ohio Medicaid Execs Criticized For Defending Pharmacy Middlemen . ........................ ..............22 Iowa Hospital Association Says State Has No Data To Support Medicaid Savings Claim .................22 West Virginia Medicaid Waiver Expands Options For Substance Abuse Treatment. .................... .22 Article Examines Why Tennessee Has Not Expanded Medicaid .......... ............ ............... .....23 2 EXT-18-248-D-000431 Op-Ed: New Chemotherapy Study Underscores Importance Of Non-Infer iority Trials ................. .26 Loved One 's Cancer Diagnos is Can Spur Others To Seek Preventive Care . ......................................26 Congress Passes Firefighter Cancer Registry Act ...27 Amazon's Latest Deal Shows It Plans To Disrupt How Industry Cares For Chronically Ill. ............27 US Judge Rules AbbV ie, AndroGe l Partner Owe $448 Million In Ant itrust Case . ..........................27 Amazon's PillPack Deal May Provide It With Access To Sensitive Health Data .... ..............................27 WSJournal : Amazon 's PillPack Deal Will Benefit Consumers , Force Compe titors To Improve .... 27 More Suits Filed Against Florida Drugmaker Accused Of Selling Contaminated Medic ines ...27 District Court Extends lndivior 's Order Blocking Launch Of US Generic Addiction Treatment. ...27 FDA Cites Mylan For Morgantown Plant Manufacturing Issues .. ........................ ..............28 Report : Nearly All Online Pharmacies Illegal. ..........28 Missouri Appeals Court Rejects $55 Million Verdict Against Johnson & Johnson In Talc Powder Suit. ...................................................................28 FDA Approves Pulmonx 's Valve For Emphysema . .28 NYC Expands Lead Testing Program For Children. 28 Learning To Play Piano May Help Children Build Up Language Skills , Study Indicates ............... .......29 Tech Company CEO: Children Need To Be Guided Through Technology Thoughtfully ... .................29 Factors Behind Lagging Ma instream Adoption Of Telemedicine Examined ....................................29 Drivers For Car Services, Ride-Hailing Apps In New York Now Able To Get Coverage For Vision Care ...................................................................29 Scientists ' Discovery Is "First Step" To Packaging Insulin In Pill. ....................................... ..............29 Roche Encouraged By Tecentriq Trial Results .... ....29 Angela Garbes ' New Book "Like A Mother " Discussed ............................................ ..............29 Hawaii Bans Sale Of Sunscreens Containing Oxybenzone , Octinoxate ..................... ..............29 Health & Medical News Scientists Warn On Increased Mortal ity Risk From Prolonged Sitting ...............................................23 People Fail To Properly Wash Hands Wh ile Cooking 97 Percent Of The Time, Study Finds .23 US Evacuates More Americans From China Following Mystery Illness Complaints .... ...........23 Most People Apply Too Little Sunscreen . ................23 Being Married May Reduce Risk Of Heart Disease , Cardiovascular Death, Review Sugges ts ..... ....23 Researchers Developing Artificial Ovary To Help Young Cancer Patients Preserve Fertility ......... 23 lmmunotherapy "Revolution " Is "Greatest Hope Yet" For Beating Cancer .... .......................... .............23 FDA Approves First Drug To Reduce Excessive Sweating ............................................................23 CDC Warns Of Shingrix Vaccine Shortage ..............24 Police Investigate Elder Abuse Aga inst Comic Book Creator Stan Lee , 95 ..... ....................................24 Mississippi Public Agenc ies Must Now Cover Increased Share Of Worker Pensions ... ...........24 Surveys : Financially Independent Millenials Are Happier Than Those With Money Worries ..... ..24 Retirees Increasingly Becoming Entrepreneurs, Cites AARP Study ... ..........................................24 Study Reveals Views On Social Med ia Bias ..... .......24 Hospitals Across US Experienc ing Shortages Of Beds For Children With Mental Health Illnesses . .............................................. .............24 Co lorado Hospital Sues Patient For Surgery Bill, Highlighting Alleged Price Gouging .................. 25 Oklahoma Drafts Rules To Regulate Medical Marijuana Following Successful Legalization . ..25 Many Families Still Live With Arsenic , Lead In Everett , Wash ington ..........................................25 Delaware Lawmakers Vote To Ban Powdered Alc ohol. ................................................. .............25 Angelman Syndrome Receives Its Own Medical Code ..... .............................................................25 Ca lifornia Vaccine Skeptic Put On Probation By State Medical Board ...... ....................................25 Opinion : Antibacter ial Debate Must Weigh Risks , Benefits ... ..........................................................25 Woman 's Facebook Post Says Mentho l Shaving Cream Soothes Sunburns .................... .............25 AMA President-Elect Profiled ... ................................25 AARP Dedicates $60 Million To Dementia , Alzheimer's Disease Research Fund ................ 26 Ohio , Washing ton Officials Confirm West Nile VirusCarrying Mosquitoes ..... ....................................26 Michigan 's Detroit Area Becoming A "Hotspot" For Vaccination Waivers , Study Suggests ..... .........26 WPost: Stalling Malaria Fight Could Jeopardize Children 's Lives .... ................................ .............26 Indiana Resident Contracts Rare Flu Strain After Exposure To Pigs At Fair . .................................26 Global Health Britain's NHS To Reduce "Unnecessary Or Risky Procedures ." ......................................................30 UK's NHS Making Plans To Ensure Ample Medical Supplies After Brexit. ........................ .................30 Irish Cancer Patients Received Faulty Tests From US-Based Labs .. ...............................................30 Globa l Fund Combating AIDS , TB, Malaria Cance ls Funding For North Korean Public Health Efforts . ...............................................................30 Novartis , Gilead CAR-T Therapies Both Gain European Panel Recommendation ..... ............. .30 AstraZeneca Receives "Speedy Approvals " For Cancer Drugs In Japan ....................... ......... ..... 30 3 T EXT-18-248-D-000432 Judge Extends Program Paying For Hurricane Maria Victims' Hotel Stays ............................... .35 Private Equity Group Offer High-Interest Loans To Cash-Strapped Americans ................................35 Median Prime For A Single-Family Home In San Francisco Bay Area Is $935,000 .......................35 High Schools Clamp Down On Student Journalists Covering Sensitive Subjects . ............................36 Seattle Bans Plastic Straws, Utensils In Restaurants .......................................................36 Murdoch Turning Much Of The Company He Built Over To Disney . ................................................36 Professors Oppose Stricter Work Requirements For Ghana Reports HS Bird Flu Outbreaks ....... .............31 Researchers Warn That Gay Hate Climate In Indonesia Is Fueling HIV Epidemic ...................31 India Celebrates End Of Nipah Virus Outbreak With Music Video .......................................................31 WTO Upholds Australia's Plain-Packaging Law .. ....31 Russians Protest Pension Age Hike.........................31 Son Debates Assisted Dying Amid Mother's Alzheimer's Diagnosis .......................................31 National News Trump Predicts Quick Supreme Court Confirmation "If I Pick The Right Person." ..............................31 Trump Retweets Elder Joke About Reporter Fired Over False MAGA Hat Claim . ...........................33 Waters: People Want Democrats To Be "More Confrontational" Against Trump ........................33 Todd: Trump Is "Winning," Democrats Are "Reeling." ...........................................................34 Ocasio-Cortez: Democratic Socialism Just "Part Of What I Am." .......................................................34 Duckworth: Democrats Can't Go Too Far Left An Win Nationwide .......... .......................................34 Portland Police Declare Riot, Revoke Permit As Antifa Disrupts Protest. .....................................34 NYTimes Analysis: Supreme Court Ruling Against Unions A Blow To Liberal Groups .....................35 Trump Says He Wants To Stay "Uninvolved" In Russia Probe, "At Least For Now." ...................35 SNAP .... .............................................................36 WPost Welcomes Transfer Of Background Checks From OPM To DOD . .........................................36 WSJournal Criticizes Individual, Corporate Tax Hikes In New Jersey ........................................ .36 Editorial Wrap-Up New York Times . ......................................................37 Washington Post.......................................................37 Wall Street Journal. ..................................................37 The Big Picture Headlines From Today's Front Pages ......................37 Last Laughs Late Night Political Humor. .......................................38 Trump may have heard. He tweeted this afternoon that people coming to this country illegally must be escorted out." CBS correspondent Kenneth Craig added, "New York 's protest brought an estimated 15,000 to the streets of lower Manhattan over the Trump Administration 's zero-tolerance policy on illegal border crossings. " Craig also mentioned that HHS said it has custody of more than 2 ,000 immigrant children separated from their parents. NBC Nightly News (6/30 , lead story , 2:35, Diaz-Balart , 12.78M) reported in its lead story, "Hundreds of thousands of people in communities across the country mobilized today for [im]migrant families, protesting President Trump 's policy that separated children from their loved ones. Tonight, more than 2,000 of those children remain in detention centers, in a country that's not their own, far from their parents. The White House mostly silent on the issue today. " The Was hington Post (6/30 , Lang , Zauzmer, Natanson , 15.68M) reported that on Saturday , some 750 "'Families Belong Together' rallies were planned throughout the country in every state from big cities such as Boston, Chicago and New LEADING THE NEWS Hundreds Of Thousands Protest Administration's Immigration Policy, Separation Of Families. ABC Wo rld News Tonight (6/30, lead story , 2 :50, Llamas, 4 .58M) reported in its lead story that "we begin tonight with the massive nationwide protests against the President's immigration policy . Tens of thousands of protesters in more than 700 demonstrations, like this one in Chicago, in cities and towns from coast to coast , in every state, urging President Trump to reunite the families separated at the southern border. Part of the fallout from his zerotolerance immigration policy ." In its lead story , the CBS Wee kend News (6/30, lead story, 2:20, Ninan , 2.62M) reported, "Americans across the country are making their voices heard this Fourth of July weekend at loud rallies from coast to coast. They're demanding that thousands of immigrant children be set free and reunited with their parents . And President 4 EXT-18-248-D-000433 York to tiny ones such as Antler, N.D., which has a population of 27." Organizers said about 50,000 people gathered in Washington, DC, although the Post indicated the total number may have been somewhat less than that. All these protesters had one message: "End President Trump's 'zero tolerance' immigration policy, which has split children from their parents and detained families crossing the southern U.S. border." The article added that whenever "the government, Border Patrol agents or the Trump administration" was mentioned, "the crowd erupted into chants of 'shame, shame, shame."' And "as they passed the Trump International Hotel, protesters booed and chanted 'vote him out."' The New York Times (6/30, Yoon-Hendricks, Greenberg, 19.33M) reported that galvanized "by what they view as the cruel treatment of [im]migrants seeking refuge in the United States from violence in their home countries, the crowds turned out Saturday bearing homemade signs that read 'Abolish ICE' - the Immigration and Customs Enforcement agency - and 'Zero tolerance for family separation."' The article said that although "Washington was the political epicenter of the protests, similar scenes unfolded in cities around the country, including large, border cities like El Paso, state capitals like Salt Lake City and Atlanta , and smaller, interior towns like Redding, Calif." The piece added that for the most part, the protests were peaceful, with only a few arrests. USA Today (6/30, Hayes, 11.4M) reported on the rallies in all 50 states, but asked, "now what? Will the issue and the outrage fade into the background or help lead to a pivotal moment in the debate over immigration in the U.S.?" A spokesman for MoveOn.org, "one of the organizations behind the nationwide rallies," said, "I've never seen so many people that so deeply care about immigration . This is unlike anything I've seen. It's just a huge amount of opportunity and we have to ride this wave to making change." The piece added that "activists plan to pressure members of Congress to hold town halls to discuss immigration and force leaders to take a stand when confronted by their constituents." The Wall Street Journal (6/30, Raice, Barrett, Duehren, Subscription Publication, 6.13M) reported that protesters said they were angry at President Trump's actions on immigration, and insisted that the world needs to see a different picture of the US. They carried signs saying, "No child should be kept in a cage" and "Keep families together'' and "Immigrants make America great." The Arizona Republic (6/30, Carranza, Larson, Steinbach, Janetsky, 1.21M) reported that some "800 people gathered outside the state Capitol building in Phoenix. Many carried signs urging the administration to bring families back together." They encountered "small groups of counterprotesters with megaphones. Some engaged, but the event was mostly peaceful." Also covering the story were the Orlando (FL) Sentinel (6/30, Santana, 593K), the Atlanta Journal-Constitution (6/30, Hansen, 1.09M), the Asbury Park (NJ) Press (6/30, Mikle, 386K), and Newsday (NY) (6/30, Chayes, 1.52M). Trump Administration Accused Of Separating Immigrant Families Who Sought Asylum At Ports Of Entry. The Los Angeles Times (7/ 1, Esquivel, 4.03M) reports that "the practice of separating families appears to have begun accelerating last year, long before zero tolerance was announced in the spring. Among these cases, according to records and interviews, are many that happened at ports of entry" as immigrants sought asylum in the US. The article adds, "Administration officials have said repeatedly that asylum seekers who don't want to be separated from their children should present themselves at a port of entry. Doing so is the legal way to ask for asylum, they said." However, court documents "describe numerous cases in recent months in which families were separated after presenting themselves at a port of entry to ask for asylum." Attorneys contend that this happened even when asylum seekers had identification and documents proving they were the children's parents. DOJ Files Documents Which Indicate Administration May Want To Detain Immigrant Families Longer Than The Current Legal Limit. The Washington Post (6/29, Barrett, 15.68M) reported that the Justice Department on Friday revealed "plans to detain migrant families together in custody rather than release them, according to a new court filing that suggests such detentions could last longer than the 20 days envisioned by a court settlement." The article added that "the filing comes as the Justice Departments seeks to navigate two different court edicts - an inj unction issued this week by a federal judge in San Diego that required the government to begin reuniting the roughly 2,000 migrant children still separated from their families, and an older court settlement 5 EXT-18-248-D-000434 in federal court in Los Angeles that requires the immigration agencies to release minors in their custody if they are held for more than 20 days." Politico (6/29, Gerstein, 3.51 M) reported that only "days after President Donald Trump announced that his administration would ask a federal court to permit detention of immigrant families by modifying a longstanding court settlement , Justice Department lawyers told the Los Angeles-based judge handling the case Friday that no change to the decree may be needed." Attorneys for the government contend that "a separate injunction a federal judge in San Diego issued Tuesday barring family separations effectively wipes out provisions in the decades-old Flores agreement that have been determined to bar detention of most children in immigration custody for more than 20 days." They wrote, 'The rulings work together to permit detention of parents with their minor children with whom they are apprehended." The Hill (6/29, Bowden, 2.71 M) reported that the Administration may seek to "detain migrant families together for months at detention facilities as they await prosecution for illegal entry, according to a court filing from the Justice Department." While the filing did not specify the potential length of time immigrant families would be detained, immigration proceedings typically take months. Administration Still Dealing With "Fallout" From Zero Tolerance Policy. The A P (7/1, Long, Alonso-Zaldivar) reports that in recent Senate testimony, HHS Secretary Alex Azar "could barely conceal his discomfort" as a Democratic senator asked "whether his agency had a role in designing the Trump administration's 'zero tolerance' policy that caused" immigrant children to be separated form their parents. Azar responded, "We deal with the children once they're given to us . ... So we don't - we are not the experts on immigration." The article says separating families "while sidelining the agency responsible for caring for the children was only one example of a communication breakdown in the federal government that left immigrant children in limbo, parents in the dark about their whereabouts and enraged Americans across the country." The Administration "is still dealing with the fallout: It's still not clear how officials will implement the policy or comply with a court order requiring that families be reunited within 30 days. Instead, the administration is hoping Congress will fix the mess." Congress Leaves For Recess Without Voting On Bill To End Separation Of Immigrant USA Today (6/29, Kelly, 11 .4M) Families. reported that "House and Senate leaders had expressed hope that Congress could act quickly this week to pass a narrow bill that would allow migrant children to remain with their parents at detention centers beyond the current 20-day limit," but "both chambers adjourned Thursday without a solution. They will return on July 9." Top House Dems Want HHS-0/G, Other To Investigate Agency Watchdogs Administration's Zero Tolerance Policy. The Hill (6/29, Weixel, 2.71 M) reported that "top House Democrats are asking federal agency watchdogs for a broad investigation" into the Administration's zero-tolerance immigration policies, "including the separation of children from their parents, as well as the recent executive order intended to partially roll them back." The lawmakers sent a letter Friday to the inspectors general of HHS, OHS, and the Department of Justice asking for a review of the Administration's "entire process for planning and implementing its immigration plan." The letter was signed by Reps. Elijah E. Cummings (D-MD), Jerry Nadler (D-NY), Bennie Thompson (D-MS), Bobby Scott (D-VA), and Frank Pallone, Jr. (DNJ), the "top Democrats on the House Committees on Oversight and Government Reform, the Judiciary, Homeland Security, Education and the Workforce, and Energy and Commerce." Dems In Connecticut Denied Access To Immigrant Child Separated From Parents. Vox (6/29, Kirby, 1.66M) reported that on Friday, Sen. Chris Murphy (D-CT), Sen. Richard Blumenthal (D-CT), and Rep. Joe Courtney (D-CT) sought "to visit a child separated from their family who was being housed in a nonprofit facility in Groton, Connecticut." But HHS "denied the lawmakers access , according to Murphy." He tweeted, "The perverse secrecy of child separation should concern us all." Murphy added, "HHS' excuse was that we need to give 14 days notice .... What?? 14 days of forced separation from your parent can traumatize a kid for life. And we aren't asking to see nuclear codes - we just wanted 10 min to make sure the child is ok." An HHS official "said that a visit from the members had not been approved, and confirmed that HHS requires a twoweek notification, at minimum, to make sure tours 6 EXT-18-248-D-000435 don't interfere with the care of unaccompanied alien children." Court Documents Allege Border Agent Wished Immigrant "Happy Mother's Day" After Informing Her Of Impending Separation From Daughter. The Arizona Republic (6/29, Ruelas, 1.21 M) reported, "A Guatemalan woman said in a federal complaint filed this week that a Border Patrol agent in an Arizona detention facility, after informing her that her daughter would be taken away, mockingly wished her a happy Mother's Day." The American Civil Liberties Union of Massachusetts is representing the woman in the lawsuit. Attorneys "say they've filed an emergency lawsuit to immediately reunite" the woman "with her daughter, who is only identified in court filings by the initials S.K. They argue that the continued separation violates the due process rights, as well as the Constitution's guarantee of equal protection." Immigrant Families Still Separated As "Outrage" Over Zero Tolerance Policy Grows. ABC World News Tonight (6/29, story 6, 0:40, Muir, 6.53M) reported that despite the growing "outrage" over the Trump Administration's zerotolerance policy, immigrant children remain separated from their parents. Congress left for recess without passing an immigration bill. The segment mentioned that during her last visit to the border, First Lady Melania Trump was shown "pictures of the six-year-old boy left alone in the desert, possibly by smugglers." That boy has since been transferred to HHS' custody. Some 2,000 Immigrant Children Remain Separated From Their Parents Despite Judge's Order To Reunite Them. The New York Times (6/30, Correal, 19.33M) reported that despite "protests being held around the country on Saturday to demand the reunification of parents and children separated at the border, progress on putting families back together has been painfully slow." The article said in spite of "a federal judge's order requiring reunification within 30 days, more than 2,000 children remain scattered across 17 states, including some 300 in New York." The piece added that "their parents too have been sent around the country - to detention centers in Arizona, Colorado and as far away as Washington State." While HHS "cit[ed] the possibility that human traffickers might pose as parents [and] said that the government intends to aggressively 'vet' those who wish to gain custody of children," the Times said officials "declined to say how many children had been reunited with their relatives since President Trump ended the separation policy with an executive order." Sponsors, Parents Reportedly Face High Transport Fees, Red Tape Before They Can Be Reunited With Immigrant Children. The New York Times (7/1, Jordan, 19.33M) reports on the transport fees and red tape facing the sponsors and parents of immigrant children. The article mentions that "Brenda, a Salvadoran [im]migrant who was separated from her ?-year-old son Kevin at the border on May 27, was charged $576.20 to cover the boy's airfare from Miami to Virginia. His escort collected the money order at Washington Dulles airport on Friday upon handing over the child to his mother." This is just one of the many "hurdles" sponsors and immigrant parents must overcome in order to be reunited with children. The piece adds that HHS' "Office of Refugee Resettlement, which has official custody of migrant children under detention and establishes conditions for releasing them, has made it clear that the requirements are intended to make sure children are not released to traffickers, and will be well cared for in their new homes." CNN (6/29, 82.6M) featured footage of Brenda's reunion with her son at Dulles. Advocates In New York Seek To Teach Separated Immigrant Children About Their Legal Rights. The Wall Street Journal (7/1, West, Campo-Flores, Texas, Subscription Publication, 6.13M) reports that advocates in New York are attempting to teach immigrant children separated from their parents about their legal rights. They must use creative methods because many of these children are too young to understand the concept, and some are illiterate. The article mentions that the children are in HHS' custody, while their parents are being held by Immigration and Customs Enforcement. Guatemalan Girl Reunited With Mother After Two-Month Separation. The Washington Post (7/1, Rozsa, 15.68M) reports on the reunification of a ?-year-old Guatemalan girl who was separated from her family for almost two months by US border officials. The child's mother, Buena Ventura Martin-Godinez, said, "I'm so happy, so happy .... I didn't know when I would see her again." She added, "She's happy now, but she wants her daddy," who remains in detention and faces deportation, adding, "She told me she never, ever wants to be away from her family again." 7 EXT-18-248-D-000436 The AP (7/1, Replogle, Kennedy) reports, 'The little girl was in the custody of a child welfare agency in Michigan and made heartbreaking calls to her mother, asking when they'd be reunited." Guatemalan Mother Detained In Arizona Begins Road Trip To New York City To Find Her Children. The Arizona Republic (7/1, Oza, 1.21M) spotlights Yeni Maricela Gonzalez Garcia, a Guatemalan immigrant who spent a month separated from her three children while detained, who is now driving with a volunteer to New York City to find her children. Children Representing Themselves In Immigration Courts. CNN (6/30, Kopan, 82.6M) reported on immigrant children who are coming before immigration judges to "fight for permission to stay in the country." The article features an immigration attorney whose client was a "crying toddler" that "frazzled" the judge because "she couldn't believe it." CNN added, 'Toddlers and infants do, in fact, appear before judges in the system to defend themselves against deportation." The piece cites immigration law experts who "have long opposed the idea of children being able to represent themselves." Immigration Playing "Outsized" Role In Arizona 's Midterms. The AP (7/1) reports, "The outrage sparked by the sights, sounds and stories of children separated from parents at the U.S.Mexico border underscores the outsized role immigration will play in the midterms in Arizona." The article says candidates from both parties are emphasizing immigration as they campaign. The piece adds that for many Arizonans, "the immigration issue is personal," because data indicate "more than 13 percent of Arizona's population as of 2015 were individuals who were born in another country." Following Visits To Immigration Detention Centers, It Remains To Be Seen What Action First Lady Will Take. The AP (6/30, Kellman) reported on First Lady Melania Trump's recent visits to the border during which she toured immigrant detention centers. The article said, "Now the question is what she does with that knowledge - and how she meshes it with her dislike for dividing up families and a concurrent belief in strong borders." Stephanie Grisham, a spokeswoman for Mrs. Trump, "says more border visits or talks with lawmakers are possible, but it's not clear what lessons the first lady took from her visits and what she'll communicate to her husband." Grisham added, "She cares about children deeply. ... She also believes in strong border laws and treating everybody equally." Trump Criticizes Dems Who Are Pushing For ICE To Be Abolished. The New York Times (7/1, Cochrane, 19.33M) reports that President Trump is attacking "Democratic lawmakers who have called for abolishing Immigration and Customs Enforcement, seeking to seize political advantage on an issue that has put him on the defensive for weeks and offer a winning message for Republicans facing a forbidding midterm election." During an interview with Fox News' "Sunday Morning Futures," Trump said, "You get rid of ICE, you're going to have a country that you're going to be afraid to walk out of your house." The article adds that Trump also urged "Democratic candidates to embrace demands to dissolve the agency, saying that doing so would doom the party at the polls. 'They're going to get beaten so badly,"' he said. The Washington Times (7/1, Boyer, 460K) reports Trump "said Sunday that Democrats 'will never win another election' if they keep pushing to abolish Immigration and Customs Enforcement." In The Face Of Growing Criticism, Trump Defends ICE. On its front page, the Wash ington Post (6/30, A 1, Nakamura, 15.68M) reported that President Trump "opened a new front in the immigration debate, diverting attention away from his administration's treatment of undocumented immigrants to a broader fight over the federal agency charged with detaining and deporting them." According to the Post, the President in a pair of tweets "forcefully defended the performance of Immigration and Customs Enforcement and lambasted Democrats for pushing a 'radical left' agenda to abolish it, even though only a handful have publicly supported doing so." The article mentioned that once immigrant children are separated from their parents, they are turned over to HHS. ICE Acting Director Accused Of Perpetuating Falsehood About Zero Tolerance Policy. The Huffington Post (6/29, Fang, 4.32M) reported that on Friday, Thomas Homan, acting director of Immigration and Customs Enforcement, "perpetuated President Donald Trump's lie that Congress is responsible for the Trump administration's zero tolerance policy of separating young, undocumented immigrant children from their parents at the U.S.-Mexico border." Homan said, "We are enforcing the laws that they enacted .... We're out, doing our sworn 8 EXT-18-248-D-000437 oath, enforcing the laws that they enacted, and they're going to vilify us for doing it." ICE Raids Reportedly Separating Children From Immigrant Parents. The Washington Post (6/30, 15.68M) reported that while the Administration promises "to reunite families separated by Immigration and Customs Enforcement (ICE) at the U.S. border, a similar crisis continues unabated within the country's interior, where children are separated from their undocumented parents with little scrutiny and increasing frequency." ICE has, in recent months, "carried out the three biggest workplace immigration raids of the past decade, including one on June 5 at a nursery here in rural Ohio, where 114 gardeners, florists and other workers were detained and put into court proceedings for deportation." Many had lived for several years in a nearby "trailer park of 74 homes known as Little Mexico, where now aid workers estimate that more than 90 children are missing one parent and at least 20 are left with no parent at all." Advocates Say Separated Immigrant Parents Are Failing Asylum Screenings Because They Are Too Distraught. The Huffington Post (6/30, Chapin, 4.32M) reported that advocates say immigrant parents who have been separated from their children "are too devastated to prepare for their court hearings. Instead, they replay the moment their kids were taken away by Border Patrol, worry about their children's well-being, and ask repeatedly where their sons and daughters are. In some cases, they simply weep." One activist said "over half of the roughly 20 parents she spoke with on Thursday did not pass their 'credible fear' interviews - a process that determines a person's asylum eligibility." She is convinced the parents "are too distressed about their children to effectively tell an asylum officer why they fled their country and could be killed upon return." Some Concerned Immigrant Children Separated From Parents Could Be Put Up For Adoption. The Arizona Republic (6/29, White, 1.21 M) reported, "Since the Trump administration's zero-tolerance border policy led to the separation of more than 2,300 immigrant children from their relatives since early May, some have wondered : Could these kids end up being adopted by American families?" Some immigrants allege they heard border agents say some of the separated children would be adopted after their parents were deported. HHS "has insisted that separated minors will soon be reunited with their relatives. Foster and adoption agencies have said separated children need to be with their families and will never be put up for adoption." However, "there are a number of scenarios that could complicate that." The Detroit Free Press (6/30, Baldas, 1.21 M) reported that Bethany Christian Services in Michigan insists that separated immigrant parents and children are being reunited. Bethany said the more than 50 children in the state "will not be adopted. These children have families, and we will continue to pursue reunification with their families." Nonprofit Says Its Database Could Help Unite Separated Immigrant Children With Parents. The Dallas Morning News (6/29, Solis, 1.05M) reported, "A nonprofit has created a database that could help more than 2,000 immigrant children be swiftly reconnected with their parents even as lawyers and advocates become increasingly frustrated about not knowing where many of the children are." The article said this "database will allow parents and legal representatives who are trying to locate separated children to submit inquires by phone and email," and "from there, the Vera Institute of Justice, a New York-based nonprofit, and its partners hope to connect the families with attorneys to work on the immigrants' legal cases." Experts Say More Central American Children Are Immigrating To The US Because Of Violence, Lack Of Opportunities. The Washington Post (6/29, Schwartz, 15.68M) examined why so many children from Central America are coming to the US. Experts attribute this trend to "economic factors and violence and insecurity. The first group includes the lack of economic opportunity, including a lack of jobs or inadequate opportunities for education. The second group includes violence and victimization, not just by gangs, other criminal groups and state security forces but at home as well ." More Commentary. The New York Times (6/29, 19.33M) said in an editorial that separating families caught illegally crossing the US-Mexico border exemplifies "cruelty & perfidy scarcely paralleled in the most barbarous ages, and totally unworthy the Head of a civilized nation." The Times added, "The Trump administration has committed a gross offense," and urged all Americans to "demand that it promptly reunite these children with their parents." 9 EXT-18-248-D-000438 Author and former Border Patrol agent Francisco Cantu wrote in a New York Times (6/30, 19.33M) op-ed that it is crucial "to understand that the cns1s of separation manufactured by the Trump administration is only the most visibly abhorrent manifestation of a decades-long project to create a 'state of exception' along our southern border." He added, "The logic of deterrence is not unlike that of war: It has transformed the border into a state of exception where some of the most vulnerable people on earth face death and disappearance and where children are torn from their parents to send the message You are not safe here. In this sense, the situation at the border has reached a point of crisis - not one of criminality but of disregard for human life." Jennifer Rubin writes in the Washington Post (7/1, 15.68M) "Right Turn" blog that "President Trump is prepared to incarcerate entire families for indeterminate periods of time for what has been traditionally treated as a misdemeanor." She argues, "This is as inhumane as it is wasteful and dangerous; rather than use resources to go after drug runners and human trafficking and other serious offenses, the administration will be spending resources to stand guard over families." Alexandra F. Levy, a senior staff attorney at the Human Trafficking Legal Center, wrote in a Washington Post (6/29, 15.68M) op-ed about "who stands to gain from the Trump administration's immigration policies." She said it is not immigrant children or their parents or even the US. Rather, it is the "two largest private prison contractors in the United States, GEO Group and CoreCivic," which "house thousands of immigrant detainees across the country. These corporations now face allegations that they force immigrant detainees to perform unpaid labor inside their facilities." Sarah Lustbader, a former public defender, writes in the Washington Post (7/1, Lustbader, 15.68M) that the Administration's defense of its family separation policy "boiled down to the following: The child's suffering is the price the parent must pay for breaking the rules. Children are, in essence, collateral damage ." Lustbader points out, "Every day, we lock parents up for decades in our prisons regardless of how it will affect their children, and no one bats an eye." She concludes, "We should be demanding more humanity of our system across the board - not just at the border." In an editorial, USA Today (7/1, 11.4M) writes, "Sometime in the not-too-distant future, the United States could face simultaneous crises, and the word of the White House would be crucial." The editorial goes on to say that "most Americans have come to recognize Trump's long and sordid abuse of facts," and "in recent weeks, his falsehoods have come even faster and with greater vigor." The editorial questions whether the White House will have the requisite credibility when that crisis comes. Anthony Scaramucci, former White House director of communications , writes in USA Today (7/1, Scaramucci , 11.4M) that following the "child separation fiasco, President Donald Trump doesn't have a credibility problem - but his chief of staff and the Democrats do." Scaramucci takes issue with the "messaging" of the policy. He concludes, "The president wants to find common ground , but the 'resistance' is peddling false narratives to avoid making a deal," adding, "the Democrats, not the president, have the real credibility problem." THE SECRETARY IN THE NEWS Judge Strikes Down Kentucky's Medicaid Work Rules. The New York Times (6/29, Goodnough, 19.33M) reported that US District Judge James Boasberg on Friday "blocked Kentucky's closely watched plan to require many Medicaid recipients to work, volunteer or train for a job as a condition of coverage." The Times said the ruling in the Kentucky case "is the first on this issue, but it will almost certainly not be the last; the question may wind up before a more conservative Supreme Court with two Trump appointees." The Trump Administration and the state of Kentucky had argued "that Congress gave the health and human services secretary broad discretion to approve Medicaid demonstration projects. Lawyers for the administration also argued that" HHS Secretary Alex Azar "provided plenty of evidence that working improves health." Judge Boasberg disagreed, saying, "While the ultimate decision whether to grant approval rests with the secretary, his discretion is not boundless." NPR (6/29, Kodjak, 3.55M) reported that in Friday's ruling, Judge Boasberg "called the Trump administration's approval of the program, Kentucky HEALTH, 'arbitrary and capricious."' He writes "that in approving Kentucky's work 10 EXT-18-248-D-000439 gone into effect Sunday. Republican Gov. Matt Bevin had threatened to discontinue Medicaid expansion in the state, which covers more than 500,000 people, if the requirements were struck down." Additional coverage is provided by CNN (6/29, Luhby, 82.6M), Congressional Quarterly (6/29, Subscription Publication), Forbes (6/29, Japsen, 10.34M), Fortune (6/29, 3.91 M), Healthcare Finance News (6/29, 93K), The Hill (6/29, Weixel, 2.71 M), the Huffington Post (6/29, Young, 4.32M), Kaiser Health News (6/29), Modern Healthcare (6/29, Subscription Publication, 239K), the Louisville (KY) CourierJournal (6/29, 419K) , Politico (6/29, Pradhan, 3.51 M), Vox (6/29, 1.66M), and the Detroit Free Press (6/29, Spangler, 1.21 M). requirement proposal, Health and Human Services Secretary Alex Azar 'never adequately considered whether Kentucky HEALTH would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid."' The Was hington Post (6/29, Sun , Goldstein, 15.68M) reported that Boasberg's decision "sends the state's program, Kentucky HEALTH, back to the federal Department of Health and Human Services for further review." Bloomberg News (6/29, 4.46M) reported Trump's HHS department '"never adequately considered whether Kentucky Health would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid,' Boasberg wrote." Reuters (6/29, Raymond) reported Kentucky "was the first of four states to receive approval from the U.S. Department of Health and Human Services (HHS) to require that able-bodied Medicaid recipients work at least 80 hours a month or lose their benefits." Kentucky "said the judge had blocked the program on the 'narrow basis' that HHS failed to consider its impact on Medicaid coverage, and that the state would work with HHS to address that problem so the program could take effect." Adam Meier, secretary of Kentucky's health department, is quoted saying, "'We will have no choice but to make significant benefit reductions' without implementing the work requirements." The Wall Street Journal (6/29, Armour, Subscription Publication, 6.13M) reported that Centers for Medicare and Medicaid Services Administrator Verma said, "We are conferring with the Department of Justice to chart a path forward." Verma added, "In the meantime, we will continue to support innovative, state-driven policies that are designed to advance the objectives of the Medicaid program by improving health outcomes for thousands of low-income Americans." The AP (6/29, Beam, Alonso-Zaldivar) reported the national implications of Friday's ruling "could take a while to sort out. Officials in Arkansas have already implemented similar work requirement rules there." The drive "to expand Medicaid in GOP-led states had gotten a boost from the prospect of work requirements, which appeal to conservatives . In Virginia, work requirements are part of a compromise between Democratic Gov. Ralph Northam and Republican legislators to expand Medicaid." The Washington Examiner (6/29, Leonard, 340K) reported the requirements "would have UNACCOMPANIED ALIEN CHILDREN Suit Filed Against HHS Alleges "A Wide Range Of Abuses" Against Unaccompanied Minors. USA Today (6/29, Gomez, 11.4M) reported that on Friday, several legal groups filed a lawsuit accusing HHS "of mistreating unaccompanied minors in its custody, ordering them to take psychotropic drugs without their relatives' consent and making it overly difficult to reunite them with family." The suit was filed on behalf of "five minors who allege a wide range of abuses at the hands of contractors who run shelters for Health and Human Services' Office of Refugee Resettlement." One of the children, "a 12-year-old boy from Guatemala who has been in custody since February, has allegedly been administered psychotropic drugs to treat depression that he developed while in custody." The suit says "the boy refused to continue taking the medication because it hurt his stomach, which led shelter officials to transfer him to a psychiatric institution without consulting his adult sister, who had been trying to win his release." The Washington Post (6/29, Davis, 15.68M) reported that the lawsuit alleges the 12-year-old boy "went from being calm and cooperative to showing signs of depression brought on by 'being kept from his family ,"' which had crossed into the US illegally ahead of him. Leecia Welch, an attorney for the National Center for Youth Law, one of the groups that brought the case, said, 11 EXT-18-248-D-000440 stir up journalists and make the public ask questions. Chasing this misleading story ...helped uncover a story that many found even more troubling. And this one was real." The article said that in April, "Steven Wagner, an official at the U.S. Department of Health and Human Services (HHS) who oversees programs that place unaccompanied minors with families, told a Senate committee that a department office 'was unable to determine with certainty the whereabouts of 1,475 unaccompanied alien children' who had been placed with sponsors living in the United States." In May, Deputy HHS Secretary Eric Hargan "disputed what was becoming a widespread narrative, saying these children were not 'lost' but had simply been placed with friends and extended family members" who could not be reached. The piece added that while investigating this story, reporters uncovered the Trump Administration's policy of separating immigrant families at the southern border. "Basic due-process rights" are being "trampled" by the Trump Administration. She added that "parents of children are going through the ringer trying to get their kids out of these detention facilities." The Wall Street Journal (6/29, Lazo, Subscription Publication, 6.13M) reported that the suit is seeking class-action status. The five children are from Honduras, Guatemala, El Salvador, and Mexico. It names HHS Secretary Alex Azar and ORR Director E. Scott Lloyd as defendants. The Hill (6/30, Anapol , 2.71 M) reported that the suit was "filed Friday in a federal court in California." The five children range in age from 12 to 17, and they all arrived in the US as unaccompanied minors. The suit "alleges that the minors have been held in 'jail-like' conditions and experienced 'cruel' practices, including being prescribed antidepressants, that may result in lifelong trauma and 'emotional harm."' NBC News (6/30, Mandell, 5.76M) and Newsweek (6/30, Hutzler, 2.18M) also covered the story. HHS IN THE NEWS HHS' Severino Speaks At National Right To Life Conference. The Wichita House GOP Seeks Answers From Azar About ORR. The Hill (6/29, Hellmann, (KS) Eagle (6/29, Burgess, 316K) reported Roger Severino, who directs the Department of Health and Human Services' Office for Civil Rights, was the featured speaker at the National Right to Life convention Thursday , becoming the first HHS official "in recent memory" to speak at the nation's largest anti-abortion organization . Severino said in his remarks, "Our president is fearless when it comes to life and conscience," adding, "We're just getting started." 2.71 M) reported that Republicans on the House Energy & Commerce Committee have sent a letter to HHS Secretary Alex Azar asking for answers about the Office of Refugee Resettlement. The article said the lawmakers "asked for answers to a series of questions about children in ORR custody, including: how many are in ORR custody as a result of being separated from their parents or families; does ORR have the resources to properly care for the high number of children being transferred to their custody; what steps is ORR taking to track and address issues of abuse within HHS funded facilities and what medications is ORR authorized to administer." The letter stated, "Given HHS' historical difficulties in properly caring for [the children], the committee believes that additional scrutiny of ORR is warranted at this time." Several Mid-Level HHS Officials Reportedly Emulating Trump In Politico (6/29, Diamond, 3.51 M) Tweets. profiled several "midlevel political appointees at the Health and Human Services Department who have helped shape the agency's communications strategy - even while taking a page out of President Donald Trump's playbook" by emulating his "taunts and gibes" on Twitter. According to Politico, the behavior "suggest[s] that some officials feel empowered to mimic the president even while representing the government to millions of taxpayers and working alongside career federal employees ." The article added that the tweeting "also raises questions about whether any officials are violating the Hatch Act, which is Fake Story About HHS Losing Immigrant Children Resulted In Discovery Of Separations At The Southern Border. On its website, ABC News (6/30, Pearle, 1.85M) reported that the story about HHS losing almost 1,500 immigrant children was untrue, yet "it was enough to outrage politicians, 12 EXT-18-248-D-000441 intended to ban most federal personnel from bringing politics into the workplace." The piece mentioned officials such as Gavin Smith, "an HHS staffer who identifies himself as deputy communications director," Ximena Barreto, "a deputy communications director who worked on the Trump campaign," and Jon Cordova, "the principal deputy assistant secretary for administration." Officially Over. The Los Angeles Times (6/29, Millman, 4.03M) reported that Federal officials have said the E. coli outbreak tied to Yuma, AZ-grown romaine lettuce is officially over. The CDC has found no "new cases from the outbreak, which started in mid-March and infected people in 36 states." The Times reported, "Dirty irrigation canal water is expected to have caused the outbreak, Food and Drug Administration Commissioner Scott Gottlieb said Thursday, and officials are investigating how the bacteria got into the water." Meanwhile, the CDC reported "the last E. coli case from this outbreak June 6." The New York Times (7/1, Jacobs, 19.33M) reports, "Samples of canal water in the Yuma area of Arizona were found to contain the same genetic strain of E. coli that caused the outbreak, Dr. Scott Gottlieb, commissioner of the federal Food and Drug Administration, said in a statement." Dr. Gottlieb said, "More work needs to be done to determine just how and why this strain of E. coli 0157: H7 could have gotten into this body of water and how that led to contamination of romaine lettuce from multiple farms." CMS Looking For Chief Health Informatics Officer. MedCity News (6/29, Dietsche) reported the Centers for Medicare and Medicaid Services "is seeking a chief health informatics officer, according to a job posting on USAjobs.gov." The individual chosen for the role "will develop requirements and content for healthrelated information technology with an initial focus on improving innovation and interoperability." CMS Releases Payment Data, Reveals Drug And Medical Device Company Contributions. The Washington Examiner (6/29, King, 340K) reported that the Centers for Medicare and Medicaid Services released its 2017 payment information on Friday. Data show drug and medical device companies provided "$8.4 billion to doctors and teaching hospitals," that year. According to the figures, "the biggest amount, $4.7 billion, went to research. Coming in second was $2.82 billion for general payments, which include items such as meals, travel to speaking events, and speaking fees." Emergency Departments Struggling Through Shortages Of Crucial Drugs. The New York Times (7/1, Thomas, 19.33M) reports that emergency departments nationwide are struggling with shortages of "crucial drugs like morphine, which is used to ease the pain of injuries like broken bones, or diltiazem, a heart drug." The Times adds, "For years, drug shortages have created a behind-the-scenes scramble as pharmacists, doctors and nurses cobble together fixes that are often invisible to patients," but physicians "around the country say the latest shortages are more directly affecting patient care." A survey of emergency physicians in May by the American College of Emergency Physicians "found that 9 of 10 said they didn't have access to critical medicines, and nearly 4 in 10 said that patients had been negatively affected." FDA Commissioner Dr. Scott Gottlieb "acknowledged in an interview that while the agency has made progress, it has not solved the underlying problem," saying, "We are still in the position of trying to put a Band-Aid on a market that fundamentally hasn't changed." National Guard Soldiers May Have Sleep Problems After Returning Home From The Battlefield, Research Suggests. Reuters (6/29, Weinstock) reported that research suggests "National Guard soldiers may be plagued with sleep problems when they return home from the battlefield." The findings were published online in Sleep Health. Reuters added, "Michael Twery, director of the National Center on Sleep Disorders Research at the National Heart, Lung and Blood lnstitute ...told Reuters Health by phone that while the study was a small one and needs to be replicated in larger groups of soldiers, it '(lays) a foundation to help us design more definitive studies of sleep in this population."' Amazon's PillPack Deal Unlikely To Impact Drug Costs, Analysts Say. The Federal Officials Say Romaine Lettuce-Linked E. Coli Outbreak Is Wall 13 Street Journal (6/29, Rockoff, Walker, EXT-18-248-D-000442 seeing more and more of the sales being shifted to the online I think as we start to reduce lawful prescribing, so a lot of the medical - a lot of the addiction was people got medically addicted as we see doctors start to prescribe fewer opioids, we're fearful that more and more of the new addiction is going to shift to illicit sources, and a lot of those sales are taking place online." Gottlieb characterized big Internet companies as having "been helpful" and said that "we've been working with them for some period of time now." Subscription Publication, 6.13M) reported that Amazon's deal to purchase PillPack may make filling prescriptions more convenient, but is unlikely to address prescription drug costs, according to industry experts. Those experts suggested that Amazon may be able to negotiate to offer generic versions of medications, but that the main issue with US drug spending is rising cost driven by high-priced biotech therapies, which often must be injected or infused, and which retail pharmacies don't dispense. However, the deal threatens to shift market share from the 64,500 US retail pharmacies, and some analysts suggest Amazon could be looking to take over the role of pharmacy-benefit managers, which currently negotiate drug discounts for insurers and employers. Meanwhile, CNBC (6/29, Lovelace, 4.81 M) reported, "FDA Commissioner Scott Gottlieb says Amazon's new push into health care is just fine because anything that makes much needed products, like pharmaceuticals, more accessible to consumers and lowers costs is a positive." In a June 29 interview with CNBC's "Squawk Box," Gottlieb said, "Disruptive competition is a good thing." FDA Report Suggests Improve Its Hiring Ways To Process. Congressional Quarterly (6/29, Siddons, Subscription Publication) reported that the FDA issued a new report that showed that the agency "sees ways that its ability to hire qualified staff could be improved, even after Congress granted it new hiring authorities at the end of 2016." The report noted that the new authorities it was granted "included the ability to offer higher salaries for some positions." The report largely "focuses on ways that the FDA has been implementing new hire authorities, including which positions it is designating for higher pay scales and how it has sped up its hiring process in several areas." First Cannabis-Based Prescription Drug Approved By FDA Marks "Watershed" Moment, Industry Bloomberg News (6/29, Members Say. FDA Policy Limiting Blood Donations From Gay Men Draws Scrutiny. The Kansas City (MO) Star (6/29, Randle, 636K) reported an FDA policy from 1983 requiring blood banks "to prohibit men who have sex with men from donating blood, blood components or plasma" has become "a point of contention for many in the LGBT community who viewed it as archaic and stigmatizing in a time when HIV is less of a threat." The FDA in 2015 "amended its ban to a '12 month deferment' policy, allowing men to donate blood as long as they haven't had sex with other men for the past year," but skeptics continue to argue against it. The piece adds that FDA spokeswoman Megan McSeveney said the agency is "fully committed in its actions to facilitate change" and is seeking new means to evaluate blood donors. Buckley, 4.46M) reported GW Pharmaceuticals has received FDA approval for its medical marijuana treatment "Epidiolex, a prescription drug for children with severe epilepsy," which has been "genetically modified to remove the psychoactive properties." As the "first prescription medicine derived from cannabis permitted to be sold in the U.S.," the drug's approval has been heralded by some industry members as "a watershed event" that the piece said "should help alleviate skepticism among some physicians about the plant's medical uses." FDA Commissioner Comments On Efforts To Stem Online Opioid Sales. CNBC's Squawk Box (6/29, 85K) reported on the FDA's summit with Facebook, Google, Twitter, and other Internet companies seeking their help in cracking down on online opioid sales. In an interview, FDA Commissioner Dr. Scott Gottlieb said, "In 2015, there was data that came out that showed $15 million of online sales, but we're FDA Warns Pfizer Over "Misleading" Consumer Video. STAT Plus (6/29, Silverman, Subscription Publication, 27K) reported the Food and Drug Administration "scolded" Pfizer "over a consumer video that created a 'misleading 14 EXT-18-248-D-000443 (6/29, Stobbe) reported that CDC Director Dr. Robert Redfield Jr. "once opposed condoms and needle exchange programs as ways to stop the spread of sexually transmitted diseases." But this week, he said during an interview that "his views have changed." He told the AP that "it has become clear to him that condoms and needle exchanges work as part of comprehensive programs to stop the spread of certain infectious diseases." Redfield was quoted as saying, "One thing I can commit to is CDC is not an opinion organization. It's a science-based , data-driven organization." Speaking about the AIDS epidemic, he added, "We do have the tools to end this epidemic. Let's use them." impression' of the Estring vaginal ring because there was no risk information." In a June 19 letter, the FDA "argued the video 'misleadingly suggests that patients will experience similar results"' as the person depicted in the video, and the FDA "complained this was 'especially concerning from a public health perspective' because Estring product labeling mentions several serious, lifethreatening risks, including two forms of cancer." Op-Ed Touts FDA Allowance Of OffLabel Healthcare Economic Discussions. In STAT (6/29, 27K) "First Opinion," John Osborn, a senior advisor with Hogan Lovells and a visiting scholar at the UCLA Fielding School of Public Health and Seth Ray, a senior counsel with O'Melveny & Myers, touted the Trump Administration's issuance of "final guidance that allows drug companies and device makers to provide health care economic and other supporting information to payers and formulary committees, even if the information is outside of the FDA approved labeling and was not submitted to the agency in the course of product approval." They suggested that this development "raises the question of whether the agency will take steps to allow companies to provide truthful off-label information to physicians and patients in other contexts." They noted that "in April, FDA Commissioner Scott Gottlieb signaled that an expanded safe harbor was coming soon that would provide a 'more robust framework' to allow companies to discuss the value proposition and health economic benefits of off-label uses." CDC Map Illustrates Incidence Of Pediatric Cancer In Different US Regions. On its website, NBC News (6/29, 5.76M) reported a new CDC map of cancers in the US indicates pediatric "cancer rates are the highest in the Northeast and lowest in the South," that leukemia "is more common in the western states," and "rates of pediatric lymphoma and brain cancer are higher in the Northeast." Lead report author CDC epidemiologist Dr. David Siegel wrote, "Variation in childhood cancer incidence might be related to differences in exposures to carcinogenic chemicals (e.g., air pollution, secondhand smoke, food , or drinking water) or radiation." The piece added, "there might be genetic variations in different populations. Inherited genetics account for about 5 percent of all childhood cancer, the National Cancer Institute says." The NCI was quoted as saying that in adults, certain "gene mutations reflect the cumulative effects of aging and long-term exposure to cancer-causing substances." Health Exec (6/29, Leider) reported the CDC study sourced "data for 2003-2014 from the National Program of Cancer Registries and the National Cancer lnstitute's Surveillance," a period during which "171,432 cases of pediatric cancer were identified - an incidence rate of 173.7 cases per one million children." Maple Syrup Producers, Beekeepers Oppose FDA's "Added Sugars" Label. The AP (7/1) reports that the FDA's "added sugars" labeling is being opposed by maple syrup producers and beekeepers. The agency "has received more than 3,000 comments on its proposal, most of which are from honey and maple syrup producers, the Wisconsin Public Radio reported." The AP reports, "The FDA said that it's looking forward to 'working with stakeholders to devise a sensible solution," but the "agency said it acknowledges that the feedback from producers indicates that their proposal 'does not provide the clarity that the FDA intended."' House Legislators Seek More Transparency From FNIH Concerning Donors. Science Magazine (6/29, Mervis, 441 K) reported a House appropriations subcommittee is concerned that the Foundation for the National Institutes of Health (FNIH) may not be adhering to funding disclosure rules CDC Director Changes Stance On Use Of Condoms To Prevent STDs. The AP 15 EXT-18-248-D-000444 who explained, "This initiative is designed to align with the goals of NCTN by taking a more networkwide centralized approach to making the specimens from these trials more available to the wider research community," adding, "Ultimately, the goal is to have studies come through the navigator process and evaluate biomarkers that can hopefully be used in future clinical trials." dictated by the Public Health Service Act (PHSA). Science said the House report specifically addressed identifying donors "who have attached strings to their gift by labeling them as 'anonymous ."' However, FNIH senior vice president of research partnerships David Wholley said, "We have the responsibility ...to do these partnerships that support the NIH mission .... And we have always complied with the law." FNIH development office head Julie Wolf-Rodda said, "The lion's share of anonymous gifts are from a relative of someone who was treated at the NIH Clinical Center ...and doesn't want their name listed in the annual report." The piece noted that "NIH Director Francis Collins canceled a $100million study on the effects of moderate alcohol drinking" following "an investigation found NIH staff had improperly solicited industry directly and shaped the study to satisfy industry interests." NIDOCD Study Indicates PartiallyRestored Hearing In Mouse Model Of Inherited Deafness. The Beckley (WV) Register-Herald (7/1, Holdren, 59K) reports a new study conducted by the National Institutes of Health's National Institute on Deafness and Other Communication Disorders, the University of Iowa, and Iowa City indicates new understandings of "the molecular mechanism in a form of deafness, DFNA27," and "focused on a small-molecule drug - the first to preserve hearing in a mouse model of an inherited form of progressive human deafness." Study co-author Thomas B. Friedman, PhD, chief of the Laboratory of Human Molecular Genetics at the NIDCD, explained, "We were able to partially restore hearing, especially at lower frequencies, and save some sensory hair cells." Andrew J. Griffith, scientific director of the NIDCD, said that by following the genetic indicators, "We find novel and unexpected pathways that can, in cases such as this one, uncover unexpected potential treatment strategies in humans." NCI Research Funding Priorities Following Budget Increases Outlined. In a paywalled piece, the Cancer Letter (6/29, Ong) reported on the NCl's funding priorities after receiving "a $147 million increase to the Research Grant Project pool," $60 million for "targeted research opportunities ," "a $20 million increase for centers and SPOREs," and "$10 million for the National Clinical Trials Network and the NCI Community Oncology Research Program." With its "$275 million increase over fiscal 2017 levels," NCI has an enacted 2018 budget of $5.66 billion. The piece quoted NCI Director Ned Sharpless as saying, "there was about almost a $40 million increase in taps, benefits, and salaries .... These are things that the NCI has to experience. There's an increase to our [Small Business Innovation Research program] funding, it's a fixed grade of our external budget." Senate Committee Considers Additional $2 Billion For NIH In 2019. In a paywalled piece, the Cancer Letter (6/29, Williams, Ong) reported the Senate Committee on Appropriations submitted a fiscal 2019 spending bill last week which would increase NIH funding by $2 billion, giving it $39.1 billion. If the measure is enacted, "federally-funded biomedical research would get its fourth consecutive increase," and $190 million in new money of the total allocation would "trickle down to NCI." The piece added that the House similarly drafted a bill which "proposes a $1.25 billion increase for NIH, bringing the total to $38.3 billion." NCI Establishes National Clinical Trials Network Navigator To Augment Access To Cancer Trial Specimens, Data. HemOnc Today (6/29, Mishkin, 98K) reported the NCI recently established the National Clinical Trials Network (NCTN) Navigator which aims "to improve the research community's access to specimens and data collected from cancer treatment trials" by providing researchers with "access to specimens donated by adults who participated in published NCI-sponsored phase 3 cancer trials." The piece included an interview with Grace Mishkin, MPH, public health analyst at NCI, NIH Recommends Strategies For Older Adults To Avoid Hypothermia In Summer Heat. The Beckley (WV) RegisterHerald (6/29, Holdren, Nelson, 59K) reported, "The National Institutes of Health (NIH) is encouraging older adults to take certain 16 EXT-18-248-D-000445 the state's high use of painkilling drugs called opioids appears to have reduced the labor pool." In a paper "published by the Federal Reserve Bank of Cleveland, economists Dionissi Aliprantis and Mark E. Schweitzer estimated that participation in the labor force by men in their prime working years - ages 24 to 54 - was 4.6 percent less on average in counties with high rates of opioid prescribing than in counties with low prescribing rates." precautions this summer to avoid hyperthermia," recommending that older adults "stay indoors on particularly hot and humid days." The NIH also advises staying hydrated, wearing light-colored and loose-fitting clothes, keeping homes and community centers cool, and visiting airconditioned locations. Johns Hopkins Tops List Of Leading NIH Grant Recipients In Baltimore Area. The Baltimore Business Journal (6/29, Georgia Will Require Doctors To Check Database Before Prescribing Opioids. The Atlanta Journal-Constitution Sieron, Subscription Publication, 823K) reported Johns Hopkins University again leads the list of top NIH grant recipients in Greater Baltimore for 2017 "with a total grant value of $651.8 million last year." The other leading grant recipients include the University of Maryland, Baltimore, the Kennedy Krieger Institute, the University of Maryland, Baltimore County, and Profectus BioSciences Inc. (6/29, 1.09M) reported that starting July 1, writing a prescription for opioid pain medications in Georgia "will require an extra step ...that lawmakers hope may push health care professionals to make better prescribing decisions." A state law that was passed last year "mandates that doctors, dentists and other prescribers check a database to determine what prescriptions patients have recently filled before doling out certain drugs, including opioid painkillers and benzodiazepines such as Xanax." OPIOID CRISIS Opioid Deaths In Missouri Still On The Rise, But Growth Rate Slowing Down. The AP (7/1) reports that while opioid related deaths "continue to increase in Missouri, the growth rate is slowing down, according to a new report." The Missouri Department of Health and Senior Services "found that there was a 4.7 percent increase in opioid deaths from 2016 to 2017, the Columbia Missourian reported." That rate "is much lower than the 35 percent spike seen from 2015 to 2016." Arizona County Joins Opioid The Arizona Manufacturer Lawsuit. Republic (6/30, Wagner , 1.21 M) reported that cities and counties across the US "have jo ined a nationwide lawsuit against corporations that make and distribute opioids, seeking to recoup tax dollars spent fighting America's painkilleraddiction epidemic." Cochise County in Arizona "became the latest to file suit this week, joining at least 1,500 local, state and tribal governments that in the past year have filed federal court complaints against Purdue Pharma LP, the manufacturer of OxyContin, and other companies." Ohio Auditor's Report Shows Impact Of Opioids On Medicaid. The A P (7/1) reports that a state auditor's report "looking at the impact of the opioid crisis on state Medicaid spending shows the number of Ohio Medicaid recipients with an opioid-related diagnosis quadrupling from 2010 to 2016." The report "recently released by Ohio Auditor Dave Yost shows the number of Ohio Medicaid recipients with an opioid-related diagnosis climbed 430 percent between 2010 and 2016." Pennsylvania Law Aims To Protect Newborns Affected By Opioid Addiction. The Philadelphia Inquirer (6/29, McCullough, 1.07M) reported the Pennsylvania legislature last week passed a bill "that will dramatically change the rules for safeguarding newborns who go home from the hospital with mothers battling addiction ." The overhaul, "effective in October, says any newborn 'affected' by the mother's drug use during pregnancy must be reported by the hospital to the county's child protective agency, which must 'immediately' assess whether protective custody is needed. The New Research Shows How Opioids Are Impacting The Workforce In Kentucky. The AP (6/30) reported that new research shows how opioids are affecting the workforce in Kentucky. The research shows "that 17 EXT-18-248-D-000446 Tahir, 3.51M) reported, "Bolstered by harsh lawand-order rhetoric from President Donald Trump and his aides, police around the country are using electronic databases to unleash a vast crackdown on opioid abusers and the allegedly crooked doctors who sustain them." The databases are helping "to reduce opioid prescriptions, which have fallen by nearly a third since 2011." agency has to develop a 'plan of safe care' for babies who go home." Innovative Program At Kentucky Jail Provides In-House Rehab For Inmates. Fox News (7/1, Kesten, 16.38M) reports that a jail in Kenton County, Kentucky started "an innovative pilot program" back in 2015 that provides in-house rehab for inmates. Today, the program "is so successful that it has a running waitlist," and "the vast majority of men sign themselves up." That rehab program, "called Unit 104, houses 70 men," who "have access to alcoholics and narcotics anonymous meetings , along with a daily schedule of classes to prepare for the G.E.D. or future job interviews." Metrohealth Cuts Opioid Prescriptions By 3 Million. The Cleveland Plain Dealer (6/29, 1.03M) reported the MetroHealth System "is looking internally to strike the next blow in Ohio's battle against the opioid epidemic." MetroHealth "cut the number of opioid pills prescribed by 3 million, Dr. Akram Boutros, president and CEO of MetroHealth, announced Friday during MetroHealth's annual stakeholders meeting at the Huntington Convention Center of Cleveland." During the annual meeting, Boutros "also told the crowd of 700 about a new initiative to address community trauma and shared updated plans for a new 11-story, 270-bed 'hospital in a park' on its main campus off West 25th Street." Modern Healthcare (6/29, Johnson, Subscription Publication, 239K) reported the efforts "resulted in 33% fewer opioid prescriptions compared with the previous 18 months." That includes "a 62% drop in prescriptions for acute pain and a 25% cut in prescriptions for chronic pain." Nashville Family Loses Three Loved Ones "To Drugs' Grip." The Tennessea n (7/1, Wadhwani, 513K) reports that a family in Nashville has lost three loved ones in drug-related accidents since 2013. Mickey and Tina Baltz's son died in a car accident in 2013 when former 3 Doors Down bassist - having the opioid oxycodone and the muscle relaxant alprazolam in his system - clipped his car on the interstate. Then in 2016, their daughter's former boyfriend, Ralph Hardin, 29, "was fatally shot with his own gun in a room at the Red Roof Inn, where - the Baltzes say - he had gone to confront" the Baltz's daughter's drug dealer. And earlier this year, their daughter, Heather Baltz, died "of a heart infection doctors believe originated with a contaminated needle used to shoot heroin. She had turned to heroin after running out of pain pills prescribed for gallbladder surgery in 2014." NBC Analysis: France Seems To Have Solution To Its Own Opioid Crisis. NBC Nightly News (7/1, story 9, 3:10, Jackson , 8.26M) reported that France appears to have found a way to "dramatically cut down on the number of people who die from overdosing" on opioids. France, which went through it's "own opioid epidemic" in the 1980s and 1990s, began allowing all general practitioners to prescribe buprenorphine in the mid-1990s. In four years, "overdose deaths dropped by 79 percent, and even now, 64 percent of heroin and other opioid substance abusers are on the treatment. Under France's universal health system, it's free." NBC's Dr. John Torres said buprenorphine "works and saves lives" but isn't being used in the US because it's not covered in all states, and doctors who would prescribe it would need "special training." Media Collaborates To Share Solutions To Opioid Crisis. The AP (6/28, De Groot) reported more than 50 print, digital, and broadcast news organizations "are casting a spotlight on the diverse and sometimes out-of theordinary tactics being used to combat the devastating effects of the opioids crisis across Pennsylvania, from the smallest towns to the biggest cities." One goal of the media collaboration was "to make sure communities in every part of the state are aware of strategies, innovations and community efforts that are helping to alleviate the crisis, or at least show promise." Police Using Databases To Crack Down On Opioid Abuse. Politico (6/29, 18 EXT-18-248-D-000447 complaint alleges that Nehaj Rizvi, 29, who operated Life Spring Housecall Physicians, "used a physician's signature stamp to sign certifications and orders for supposedly homebound patients who did not actually need the endorsed treatments," according to the article. Life Spring distributed physician orders and certifications "to over 100 home health agencies, allowing them to charge Medicare about $2.5 million in false billings, according to the complaint." MENTAL ILLNESS Student Groups On College Campuses May Improve Access To Mental Health Resources, Study Suggests. The Huffington Post (6/30, Pajer, 4.32M) reported that some college students "are taking action" to improve access to mental healthcare and "address the culture that makes their peers reluctant to seek help." The article said some students "have formed clubs and support groups," while "others educate fellow students about mental health offerings on campus." A new study which examines such groups across 12 California schools found that "students' efforts are working," and said that the presence of these groups on campus "was found to foster an increase in general knowledge and positive attitudes about mental health," according to the article. PRESCRIPTION DRUG PRICING Epilepsy Drug's Price Increase Highlighted. CNN (6/29, Drash, For, 82.6M) highlighted the case of Trevor Foltz, a teen who lives with infantile spasms, a rare form of epilepsy. The treatment needed for his survival, Acthar (repository corticotropin), increased in price from $1,600 per dose to "more than $23,000," and his family "wrestled with their insurance" to get him treated "at a cost of more than $125,000." The family had to fight for another round of treatment more than a year later, meaning another cost of $125,000. The drug, first invented in the 1930s, cost $40 per vial back in 2001 and now costs $39,000 per vial. Ultimately, the steep price hike "resulted in a $100 million settlement between the government and the drugmaker - as well as revelations that Medicare has spent nearly $2 billion covering Acthar prescriptions for seniors while the drugmaker paid millions to prescribing doctors." HEALTHCARE FRAUD Tennessee CEO Indicted In Million Medicare Fraud Case. $2.5 The Tennessean (6/29, Kelman, 513K) reported in continuing coverage about a "nationwide health care fraud takedown" that "led to hundreds of arrests in a host of unconnected cases across the nation." The article said "Brenda Montgomery, 70, of Camden, the owner of CCC Medical, Inc., has been charged with conspiracy and bribery, according to a federal indictment that was unsealed Thursday." The Tennessee company "sold knee, wrist and back braces." According to the piece, "Montgomery was identified as [the] leader of the alleged Tennessee bribery conspiracy, which prosecutors say spanned six years before being discovered in January. Federal prosecutors also charged four others: Beau Jones, 50, of Loudon; and Sarah Dacus, 36; Greg Lawson, 42; and Josh Wiley, 35; all of Knoxville." Op-Ed: "American Patients First" Plan Neglects Key Elements Necessary To Reduce Drug Costs. Hagop Kantarjian, MD, health policy fellow at Rice University's Baker Institute for Public Policy, and Vivian Ho, PhD, Baker Institute chair in health economics and director at the Center for Health and Biosciences, write in an op-ed for The Hill (7/1, 2.71 M) that the Trump Administration "should reconsider thoughtfully" the "American Patients First" drug pricing proposal released in May by the Department of Health and Human Services because it "is unlikely" the plan will yield the changes necessary to cut drug costs. According to the authors, a successful plan "must address controlling drug prices through reducing the launch price of new drugs; prohibiting unjustified annual increases of prices, and protecting patients from excessive out-of-pocket expenses." Dallas Healthcare Center Service Provider Charged In $2.5 Million Medicare Fraud Scheme. The Dallas Morning News (6/29, Coello, Reporter, 1.05M) reported that the operator of a Dallas healthcare practice was arrested Thursday and "faces a fraud charge after a record-breaking enforcement action by the Medicare Fraud Strike Force." A federal 19 EXT-18-248-D-000448 Executive Vice President and CEO of the American Association of Colleges of Pharmacy , argued that "pharmacists are in a good position to assist" with the challenges of medication costs , "if state and federal laws would allow." She pointed out that when "patients elect not to fill a prescription or use only a few doses without finishing the course," this can increase healthcare costs . She pointed out that "the American Association of Colleges of Pharmacy has long advocated for legislative and regu latory changes to professional practice that would help some 200 million Americans better manage their chronic diseases so that more lives could be saved." Among the changes she suggested is "increasing public access to and coverage for pharmacists ' medication management services." However , they conclude , the "'American Patients First' road map ignores all three." Editorial: More Policies Requiring Transparency Of PBMs Are Necessary To Combat Drug Prices. In an editorial, the Columbus (OH) Dispatch (7/1, 399K) argues for increased transparency regarding the role of pharmacy benefit managers (PBMs) play in drug pricing. The Dispatch says PBMs "were once hailed as an answer to provide needed cost controls through claims management for insurers and payers ," but now "have been revealed as lining their pockets" in their contracts with prescription-drug manufacturers and payers. The editorial applauds the implementation of state contracts requiring transparency about pricing from "two of the nation's largest PBMs, CVS Caremark and Optum Rx," which took effect Sunday , and calls for "Medicaid administrators, legislators, office holders and would-be office holders ...[to] continue demanding more transparency until we can all be assured that consumers and taxpayers are being treated fairly." HEAL TH CARE REFORM & INSURANCE Sen. Collins Says She Will Oppose Supreme Court Pick Who Shows The "Hostility" To Roe V. Wade. Op-Ed Criticizes Pharmacy Benefit Managers. In an op-ed in STAT (6/29, 27K), Washington Post (7/1 , Long, 15.68M) reports Sen. Susan Collins (R-ME) is a "key swing vote on President Trump's next Supreme Court pick" and she said she will not support "any judge who would overturn Roe v. Wade." Collins said Sunday on CNN's State of the Union, "I would not support a nominee who demonstrated hostility to Roe v. Wade. " The New York Times (7/1, Fandos, Cochrane , 19.33M) reports that Sen . Collins is "among the few remaining voices of centrism in the Republican Party," and "is one of two Republican senators who have supported abortion rights and, in the past, have shown themselves willing to break with their party." The AP (7/1 , Yen , Thomas) reports Sen. Collins explained that any judge with such hostility to precedent "would not be acceptable to me because that would indicate an activist agenda ." The AP adds, "Repub licans hold a narrow 51-49 majority in the Senate , and it's even closer because of the absence of ailing Sen. John McCain of Arizona ." CNN (7/1, Watkins, 82.6M) reports Collins "said when she met with President Donald Trump to discuss the vacancy created by the retirement of Justice Anthony Kennedy, she encouraged Trump 'to broaden his list beyond ' his standing list Scott Knoer , PharmD , the chief pharmacy officer of the Cleveland Clinic, argued that pharmacy benefit managers engage in "financial shenanigans" rather than helping "control costs for payers and lower out-of-pocket costs for plan members." Knoer contended that PBMs have been able to do this for so long because they "closely guard their complicated processes to avoid scrut iny, and require pharmacies to sign confidential agreements that shield them from visibility." And, since just three PBMs "control 73 percent of the market ," there are often "abuses " of the system. Knoer detailed five ways in which PBMs "make their unparalleled high profits" processing of claims, negotiation of rebates , the spread , or "difference between what a pharmacy benefit manager collects from the payer (such as Medicaid) for medications and the amount it pays the pharmacy that dispenses it," as well as by "forcing patients to use specific pharmacies," and via remuneration fees. Op-Ed: State, Federal Laws Should Empower Pharmacists To Help Manage Drug Costs. In an op-ed in The Hill (6/29, 2.71 M), Lucinda L. Maine, PhD, RPh, the 20 EXT-18-248-D-000449 Politico (6/29, Diamond, 3.51 M) reported the poll found 67 percent of Americans "oppose rolling back constitutional protections for access to abortion." The poll also showed that "67 percent of Democrats oppose the Trump administration's proposal to prohibit federal funding from going to organizations that provide abortion services, while Republicans are nearly split" with 46 percent in support and 48 in opposition. The Washington Examiner (6/29, Leonard, 340K) also reports. Trump Judicial Adviser Claims None Of Top Supreme Court Candidates Have A "Clear Position" On Roe V. Wade. The Washington Examiner (7/1, Williams, 340K) reports Leonard Leo, a "top Trump judicial adviser'' and vice president of the Federalist Society, "none of the reportedly top individuals on the administration's shortlist of candidates to replace retiring Supreme Court Justice Anthony Kennedy have a clear position on whether to overturn" the Roe v. Wade holding. Leo said, "Prospective nominees like Brett Kavanaugh, and Amy Barrett, and Raymond Kethledge, and Tom Hardiman are people who have not specifically said they oppose Roe v. Wade, and their writings and their work show that they are very fair." He added, "They look at arguments from both sides all the time and they analyze them very carefully, and when they take a position, they then say these are what the other people have said about this and here's why I don't agree with them." Advocacy Groups Plan To Spend Millions On Supreme Court Nomination Battle. NPR (7/1, Overby, 3.55M) reports both sides of the upcoming battle over President Trump's nomination to the Supreme Court are "expected to spend tens of millions of dollars." NPR adds, "the Judicial Crisis Network, which pledged $10 million to win confirmation for Justice Neil Gorsuch last year, is gearing up again" and so are "plenty of other groups," including "the Koch brothers' Americans for Prosperity, which said it's 'prepared to commit seven figures,' the anti-abortion Susan B. Anthony Fund, Heritage Action and others." The article says, "Some liberal groups say this won't be like other confirmation fights, and they hope to put the future of the Affordable Care Act, or Obamacare , at the center." Opinion: Ending Abortion Is The Beginning, Not The End. Kimberly Ross wrote in the Washington Examiner (6/29, Ross, 340K) that "Abortion has reached a near-sacramental of 25 potential choices." She said, "The President really was soliciting my views on the type of nominee that I was looking for," adding, "I emphasized that I wanted a nominee who would respect precedent, a fundamental tenet of our judicial system." Collins also said, "I want a judge who will apply the law to the facts of the case with fidelity to the Constitution" and "Roe v. Wade is a constitutional right that is well established, and no less an authority than Chief Justice Roberts said that repeatedly at his confirmation hearing." Bloomberg News (7/1, Niquette, Condon, 4.46M) reports Collins said of the president's process, "I got the feeling that he was still deliberating and had not yet reached a decision, and that this was genuine outreach on his part." She added, 'There are people on that list whom I could not support." The Washington Examiner (7/1, Ayers, 340K) reports Sen. Collins pointed out that Justice Neil Gorsuch would likely not overturn Roe v. Wade. She explained, "I had a very long discussion with Justice Gorsuch in my office and he pointed out to me that he [is] the co-author of a whole book on precedent," adding, "So someone who devotes that much time to writing a book on precedent, I think, understands how important a principle that is in our jud icial system." Also reporting are Reuters (7/1, Dunsmuir), the Washington Times (7/1, Richardson, 460K) and Politico (7/1, Kullgren, 3.51 M). Most Americans Do Not Want To Overturn Roe V. Wade, Poll Says. Congressional Quarterly (6/29, Raman, Subscription Publication) reported according to a survey released Friday, only 29 percent of Americans support overturning Roe v. Wade. The poll was conducted before Supreme Court Justice Anthony Kennedy announced he was retiring. Among Republicans, 53 percent want the case overturned, while 81 percent of Democrats and 73 percent of independents do not. The Hill (6/29, Hellmann, 2.71 M) reported, "Sixty-eight percent of women and 65 percent of men said they want the decision to remain the law of the land." The poll was from the Kaiser Family Foundation. The Hill added, "Forty-percent of adults said they are more likely to vote for a candidate who supports access to abortion services, while 30 percent said a candidate who supports abortion restrictions is more likely to get their vote." 21 EXT-18-248-D-000450 hour waiting period for abortions is unconstitutional, saying that "autonomy and dominion over one's body go to the very heart of what it means to be free." The court determined the restriction was not "narrowly tailored to serve a compelling interest of the state." Reuters (6/29, Goldberg) reported that there is a "separate challenge pending" over another provision of the law "that outlaws abortion after a fetal heartbeat is detected." Also reporting were The Hill (6/29, Wise, 2.71M) and the Washington Examiner (6/29, King, 340K). status in the Left's political religion" and "to encroach upon this holy ground is tantamount to war." Ross added, "One day, we hope to look back on abortion as we now do slavery and wonder how a nation built on freedom ever permitted and celebrated such a daily horror." She concluded, "While there may be a potential victory on the horizon, pro-lifers should not trick themselves into believing such a thing means our mission is accomplished." Opinion: Antiabortion Groups Are "Laying Low" About Overturning Roe. Jennifer Rubin wrote in the Washington Post (6/29, 15.68M) in its "Right Turn" blog that "pro-life activists are trying to lay low" about being "on the brink of achieving their dream of a 5-4 court ready to reverse Roe v. Wade." Rubin criticized their "different tune" and says, "pro-life activists should have the power of their convictions," noting, "they have spent their lives saying they want to eradicate abortion and that the American people were with them. Now is the time to have that fight." Opinion: People Need To Mobilize Against Trump's Supreme Court Pick. EJ Dionne Jr. writes in the Washington Post (7/1, Dionne, 15.68M) that Sen. Elizabeth Warren (D-MA) was correct when she called the replacement of Supreme Court Justice Anthony Kennedy the "fight of our lives." Dionne says, "There is no choice but to mobilize." He adds, "The future of abortion rights is central to the coming battle. But so are civil rights, corporate power and our democratic capacity to correct social injustices." Opinion: Women Must Speak Up To Defend Abortion Rights. Cindi Leive, former editor in chief of Glamour and Self, wrote in the New York Times (6/30, 19.33M) that as Justice Anthony Kennedy, "whose vote has helped protect abortion rights over his 30 years on the Supreme Court, prepares to retire, we are faced with the very real prospect of a court that would overturn Roe, at a time when states across the country are already restricting abortion rights." Leive emphasized the importance of women who have had an abortion sharing their stories if they feel comfortable with doing so because "silence ...allows menacing myths about abortion to thrive." Leive said the right to abortion "is under greater threat than it has been in my adult lifetime," and concluded that "just as women decades ago shared their stories en masse in an effort to change inhumane laws, it's time for those of us who feel we can share to do so once again." Medical Advances Have Contributed To Plunging Abortion Rates. The New New Mexico Democrats Push To The Repeal State Abortion Law. York Times (7/1, A1, Belluck, Hoffman, 19.33M) reports on its front page that "America even without legal abortion would be very different from America before abortion was legal." The article explains, "a full-fledged return to an era of backalley, coat-hanger abortions seems improbable" because "a burst of scientific innovation has produced more effective, simpler and safer ways to prevent pregnancies and to stop them after conception - advances that have contributed to an abortion rate that has already plunged by half since the 1980s." Albuquerque (NM) Journal (6/29, McKay, 215K) reported that Democratic lawmakers in New Mexico are renewing efforts to repeal a state law that makes it a crime for an abortion provider to end a women's pregnancy, except in narrow circumstances. The push comes "in part because the retirement of U.S. Supreme Court Justice Anthony Kennedy will allow President Donald Trump to nominate his successor," according to the article. Supreme Court Ruling Raises Doubts About Illinois Abortion Law. The Chicago Iowa Supreme Court Rules Against 72-Hour Abortion Waiting Period. The Tribune (7/ 1, Lourgos, 2.37M) reports the Supreme Court's recent decision to back antiabortion pregnancy centers is raising doubts AP (6/29, Pitt) reported the Iowa Supreme Court on Friday ruled 5-2 that a state law requiring a 7222 EXT-18-248-D-000451 about an Illinois law that says "medical providers must inform patients about all available medical options, including abortion and contraception, even if the nurse or physician has faith-based or moral objections." Trump Administration Proposes Cuts To ACA Navigators. The Hill (6/29, Sullivan, 2.71M) reported the Trump Admin istration has proposed cutting the funding for Affordable Care Act navigators from $36 million last year to $10 million this year. The Administration cut the funding from $63 million to $36 million in 2017. While a spokeswoman for the Department of Health and Human Services "did not respond to a request for comment ," but sources "say that proposal now could be walked back, and it is possible funding could remain the same as last year, but it is unclear where the final number will end up." Some States Taking Action To Support ACA. The Washington Post (7/ 1, Goldstein, 15.68M) reports on efforts by state governments to buttress the protections of the Affordable Care Act against efforts by the federal government to "erode the ACA." The Post discusses individual mandate requirements passed in New Jersey, Vermont, and DC, as well as state efforts to erect "barriers against rules the Trump administration is writing to promote shortterm health plans." The Post explains how "taken together, the moves mean the nation is starting to revert to the insurance landscape of a decade ago - a hodgepodge that created the political pressures that culminated in the sweeping 2010 law" - where each state had different insurance requirements. Health Insurers Offering ACA Plans In More States, But At Higher Premiums. The Washington Examiner (7/2, Leonard, 340K) reports that even though health insurers are planning to expand their participation under the Affordable Care Act, the "trend is coming at the expense of higher premiums for certain customers ." The "entrance by insurers into Obamacare is a reversal from years of exits." The Examiner reports that Oscar Health is expanding into three new states; Centene "has filed in North Carolina and Tennessee;" and Wellmark Blue Cross and Blue Shield, Molina, and Medica are also adding states. House Vote To Repeal Medical Device Tax May Bolster Vulnerable GOP Lawmaker. The Hill (7/ 1, Sullivan, 2.71M) reports that the House is planning to vote this month on legislation that would repeal the Affordable Care Act's medical device tax, which would "satisfy industry leaders and boost the reelection prospects for the bill's sponsor," Rep. Erik Paulsen (R-MN), whose seat is "vulnerable." Several device makers are based in Paulsen's district. Repealing the tax is "absolutely popular in this district," according to Larry Jacobs, a political science professor at the University of Minnesota. Obama Told Trump To Take Credit For ACA. The Hill (6/29, Sullivan, 2.71 M) reported former President Barack Obama revealed Thursday that he told President Trump, "Just change the name and claim that you made these wonderful changes and I would be like, 'You go."' Obama added, "Because I didn't have pride of authorship, I just wanted people to have health care." Newsweek (6/29, Touchberry, 2.18M) reports that "Obama reiterated Thursday that he did not take up the issue of health care because he wanted to preserve his legacy or receive credit." Obama said, "The idea that I somehow took on health care just because I thought it was fun or it would somehow burnish my legacy is nuts," adding, "Because we knew going [into] 2008 that every president since Teddy Roosevelt had failed to do what every other advanced democracy in the world has done." Sen. Durbin Says Trump Seeking Court Nominee Who Will Overturn Roe, Affordable Care Act. The Washington Times (7/ 1, Richardson, 460K) reports Senate Minority Whip Dick Durbin said President Trump is seeking to nominate a justice to the Supreme Court who will overturn Roe v. Wade and the Affordable Care Act. Durbin said, "The president is looking for someone who will overturn Roe versus Wade. ... But even equally important, he's looking for someone on the court who will make sure that they rule that the Affordable Care Act's protection of those with preexisting conditions is unconstitutional." Insurance Premiums Set To Sharply Rise Next Year In New York. Newsday 23 EXT-18-248-D-000452 (NY) (7/1, Polsky, 1.52M) reports that insurance premiums in New York state are positioned to "rise sharply in January, as measures to undercut the Affordable Care Act start to take effect." The 14 insurers in the state "are asking for a weightedaverage hike of 24 percent, with individual requests ranging from an actual rate cut to up to a 38.6 percent increase." Newsday adds, "The highest rate was requested by Fidelis Care, which has the highest percentage of individual enrollment in 2018, with 41 percent of enrollees with qualified health plans." Editorial: Minnesota Helps Bring Insurance Premiums Down, But Faces Funding "Cliff." The Minneapolis Star Tribune (6/30, 1.16M) editorialized that insurers in Minnesota are proposing rate decreases on the individual market by 7 to 12 percent. The editorial explained that the state legislature's "reinsurance" program "played a played a lead role in keeping rates down." The piece adds, "A different and far more daunting health care challenge looms: a towering state funding cliff that could weaken Minnesota's health-care-driven economy and undermine coverage for 982,000 Minnesotans relying on public programs." Medica To Add Two More States: Missouri, Oklahoma. The Minneapolis Star Tribune (6/29, Snowbeck, 1.16M) reports health insurer Medica is planning on expanding next year into individual insurance markets in Missouri and Oklahoma. The growth brings the insurer's total to eight states. The Star Tribune points out, "While many health insurers over the past two years have fled red ink in the individual market under the federal Affordable Care Act (ACA), Medica has grown from its base in Minnesota, North Dakota and Wisconsin into Iowa, Kansas and Nebraska." Op-Ed: Most Physicians Unaware Of Ways They Can Reduce Healthcare Costs For Patients. Hussain Lalani, resident physician in Dallas, Texas, writes in a column for the Dallas Morning News (6/29, 1.05M) that as one of more than 30,000 new physicians beginning medical residency July 1, he is "concerned that we will contribute to the $750 billion epidemic of excessive health care spending ...and risk financially hurting our patients if we do not know the cost of what we prescribe." Lalani explained, "Most patients want their doctors to talk about costs of care with them . ... Yet, most doctors don't know the specific costs of what they prescribe." He noted that often, there are "cheaper, equally effective alternatives" physicians can use to minimize healthcare costs. University Of Mississippi Medical Center To Continue Treating Blue Cross Patients As In-Network During Mediation Process. The Jackson {MS) Clarion Ledger (6/29, Wolfe, 287K) reported the University of Mississippi Medical Center has agreed to continue treating patients with insurance from Blue Cross & Blue Shield as "in-network" while the two attempt to resolve a contract dispute. Both sides have agreed to meet with a "professional mediator." HUMAN SERVICES NEWS HHS Provides Maine Group With $200K Grant For Health Work. The AP Opinion: IRS Should Let Workers Spend Pretax Money On Healthcare. (7/ 1) reports that the Department of Health and Human Services has provided a $200,000 grant to help the Aroostook County, Maine Action Program "connect more residents with health services." Sens. Angus King (I-ME) and Susan Collins (RME) "say the action program plays an important role in linking residents of far northern Maine to services." Regina Herzlinger, a Harvard Business School professor, and Joel Klein, chief policy and strategy officer at Oscar Health, writes the Wall Street Journal (7/1, Subscription Publication, 6.13M) that healthcare is becoming an unsustainable expense as the Milliman Medical Index estimates that insurance for an American family of four was $28,000 this year. They propose a solution to have the Internal Revenue Service permit workers to buy health insurance using pretax dollars, like employers. July 1 Marks Change In Arizona Child Welfare Laws. The Arizona Republic (7/1, 1.21 M) reports that July 1 marked a change in Arizona's child-welfare proceedings. As of that date, "except in emergency situations, child welfare workers will no longer be able to remove a 24 EXT-18-248-D-000453 Press Herald (6/29, Pols, 157K) reported that on the evening of June 29, Gov. Paul LePage (R-ME) vetoed two measures that would have boosted "reimbursement rates for the agencies that hire direct care workers who provide key support for adults with intellectual disabilities, as well as those who care for the elderly in nursing homes." Last week, the Legislature unanimously passed a measure affecting workers who care for "intellectually disable d adults," and supporters hope they will be able to gather "the two-thirds majority necessary to override the governor's veto when lawmakers return on July 9." The current veto, however, means pay rates reverted to 2017 levels as of July 1, and workers were set to "face an immediate 12 percent pay cut," according to Maine Association for Community Service Providers Executive Director Lydia Dawson, to a pay level of $9.17 per hour, less than the minimum wage. child from her home to protect against abuse or neglect without first getting a court's permission." While critics hope the change will end what they refer to as the "warrantless seizures" of children, "the experience of other states, and the expectations of the lawmakers who championed the legislation, suggests it will have a more subtle effect on the number of child removals." District Of Columbia Extends Deadline For Daycare Workers To Meet New Education Requirements. The Washington Post (6/29, Stein, 15.68M) reported that Washington, DC's government has extended a deadline for the city's "daycare employees to meet stricter education requirements after workers in the field argued that the new rules were unrealistic to complete." Two years ago, the city enacted some of the "most advanced education requirements for childcare workers" in the US, but faced "a backlash, with critics arguing that childcare workers are often paid minimum wage and there is little incentive for them to obtain higher degrees." On June 29, the city announced it would provide "employees an additional one to four years to complete certification or degree requirements." The AP (6/30) reported that "lead teachers in child care centers now have until December 2023 instead of 2020 to earn an associate's degree," while "requirements for assistant teachers , home caregivers and associate home caregivers were pushed back from 2018 to 2019." FOOD & IMPORT SAFETY Wish-Bone Recalls Salad Dressing For Possible Allergens. The Knoxville (TN) News Sentinel (7/1, 252K) reports, "Pinnacle Foods Inc. is recalling 7,768 cases of Wish-Bone House Italian salad dressing distributed nationwide after learning from a customer that some bottles were mislabeled," according to the FDA. The voluntary recall pertains to "15-ounce bottles which may not list milk or egg, potential allergens, as ingredients," and impacts products with a "Best If Used By" date of Jan. 13, 2019. The New Orleans Times-Picayune (7/1, Krueger, 521 K) reports, "According to the company, 7,768 cases of the recalled product was distributed." Ohio Hasn't Used $SM Designated For At-Risk Youth In 2018. The AP (7/1) reports that so far, Ohio has not spent any of the $5 million it has designated in 2018 "for services for troubled youth on the cusp of being removed from the ir homes or at risk of entering the justice or foster-care systems." Money from the so-called "crisis stabilization fund" was earmarked "to help pay for support groups, child care, transportation and other expenses," and "county Family and Children First councils were given the task of making local plans to administer the funds." Child welfare advocates argue that "stipulations attached to the federally funded program have caused roadblocks." NUTRITION & OBESITY Beverage Industry Scores "Defining Victory" In Banning Soda Taxes In California. The Washington Post (6/30, Dewey, 15.68M) reported that the beverage industry "scored a defining victory" in its battle against soda taxes last week when California lawmakers voted to bar future local taxes on sugary drinks. According to the Post, "under the fast-moving ban introduced June 23 and signed into law five days later, no new food or beverage taxes can be passed in the state until 2031 at the Maine Governor Vetoes Bills To Increase Reimbursement Rates For Direct Care Workers. The Portland (ME) 25 EXT-18-248-D-000454 changes its structure to a more cost-effective managed care model." The New Hampshire Union Leader (6/29, 122K) quoted Sununu saying, "This is probably the biggest single piece of landmark legislation I have been involved with as governor." The Nashua (NH) Telegraph (6/30, 44K) reported that the law "still needs federal approval for some of the waivers it is seeking, such as for the work requirement for able-bodied, childless adults." earliest." The article said that the law "represents a significant, if long-anticipated, shift among the nation's soda makers, who have previously fought taxes, city by city, and expended millions of dollars in the process." Fortune (6/29, Mukherjee, 3.91 M) examined how such a measure seems unlikely in a state known for progressive policies and attributed to passing of the legislation to a "successful, noholds-barred campaign by the beverage industry and its supporters to nix even the possibility of local soda taxes in exchange for standing down on a controversial tax-related ballot measure." In commentary published by The Hill (7/1, 2.71 M), Larry Cohen, the executive director of the nonprofit Prevention Institute, maintains that the "new law banning soda taxes in California is a setback." But when teenage health advocates from Stockton "urged lawmakers to stand with communities like theirs and put people's health over corporate profits," the "other side was conspicuously quiet" so, we "won't give up on reigning in the soda industry." Also reporting were Kaiser Health News (6/29, Young) and U.S. News & World Report (6/29, Lardieri, 1.97M). Maine Governor Vetoes Medicaid Expansion Funding. The Portland {ME) Press Herald (6/29, 157K) reported Maine Gov. Paul LePage "vetoed a $60 million Medicaid expansion funding bill Friday, an expected move that sets up a veto override vote by lawmakers when they return on July 9." LePage "said in a statement Friday evening that he vetoed the bill, passed by the Legislature last week, because lawmakers acted in a fiscally irresponsible manner." The AP (7/1, Villeneuve) reported Maine "is the only state whose voters have approved expanding Medicaid to low-income residents, but expansion originally set for Monday is in limbo as a legal battle between the fiscally conservative governor and advocates continues." Maine's Medicaid Program To Cover Chiropractic Exams. The AP (6/30) reports Maine's Medicaid program "will start covering chiropractic exams under a new law," which is expected to require "about $67,000 from Maine's general fund and $122,000 in federal funds ." MEDICARE CMS To Test Medicare Advantage Plans As APMs. Modern Healthcare (6/29, Dickson, Subscription Publication, 239K) reported the CMS "wants to launch an experiment that allows doctors in Medicare Advantage plans to qualify as participating in an alternative pay model." Clinicians in Medicare Advantage plans "have urged the CMS to consider those plans as APMs since some are offering risk-based contracts." Idaho GOP Committee Passes Resolution Opposing Medicaid Expansion Initiative. The Idaho Press Tribune (6/29) reported the Idaho Republican Party's resolutions committee "approved a resolution this morning opposing the Medicaid expansion ballot initiative, in one of the first resolutions to gain support during the 2018 GOP convention, reports Bryan Clark of the Idaho Falls Post Register." The resolution, "drafted and submitted by the Bonneville County Central Committee, passed on an overwhelming voice vote in the committee, though there was a small group of dissenters." The AP (6/29, Kruesi) reported the resolution - which "still needs to win approval from delegates during Saturday's general session - warns 'the current Medicaid program is already cannibalizing MEDICAID & CHIP Sununu Signs Reauthorized Medicaid Expansion Bill. The A P (6/29) reports Republican Gov. Chris Sununu "has signed a bill to continue New Hampshire's expanded Medicaid program for another five years." The current program "uses Medicaid funds to purchase private health plans for about 50,000 low-income residents. It would have expired this year if lawmakers didn't reauthorize it." The bill "also 26 EXT-18-248-D-000455 dollars for schools and roads by growing at a faster rate than other major programs and expansion will further erode support for other critical spending needs."' Enterprises Director Michael Randol has no data to back up his claim that the state's managed-care model is saving money. The IHA says the state is saving money "because the Medicaid insurance companies are not adequately reimbursing health care providers for their services," according to the article. Iowa's New Private Medicaid Company Has "Troubled Past." The Des Moines (IA) Register (7/1, Clayworth, 292K) reports that an investigation shows that "the corporation selected to help manage Iowa's controversial privatized Medicaid system has faced serious charges of mismanagement resulting in at least $23.6 million in penalties in more than a dozen states." Iowa Total Care , a subsidiary of Centene, "was awarded a state Medicaid contract in May by the Iowa Department of Human Services despite scoring nearly 14 points lower on its evaluation than when it had applied and was rejected in 2015, public records show." But with "only two companies bidding for the work, Iowa Total Care won a spot managing Iowa's annual $4.8 billion Medicaid program." West Virginia Medicaid Waiver Expands Options For Substance Abuse Treatment. The Exponent Telegram (WV) (7/1, Snoderly) reports that the second phase of a Medicaid waiver in West Virginia has been "rolled out" which will focus "more on intensive services for individuals with substance use disorders, according to Bureau of Medical Services Commissioner Cindy Beane." The waiver allows the state to sidestep the Institutions for Mental Diseases Medicaid exclusion that "prohibits the use of federal funds for care provided to patients in mental health facilities with more than 16 beds." West Virginia was "awarded the waiver in October 2017, making it the fifth state to receive the approval." Arkansas Suspends Medicaid Payments To Missouri Nonprofit After Arrest. The AP (6/30) reports authorities in Article Examines Why Tennessee Has Not Expanded Medicaid. The Tennessean Arkansas "have suspended Medicaid payments to a Missouri nonprofit after a former executive with the agency was arrested as part of a scheme to improperly bill almost $2.3 million in claims for mental health services." Citing the Arkansas Democrat-Gazette, the AP reports that the suspension Friday of Medicaid payments "comes a day after Robin Raveendran, formerly executive vice president for Preferred Family Healthcare, was arrested on two counts of Medicaid fraud." (6/29, Allison, 513K) featured an article that examined why the state has not been among those to expand Medicaid. The piece highlighted a way to cover Tennessee's 10% share of Medicaid expansion cost, and how it could lower insurance premiums. HEALTH & MEDICALNEWS Scientists Warn On Increased Mortality Risk From Prolonged Sitting. Ohio Medicaid Execs Criticized For Defending Pharmacy Middlemen. The NBC Nightly News (6/29, story 12, 0:20, Holt, 6.8M) reported American Cancer Society scientists warn that sitting for at least six hours a day can "lead to a nearly 20 percent higher risk of death, compared with people who sat for just three hours." They said, "Spending all that time sitting was linked to 14 diseases." Columbus (OH) Dispatch (7/1, 399K) reports that criticism "rained down" on Ohio Medicaid executives during a legislative hearing last week as they "reported on findings by a consultant who delved into practices of pharmacy benefit managers, which play the role of middlemen between Medicaid's managed care outfits and Ohio pharmacies." People Fail To Properly Wash Hands While Cooking 97 Percent Of The Time, Study Finds. USA Today (6/29, Iowa Hospital Association Says State Has No Data To Support Medicaid Savings Claim. The Cedar Rapids (IA) Molina, 11.4M) reported, "Ahead of Fourth of July grilling, the U.S. Department of Agriculture is offering a reminder to wash our hands" properly. Gazette (7/1, Ramm, 146K) reports the Iowa Hospital Association said Iowa Medicaid 27 EXT-18-248-D-000456 heart disease and cardiovascular death." The findings were published in the BMJ. TIME (6/30, Ducharme, 19.27M) reported, "People fail to properly wash their hands while cooking 97% of the time, potentially opening them up to food-borne illnesses such as salmonella, norovirus and E. coli," research indicated. The findings came from a US Department of Agriculture's Food Safety and Inspection Service study. Researchers Developing Artificial Ovary To Help Young Cancer Patients Preserve Fertility. On its website , CNN (7/1, Scutti, 82.6M) reports a group of Danish researchers developing an artificial ovary "have engineered a 'scaffold' on which early-stage cells can develop into functional ovarian follicles ," which could help younger cancer patients preserve their "fertility from the impact of cancer treatments, experts say." Researchers will present the study Monday at the European Society of Human Reproduction and Embryology annual meeting in Barcelona, Spain. US Evacuates More Americans From China Following Mystery Illness Complaints. The Wall Street Journal (7/1, Chen, Subscription Publication, 6 .13M) reports that at least nine Americans have been medically evacuated from the Chinese city of Guangzhou following complaints of abnormal aural sensations similar to those experienced by US diplomats in Cuba last year. To date, only one American in China has been confirmed as having symptoms and clinical findings consistent with those experienced by U.S. diplomats in Cuba, according to the Journal. However, US embassy staff were told in June that the evacuations of the Americans were not all connected to the mysterious symptoms. The New York Times (6/30, Myers, 19.33M) said the State Department "evacuated at least 11 Americans from China" after abnormal sounds or sensations were reported by government employees at the US Consulate in Guangzhou. lmmunotherapy "Revolution" Is "Greatest Hope Yet" For Beating Cancer. The Telegraph {UK) (7/2, Vonderheide, 976K) reports that new cancer treatments "that harness the patient's immune system mark the 'end of the beginning' of the fight against cancer." The story of immunotherapy drugs "has radically altered how we treat some of the most common and deadly cancers - and our work applying those approaches to tackle even more of them." FDA Approves First Drug To Reduce Excessive Sweating. The AP (6/29, Most People Apply Too Little Sunscreen. The Wall Street Journal (6/29, Johnson) reported that on June 29, the Food and Drug Administration "approved the first drug developed specifically to reduce excessive sweating," Qbrexza (glycopyrronium), manufactured by Dermira. The drug will be "inside a cloth wiped over the skin daily to block sweat glands from activating." The drug will start being available in October. Reuters (6/29, Mishra) reported, "Currently, Allergan's (AGN.N) Botox injection is used to treat" excessive sweating, and "other treatments include antiperspirants and costlier alternatives such as laser therapy, as well as localized surgery like liposuction to remove sweat glands." Cowen analysts have estimated the drug could have "sales of $250 million to $300 million by 2023." Newsweek (6/29, Spear, 2.18M) reported that "in one study, 53 percent of patients said Qbrexza reduced sweat production by roughly half, versus 28 percent in a comparison group using a non-medicated cloth, the drug company reported." McGinty, Subscription Publication, 6.13M) reported that many people do not apply enough sunscreen, and dermatologists sometimes have difficulty explaining how much should be used. Sandy Walsh, a spokeswoman for the FDA, said, "The amount of sunscreen applied for each consumer will be based on their specific attributes including body size, the amount of body hair and sensitivity to the sun." The article also pointed out that a study published earlier this year in the Journal of the American Academy of Dermatology indicated that using sunscreens that have an SPF that is higher than 50 is beneficial. Being Married May Reduce Risk Of Heart Disease, Cardiovascular Death, Review Suggests. The New York Times (6/29, Bakalar, 19.33M) reported that a review suggests "being married may reduce the risk of 28 EXT-18-248-D-000457 board." Employers will now be required to provide 17.4 percent of a worker's salary, up from 15.75 percent, while workers will continue to contribute 9% of their own paychecks. The state's retirement system currently has 61 percent of the assets needed to cover future benefits. approved changes indicate that the state's retirement plan will be 100 percent funded by 2047, although that remains heavily reliant on the projected rate of investment returns. Also covering the story were Forbes (6/30, Lee, 10.34M) and TIME (6/30, Ducharme, 19.27M). CDC Warns Of Shingrix Vaccine Shortage. CBS News (6/29, 6.78M) reported on its website that the Centers for Disease Control and Prevention has warned about a shortage of the Shingrix shingles vaccine. On "CBS This Morning" on June 30, Dr. David Agus said, "It's a really potent, excellent vaccine. I got it myself. And this is a vaccine where the old vaccine worked 30, 40 percent of the time. This is 97 percent of the time." He offered advice for people attempting to find the vaccine, adding, "Call ahead to a pharmacy. Make sure they have it. You can get it at a pharmacy, your doctor's office." The Philadelphia Inquirer (6/29, Schaefer, 1.07M) reported on the high demand for the Shingrix vaccine, pointing out that "a quick check of some pharmacies in the Philadelphia region found the vaccine was still available, but not at all locations." The Inquirer reported that Shingrix's maker, GlaxoSmithKline , "has recommended that people who need the second of the two-dose series of the vaccine get priority." Surveys: Financially Independent Millenials Are Happier Than Those With Money Worries. CNBC (7/1, 4.81M) reports on its website that a decade-long study by the National Endowment for Financial Education found that financ ially independent millenials tended to be more confident and happier overall. NEFE Chief Executive Officer Ted Beck said that the path to financial independence begins long before college, urging parents to have regular discussions with their children on financial responsibility. Similarly, a recent survey from T. Rowe Price found that "young adults who discussed money with their parents are more likely to have a budget, more likely to have an emergency fund, more likely to put 10 percent or more of their income toward savings and more likely to have a retirement account." Police Investigate Elder Abuse Against Comic Book Creator Stan Lee, 95 . The AP (6/30, Dalton) reported that, after the Retirees Increasingly Becoming Entrepreneurs, Cites AARP Study. As death last July of Joan, "his wife of 69 years and partner in all things," comic book creator Stan Lee, 95, "has found himself in the middle of a fight over his finances and legacy that has led to lawsuits, a restraining order and a police investigation of elder abuse." The article used Lee's case to make the larger point that "Lee's status as a celebrity in declining mental health and vulnerable to exploitation has many precedents and may become increasingly common as a wave of wealthy baby boomers reaches old age." A restraining order against a memorabilia collector alleged that the collector "isolated him from associates, friends and relatives, which is considered a form of elder abuse ." part of a series, "Silver Linings," on the issues of New Hampshire's aging population, the New Hampshire Union Leader (7/1, Baker, 122K) reports the rising number of retirees starting businesses as entrepreneurs. The article cites Small Business Administration data that the number of people aged 62 and older who are selfemployed is "rising" nationwide. It also cites a 2015 AARP survey that "only" 10 percent of New Hampshire residents aged 50 and older plan to retire and never return to work. Study Reveals Views On Social Media Bias. The Washington Times (6/29, Sabes, Mississippi Public Agencies Must Now Cover Increased Share Of Worker Pensions. The AP (6/29, Amy) reported, 460K) reported that a new Pew Research Center poll of about 5,000 people found that 85 percent of Republicans believe social media sites tend to bias what they show, and 72 percent of Americans believe social media sites censor political views. Younger adults tended to trust social medias sites more than older respondents, "Public agencies in Mississippi will have to contribute another $100 million toward worker pensions beginning July 1, 2019, after a vote by the state Public Employees Retirement System's 29 EXT-18-248-D-000458 use it and businesses looking to grow, process or sell it." with 67 percent of those 18 to 29 years of age saying that the websites censor views, while 81 percent of "seniors" believe that they do. Many Families Still Live With Arsenic, Lead In Everett, Washington. The AP Hospitals Across US Experiencing Shortages Of Beds For Children With Mental Health Illnesses. NBC Nightly (6/30) reported that "nearly three decades" after Washington state discovered large amounts of arsenic and lead in properties surrounding a former smelter site in Everett, "about 150 homeowners are still waiting for the contamination to be cleaned up." So far, about 350 properties have been cleaned up using a $34 million settlement, but the fund only has enough to remediate 20 more properties in 2019. News (6/29, story 8, 4:05, Holt, 6.8M) reported on a "growing crisis" in American hospitals: "there are simply not enough beds to accommodate kids who need to be hospitalized" for mental illnesses. According to NBC News, "the crisis is nationwide, with nearly a 40-percent increase in psychiatric visits to emergency rooms." One hospital in Kansas said it turned away 2,000 children last year alone, NBC added. Delaware Lawmakers Vote To Ban Powdered Alcohol. The AP (6/30, Chase) Colorado Hospital Sues Patient For Surgery Bill, Highlighting Alleged Price Gouging. The Denver Post (6/29, reported that Delaware lawmakers gave final approval to a bill "outlawing the manufacture, sale and use of powdered alcoholic beverages." Enactment of the legislation would make Delaware the 37th state to ban "powdered substances that form alcoholic drinks when reconstituted with liquid." According to the AP, "the American Medical Association has called for a nationwide ban on powdered alcohol, which critics say carries the risk of more potent drinks and harmful overconsumption ." Osher, 755K) reported on a patient in Colorado who underwent spinal-fusion surgery at the nonprofit St. Anthony North Health Campus and was later sued by the hospital for $229,112.13 for unpaid medical bills. The article said the case highlights "a growing conflict over skyrocketing health care costs pitting employer-based, selffunded insurance plans against hospitals," and added that "a growing number of employers are refusing to pay the full amount of the hospital bills of their workers due to alleged price gouging by the hospitals." The piece continued, "As justification, they point to data that consultants have unearthed showing wide disparities in hospital billing." Angelman Syndrome Receives Its Own Medical Code. The Atlantic (6/29, Yong, 3.08M) reported that Angelman syndrome has been granted its own medical code, 093.51 , under the International Classification of Diseases. The article said the medical standard allows researchers "to interrogate large databases and find out how many patients have a particular disorder, what secondary problems they experience, what treatments they typically receive, how many times they're admitted to the hospital, and more. Insurers use them to decide what treatments should be reimbursed." Oklahoma Drafts Rules To Regulate Medical Marijuana Following Successful Legalization. The A P (6/30) reported that Oklahomans voted to legalize medical marijuana Tuesday "via State Question 788, which passed with about 57 percent support in an election with unusually high turnout." Now, the state health department is circulating draft rules to regulate medical marijuana licenses for patients, caregivers, and businesses in a move to tighten the new legislation that the AP said is "broad." The proposed rules would ban "dispensaries near schools, indoor smoking in public places and psychoactive gummy bears," and "lay out guidance for doctors interested in recommending marijuana, patients who want to California Vaccine Skeptic Put On Probation By State Medical Board. The Los Angeles Times (6/29, Karlamangla, 4.03M) reported that the Medical Board of California has ordered 35 months' probation for Dr. Bob Sears, "an Orange County pediatrician well-known for being sympathetic to parents opposed to vaccines." According to the Times, "Sears can keep practicing medicine but will be required to take 40 hours of medical education courses a 30 EXT-18-248-D-000459 year, as well as an ethics class, and also be monitored by a fellow doctor." In addition, he "must notify all hospital and medical facilities where he practices of the order and is not allowed to supervise physician assistants or nurse practitioners." dementia and Alzheimer's disease." The research is considered "vital for dementia treatment as the condition becomes more and more prevalent," the piece said, adding, "NIH also recently convened a group of leading experts to discuss how to best foster a collaborative research environment and use precision medicine to ultimately discover a cure for these chronic, degenerative conditions." Opinion: Antibacterial Debate Must Weigh Risks, Benefits. Bloomberg View Ohio, Washington Officials Confirm West Nile Virus-Carrying Mosquitoes. (6/29, 4.46M) opinion columnist Faye Flam wrote about the safety concerns surrounding the antibacterial chemical triclosan, and highlighted recent evidence which showed the chemical can have negative side effects. Flam wrote, "There's only one rational way out of this bind: to think about safety not as a black or white issue, but to consider risk-benefit ratios." Flam said "the FDA did consider both sides of the equation in 2016, when it required companies to phase triclosan out of soaps and body washes, citing safety concerns and lack of evidence for any benefit." Newsweek (6/29, Spear, 2.18M) reported Ohio and Washington health officials "are urging people to protect themselves against mosquitoes after insects in these states tested positive for the West Nile virus." Data from the Ohio Department of Health showed "mosquitoes near Alexandria, Johnstown and Harrison Township in Ohio had the virus," while Washington officials "discovered a pool of mosquitos that tested positive for the virus in Benton County." The article added that the National Institutes of Health says severe cases of West Nile virus in humans can "affect the nervous system, and trigger conditions including meningitis, and inflammation of the brain called encephalitis." Woman's Facebook Post Says Menthol Shaving Cream Soothes Sunburns. TODAY (6/29, Murray, 1.19M) reported that in a Facebook post, a woman discusses her "trick to getting rid of sunburn," which is "applying menthol shaving cream on the burn, which the poster said 'takes the heat out' and soothes skin." However, "dermatologists say it's no magic solution for sunburns, although it might provide some relief." Michigan's Detroit Area Becoming A "Hotspot" For Vaccination Waivers, Study Suggests. The Detroit News (7/1, 71OK) reports that according to health researchers, a growing number of "parents choosing not to vaccinate their children for nonmedical reasons" has led to the rise of '"hotspots' across the country and in Metro Detroit." The piece says that since 2009, "the number of kindergarten-age children enrolling in school with non-medical waivers has climbed in 12 of 18 states that allow the exemptions, according to a peer-reviewed study published June 12 in the Public Library of Science journal PLOS Medicine." Cities including "Troy, Warren and Detroit were among the areas in Michigan where more than 400 kindergartners had received the non-medical vaccination exemptions, according to the PLOS report." AMA President-Elect Profiled. The AP (7/1, Severino) profiles Patrice Harris, MD, who "will become the 174th president of the AMA in June 2019, and is now serving as president-elect." Dr. Harris "was elected to the post earlier this month." The AP adds , "In her vision for the AMA, Harris said she wants to improve the education of up and coming medical professionals." The article also points out that Dr. Harris "served on the American Psychiatric Association board and was later named by the APA as a delegate to the AMA." AARP Dedicates $60 Million To Dementia, Alzheimer's Disease Research Fund. Health IT Analytics (6/29) WPost: Stalling Malaria Fight Could Jeopardize Children's Lives. The Washington Post (7/1, 15.68M) editorial says that while the number of malaria cases and deaths have declined steadily for a decade and a half as "global public-health officials have been at war" reported the AARP's Brain Health Fund has vowed to "invest $60 million in the Dementia Discovery Fund (DDF) to accelerate the development of innovative treatments for 31 EXT-18-248-D-000460 with the disease, the "battle shows signs of stalling." In 2016, "the number of malaria cases went up to 215 million, from 210 million the year before," the Post says, adding that malaria "kills more than 445,000 people annually, about 70 percent of them children under 5 years old." The Post adds that the fight against malaria will be won "by action on many fronts. A stall, after so much promise, would be terrible and costly." daughter to undergo genetic testing, finding that she "tested positive for the same mutation as her mother" and prompting her to undergo a double mastectomy. The piece noted that the National Cancer Institute reports "about 69 percent of women who inherit a harmful BRCA2 mutation will develop breast cancer by the age of 80." Indiana Resident Contracts Rare Flu Strain After Exposure To Pigs At Fair. Republican (6/29, Flynn, 412K) reported Congress has passed the Firefighter Cancer Registry Act, which "allows the Centers for Disease Control and Prevention under the Secretary of Health and Human Services to create a voluntary and inclusive national registry that would allow scientists and others to track jobrelated cancer incidence for both career and volunteer firefighters." The legislation also "authorizes $2.5 million for each of the fiscal years 2018 through 2022 to carry out this broader collection of data to help improve measures to protect firefighters." The piece added that the National Institute for Occupational Safety and Health in 2010 "began a five-year study of nearly 30,000 firefighters" which found they "have a greater number of cancer diagnoses and cancerrelated deaths," which helped spur the creation of the legislation. Congress Passes Firefighter Cancer The Springfield (MA) Registry Act. The Indianapolis Star (7/1, Fittes, 477K) reports health officials are warning Indiana residents "to take preventative measures this fair season, after an Indiana resident caught the influenza virus following a visit to a county fair." In what is "the first human case of the H3N2 influenza in the Indiana since 2013, and first case reported nationwide this year, according to the Centers for Disease Control and Prevention," a resident has been sickened with a flu strain "commonly associated with contact with pigs, the Indiana State Department of Health and Indiana Board of Animal Health said in a statement Friday." Op-Ed: New Chemotherapy Study Underscores Importance Of NonInferiority Trials. Contributor Dr. Conor Lavelle wrote for Quartz (6/29, 788K) that a study published in New England Journal of Medicine assessing the effectiveness of "chemotherapy for a specific, common variant of breast cancer. ..found that thousands of women may not actually need to undergo the intensive, painful treatment." Dr. Lavelle considers this "another important victory for something called a 'noninferiority trial,"' which "is arguably our most powerful weapon in the war against unnecessary or harmful pharmaceuticals - and it starts with putting people first." Amazon's Latest Deal Shows It Plans To Disrupt How Industry Cares For Chronically Ill. STAT Plus (6/29, Ross, Subscription Publication, 27K) reported that Amazon's acquisition of the home delivery pharmacy PillPack makes clear the company's ambitions to "not only fundamentally change treatment of U.S. patients, it wants a large chunk of the $370 billion market for selling and distributing their prescription drugs." The PillPack deal "gives Amazon the infrastructure to become a national seller of prescription drugs," noting that "PillPack is already an in-network pharmacy for all the largest pharmacy benefit managers." STAT Plus adds, "To turn the corner in the pharmacy business - and lower costs within its own ranks Amazon will need to figure out how to improve services for the chronically ill population." Loved One's Cancer Diagnosis Can Spur Others To Seek Preventive Care. U.S. News & World Report (6/29, Howley, 1.97M) examined the impact of watching a loved one endure cancer treatment , noting it "can have a hyper-focusing effect for many people." The article spotlighted the case of one woman who was diagnosed with breast cancer and whose daughter after determining that the family had a history of "known breast-cancer causing mutation" on their BRCA2 genes. The ordeal caused the US Judge Rules AbbVie, AndroGel Partner Owe $448 Million In Antitrust Case. Reuters (6/29, Raymond) reported that on June 29, US District Judge Harvey Bartle in 32 EXT-18-248-D-000461 Philadelphia ruled "that pharmaceutical company AbbVie Inc. used sham litigation to illegally prevent generic versions of testosterone replacement drug AndroGel from getting to market and ordered the drugmaker and its partner to pay $448 million." The ruling was for an antitrust suit filed in 2014 by the FTC against both AbbVie and partner Besins Healthcare. The FTC had alleged AbbVie and Besins filed "baseless patent infringement lawsuits in 2011 against generic drugmakers Teva Pharmaceutical Industries Ltd and Perrigo Company to delay the launch of their generic versions of AndroGel." More Suits Filed Against Florida Drugmaker Accused Of Selling Contaminated Medicines. The South Florida Sun Sentinel (6/29, Hurtibise, 601 K) reported that more suits have been filed against South Florida drugmaker PharmaTech LLC and its principals and distributors. The company is now facing seven suits "on behalf of patients said to have been sickened or killed, including three infants who reportedly died after being given a liquid stool softener made by the company." The company vacated its Davie, FL plant in June 2017 following FDA inspection reports in August 2016 and May 2017 that "identified numerous quality control deficiencies in its manufacturing processes," the Sentinel reported. The latest suit, filed in June in Broward County Circuit Court, identified the victim of an outbreak of water-borne bacteria "as Londyn Simone Manuel, who was born with a congenital heart defect in December 2016, and died before turning 8 months old after being given liquid docusate" made by the company. Amazon's PillPack Deal May Provide It With Access To Sensitive Health Data. The Wall Street Journal (7/1, Stevens, Terlep, Subscription Publication, 6.13M) reports that Amazon's acquisition of PillPack will provide it with information about people's prescriptions, a move into the health and medical records space which the Journal describes as much more detailed than Amazon's previous efforts to track customers' purchases of things such as movies or toiletries. The Journal reports that an Amazon spokeswoman said the company plans to comply with regulations, including HIPAA. District Court Extends lndivior's Order Blocking Launch Of US Generic Reuters (6/29, Addiction Treatment. WSJournal: Amazon's PillPack Deal Will Benefit Consumers, Force Competitors To Improve. The Wall Street Varghese) reported that on June 29, the US Court for the District of New Jersey "extended a restraining order blocking" Mylan NV and Dr. Reddy's from launching a generic version of lndivior's Suboxone (buprenorphine and naloxone) Film, an opioid addiction treatment that generates around 80% of lndivior's revenue. "lndivior said its temporary restraining order (TRO) issued on June 15 had been extended for another 14 days, during which time the U.S. court for the District of New Jersey will consider the application and issue a ruling on the injunction." Journal (6/29, Subscription Publication, 6.13M) editorialized that Amazon's acquisition of online pharmacy PillPack will enable the company to grow rapidly to compete with drugstore industry giants. The combination will help patients get drugs faster and cheaper and will force competitors to improve service, the Journal adds. The article concludes Amazon's decision to enter the drug delivery industry is welcome, and could benefit consumers in the long run. Similarly, a Forbes (6/29, 10.34M) column written by Christopher Walton suggested that Amazon's entry into the industry will likely have an impact on CVS and Walgreens . Meanwhile, for Bloomberg View (6/29, 4.46M) , Faye Flam wrote, "If Amazon's move to disrupt health care is going to make Americans any healthier, the improvement is most likely to take place in the business of getting prescription drugs to patients more reliably." FDA Cites Mylan For Morgantown Plant Manufacturing Issues. The Pittsburgh Post-Gazette (6/29, Sabatini, 507K) reported that on June 28, Mylan announced the FDA cited it in April for manufacturing issues at its Morgantown, WV plant. Among the issues an FDA inspection report cited were "numerous instances of a lack of appropriate oversight by the quality unit," along with problems related to "cleaning procedures used to prevent cross-contamination of drug ingredients." In a statement, Mylan said, "The company has submitted a comprehensive 33 T " " EXT-18-248-D-000462 cost of treatment could go up to $10,000 per patient." Mass Device (6/29, Perriello) reported that the FDA "granted pre-market approval under its breakthrough devices designation," based upon "a 190-patient study comparing treatment with Zephyr , plus standard medical management and pulmonary rehabilitation, to treatment with standard medical management and rehab only." The trial benchmark "was at least a 15% improvement in pulmonary function score," and around "47.7% of patients in the Zephyr arm met that mark, compared with 16.8% of the control arm, according to the FDA." response to the agency and committed to a robust improvement plan." Report: Nearly All Online Pharmacies Illegal. Newsweek (7/1, Hugo, 2.18M) reports that "if you buy drugs from an online pharmacy, there's a good chance that exchange is illegal - or worse." In a report on darknet opioid sales, the Center for Safe Internet Pharmacies "found that people on both the darknet and surface web sell drugs like opioid painkillers through online 'pharmacies,' 97 percent of which operate illegally, according to the FDA." Many of these online "pharmacies" are actually "drug-dealing websites set up to look like they simply sell prescription pills to those in need, and some claim to offer prescriptions." CSIP Executive Director Marjorie Clifton "said that some non-opioid-selling pharmacies are legal, if they follow certain rules," such as having "brick-and-mortar locations," as well as being "licensed in every state that they sell to." NYC Expands Lead Testing Program For Children. The New York Times (7/1, A18, Ferre-Sadurnf, 19.33M) reported that in New York City, "the exact number of children residing in public housing poisoned by lead was never disclosed." This past weekend, however, "the city department of health offered a number," saying that "820 children younger than 6 were found to have elevated levels of lead in their blood between 2012 and 2016.'' AM New York (7/1, Cook, Trangle, 591 K) reports on its website that on July 1, New York City Mayor Bill De Blasio's Administration announced an expansion to a program to test lead levels in children. The city now will start "environmental investigations for all children younger than 18 who test above a blood lead level (BLL) of 5 micrograms per deciliter," an adjustment from the previous level of "1O micrograms per deciliter." The city health department has already started "investigations for children at NYCHA developments and will implement the new rules for the rest of the city by the end of the year, according to the mayor's office." The news follows the "day after a Daily News report that revealed the city knew of more than 800 children living in NYCHA apartments between 2012 and 2016 who had blood lead levels between 5 and 9 micrograms per deciliter." The New York Post (7/1, Hicks, 4.46M) reports, "As many as 820 children in the city's housing projects tested for elevated levels of lead, but health officials failed to follow up and inspect their apartments, City Hall admitted Saturday." Despite the CDC in 2012 implementing a recommendation "that authorities take action if children test positive for having more than 5 micrograms of the compound in their blood," New Missouri Appeals Court Rejects $55 Million Verdict Against Johnson & Johnson In Talc Powder Suit. Reuters (6/29, Bellon) reported that on June 29, a Missouri appeals court "threw out a $55 million verdict against Johnson & Johnson in a lawsuit by a woman who claimed she developed ovarian cancer after using talc-based products, including J&J's baby powder." The appeals court's decision to dismiss the 2016 verdict cited "a 2017 U.S. Supreme Court decision that limits where companies can be sued for personal injuries" and that found that "state courts cannot hear claims against companies that are not based in the state or when the alleged injuries did not occur there." In a statement, J&J "said it was extremely pleased with the court's decision to recognize that the trial should have never occurred." FDA Approves Pulmonx's Valve For Emphysema. Reuters (6/29, Mitra) reported that on June 29, the Food and Drug Administration "approved Pulmonx lnc.'s valve to treat" emphysema. The valve works by being "permanently implanted using a catheter in the affected part of a patient's lung," then regulating "the airflow to the healthier parts" of the lung. The average patient "may need four valves and depending upon the severity of emphysema, the 34 EXT-18-248-D-000463 York City "health officials continued to use the CDC's old 10-microgram standard, meaning these 820 positive tests would not have been forwarded by city health officials to the New York City Housing Authority and would not have triggered a home inspection - potentially allowing the exposure to continue." Coverage For Vision Care. The AP (6/29, Matthews) reported that starting July 1 in New York, "drivers for car services and ride-hailing apps like Uber and Lyft" will "now be able to get coverage for vision care as well as phone or video appointments with doctors, industry representatives announced." This "coverage for an estimated 43,000 drivers statewide will be paid for by the Black Car Fund, a workers' compensation fund for car-service drivers that is funded by a 2.5 percent surcharge on each ride." Learning To Play Piano May Help Children Build Up Language Skills, Study Indicates. TIME (7/1, Ducharme, 19.27M) reported research indicates learning to play the piano may help children "build up their language skills ." As youngsters' "ears become trained to distinguish between different pitches and tones at the piano ...they also seem to get better at parsing subtle differences between spoken words, a key element of language acquisition," the study revealed. The findings were published online in the Proceedings of the National Academy of Sciences. Scientists' Discovery Is "First Step" To Packaging Insulin In Pill. The Boston Globe (7/2, 945K) reports that two developments - "a newly released study and the publication of new clinical trial data" - describe "advances toward an alternative approach" to diabetes management: "the delivery of blood-sugarregulating hormones in a pill, long regarded as the 'holy grail' of diabetes treatment." The study, "by University of California Santa Barbara and Harvard University scientists, demonstrated a technical breakthrough in the oral delivery of insulin, a hormone produced in the pancreas that allows the body to absorb and store sugar from the blood." This discovery "is the first step in a longer process to package insulin in a pill that could take many years." Enclosing insulin "in a particular ionic liquid, aptly named CAGE, has the dual benefit of protecting the hormone from stomach acid and promoting its absorption through layers of mucous and the intestinal wall. That could help it reach the liver." One promising note, "experts say, is that the two ingredients of CAGE, choline and geranic acid, are generally regarded as safe by the Food and Drug Ad ministration." Tech Company CEO: Children Need To Be Guided Through Technology Thoughtfully. In an opinion piece in USA Today (6/30, lngram-Cauch i, Contributor, 11.4M), Pete lngram-Cauchi, "CEO of iD Tech Camps, a STEM education company based in" California, wrote that even though "technology has its downsides ...it holds untold promise and it is not going away." Children "just need to be guided through it thoughtfully and led to a place of creativity and passion." Factors Behind Lagging Mainstream Adoption Of Telemedicine Examined. CNBC (6/30, Farr, 4.81 M) examined factors behind lagging mainstream adoption of telemedicine. The primary and "most important" factor "is that many U.S. consumers are still not aware they have the option to chat with their doctor over the phone or via video." In addition, patients who have "heard of telemedicine apps often fear the expense, especially if it's unclear whether they can use their health insurance." What's more, clinicians "who are willing to work with app makers are inexperienced, or lowquality." Many clinicians "are afraid of liability, as it's possible to miss something during a remote visit," and "reimbursement questions" remain . Roche Encouraged By Tecentriq Trial Reuters (7/2) reports Swiss ResuIts. drugmaker Roche "said on Monday that a trial showed its immunotherapy Tecentriq plus the chemotherapy Abraxane significantly reduced the risk of disease worsening or death in people with metastatic triple negative breast cancer." The company, "citing its 1Mpassion130 study, said it also recorded an encouraging overall survival benefit for the PD-L 1 positive population, whose tumors express a protein that help them evade immune system detection, at interim analysis." Drivers For Car Services, Ride-Hailing Apps In New York Now Able To Get 35 EXT-18-248-D-000464 Angela Garbes' New Book "Like A Mother" Discussed. ABC's Good Morning UK's NHS Making Plans To Ensure Ample Medical Supplies After Brexit. America (7/2, Kindelan, 4.2M) discusses mother of two and author Angela Garbes' new book, "Like a Mother: A Feminist Journey Through the Science and Culture of Pregnancy," which GMA says "gives women straight talk on pregnancy, their bodies and life after giving birth." One topic the book covers is "lack of post-delivery care for new moms." Garbes' interest in post-delivery care for moms "stemmed from hip pain she suffered after giving birth." The piece adds that the American College of Obstetricians and Gynecologists "recently launched an initiative to address the issue of postpartum care for new moms called 'the fourth trimester."' The AP (7/1) reports that Britain's National Health Service "is making plans to ensure that medical supplies will be available if Britain leaves the European Union without a trade deal." NHS chief Simon Stevens said Sunday there is "significant planning" underway to make sure the NHS "can cope with a no-deal Brexit without a disruption in services." Stevens explained that Britain's health agency and other governmental departments are working to make sure supplies of medicine and medical equipment can still be accessed under various Brexit scenarios, according to the AP. Reuters (7/1) reports that Stevens said the NHS is "working with pharmaceutical companies to make sure there will be no breakdown in supply if there is no deal with the EU." Hawaii Bans Sale Of Sunscreens Containing Oxybenzone, Octinoxate. Irish Cancer Patients Received Faulty Tests From US-Based Labs. The CBS NPR (7/2, Fulton, 3.55M) reports Hawaii's governor David lge is expected "to sign the world's first ban on the sale of sunscreens containing the chemicals oxybenzone and octinoxate this week." The state is "banning the products because of concerns they may be harming one of the state's biggest attractions coral reefs." Both chemicals "have had the Food and Drug Administration's OK for decades , but in recent years, some environmental research has suggested octinoxate can contribute to coral bleaching and that oxybenzone exposure leads to the death of baby coral." Evening News (6/29, story 7, 2:45 , Glor, 5.29M) reported American laboratories Quest Diagnostics and Clinical Pathology Laboratories (CPL) "are coming under scrutiny because of faulty cancer tests in Ireland," where hundreds of women "were told they tested negative, only to find out years later they had cancer all along." Correspondent Roxana Saberi reported that Quest and CPL along with "an Irish lab processed smear tests for Ireland's health service. A government review four years ago found that the labs mistakenly cleared more than 200 women ...who were later diagnosed with cervical cancer." Since that time, "18 of those women have died. But most of the women affected were never told until one of them ...discovered a page from that review in her medical file." GLOBAL HEALTH Britain's NHS To Reduce "Unnecessary Or Risky Procedures." The A P (6/30) reported that Britain's NHS has proposed cutting back on operations including breast reductions and anti-snoring treatments as part of plans to save money and reduce "unnecessary or risky procedures." NHS medical director Stephen Powis said the agency "could save an estimated 200 million pounds ($264 million) a year by tightening the criteria for treatments where the risks could outweigh the benefits." According to the AP, "the list of 17 treatments under consideration to be halted or reduced includes tonsil removals and procedures for carpal tunnel , hemorrhoids and varicose veins." Global Fund Combating AIDS, TB, Malaria Cancels Funding For North Korean Public Health Efforts. Science Magazine (6/29, Stone, 441 K) reported The Global Fund to Fight AIDS, Tuberculosis and Malaria announced that effective June 30, it will revoke its grants to North Korea, a revelation which "leaves the isolated nation with about 1 year to line up a new source of medicines and diagnostics to combat a deepening [tuberculosis] crisis." Medical researchers say they have "not gotten any clarity on why they are doing this," adding that the fund's financial contributions of more than $100 million to TB and malaria control 36 EXT-18-248-D-000465 out of an 11,000-strong flock on a farm in Boankra in the Ashanti region, while the other killed 5,935 out of 13,188 birds on a farm in Nkawkaw in the Eastern region." in the country "has been the biggest outside investment ever in public health in North Korea." Novartis, Gilead CAR-T Therapies Both Gain European Panel Recommendation. Reuters (6/29, Miller) Researchers Warn That Gay Hate Climate In Indonesia Is Fueling HIV Epidemic. The AP (7/2, Wright) reports on an reported that rival cancel therapies from Gilead Sciences and Novartis both won recommendations from the European Medicines Agency's Committee for Medicinal Products for Human Use. The committee recommended both Gilead's Yescarta (axicabtagene ciloleucel) and Novartis' Kymriah (tisagenlecleucel) for diffuse large B cell lymphoma, while it also recommended Yescarta for primary mediastinal B cell lymphoma and Kymriah for B cell acute lymphoblastic leukemia. Both of the CAR-T therapies are singleuse treatments "in which immune cells are removed from patients, genetically engineered in the laboratory using disarmed virus to target their blood cancers, and then re-infused." Both drugs range in price in the US from between $373,000 and $475,000, depending on the cancer being treated. Fierce Pharma (6/29, Sagonowsky) reported that both treatments received US approval several months ago. One reason for the high cost of the drugs "is their unique, patient-specific manufacturing," as "CAR-T drugs are made of reengineered T cells collected from each patient, which are then infused back into the patient to attack cancer." Gilead recently said it will build "a CAR-T manufacturing plant at the Amsterdam airport in an effort to cut down on logistics and manufacturing turnaround time." "out-of-control but little-acknowledged epidemic of HIV among gay men in Indonesia that researchers say is being fueled by a gay hate climate whipped up by the country's conservative political and religious leaders." A Human Rights Watch report released Monday explained that "highly publicized police raids targeting gay men and a vicious outpouring of anti-LGBT rhetoric from officials and other influential figures since early 2016 have caused significant disruption to HIV awareness and testing programs." TIME (7/2, Haynes, 19.27M) reports Kyle Knight, an LGBT rights researcher at Human Rights Watch and author of the report, said, "What's shifted in the last two years is that the government and police have made it abundantly clear that it's perfectly okay to hate LGBT people and to act on it." He cautioned, "Unless certain steps are taken to dial back on these raids, to create safe spaces for those to gather to gain information, to get safety, sense of dignity, community and privacy, this will spin out of control not just from a human rights perspective, but also from a public health perspective." TIME adds, "Combined with the crackdown and heightened discrimination against LGBT people, the impending health crisis threatens to force the community into total retreat." AstraZeneca Receives "Speedy Approvals" For Cancer Drugs In Japan. Reuters (7/2) reports AstraZeneca has India Celebrates End Of Nipah Virus Outbreak With Music Video. NPR (7/1, Thiagarajan, 3.55M) reports India's Nipah virus outbreak "in May had all ingredients of an-edgeof-the-seat medical thriller" as the nation battled "one of the most lethal pathogens of our times." The article says, "Three weeks after Nipah had been identified as a cause of the outbreak, on June 10, Kerala's Minister for Health, K.K. Shylaja, declared that the state was Nipah-free. Of the 19 cases, two patients have recovered." After the outbreak was declared over, "a group of musicians and filmmakers decided to make a video to celebrate." won "rapid regulatory approval for new uses of two of its important cancer drugs in Japan , less than six months after the first global approvals in Western markets." The decisions by the Japanese Ministry of Health, Labour, and Welfare "reflect an increased urgency by officials in the country to access modern medicines, after many years of slow adoption." Ghana Reports HS Bird Flu Outbreaks. Reuters (6/29, Trompiz) reported that Ghana announced two outbreaks of "highly pathogenic H5 bird flu" on farms in the country. According to Reuters, "one of the outbreaks killed 5,431 birds 37 EXT-18-248-D-000466 WTO Upholds Packaging Law. Australia's regardless," which "was the way her generation coped," but has proved "disastrous" for her carers because "whenever we hoped she'd understand some new limitation, or accept a new level of care, we _had to choose between complicity in a facesaving but ultimately pointless pretence and provoking unreasoning anger." While "Kath had argued for the right to die, has a living will, and would have been horrified to see herself like this " now Lyall says that as "the power to let her go ha~ fallen to me, it's not so simple." Lyall wonders whether someone's "younger self' should "be allowed to make such decisions about the person they are now." Plain- Fortune (6/29, Meyer, 3.91 M) reported in continuing coverage that the WTO l~st week ruled in favor of Australia's plainpackaging laws and said the country "is free to continue selling cigarettes in drab, olive-colored packaging without no branding beyond the manufactur~r·s name in small print, and with large and graphic health warnings dominating the packaging." The article said the WTO's decision "will likely have major ramifications around the world." Bloomberg View (7/1, 4.46M) columnist David Fickling says "the world's ugliest cigarette packets aren't going away." Fickling says claims that Australian plain packaging does not make much of a difference do not "stand up to a lot of scrutiny: Studies supporting that claim have either been based on non-public data that can't be checked, or commissioned by the industry, or both, according to a 2016 analysis by Australia's Department of Health." NATIONAL NEWS Trump Predicts Quick Supreme Court Confirmation "If I Pick The Right Person." During an interview Sunday with Fox News' Sunday Morning Futures (7/ 1, Bartiromo, 1.79M), the President vowed he would "pick somebody who is outstanding" to replace retiring Supreme Court Justice Anthony Kennedy. He also predicted that while Democrats would work to resis~ his choice, "I think it will go quickly if I pick the ~1~htperson." The Washington Examiner (7/ 1, Cha1t1n , 340K) reports the President also predicted a "big week" ahead, declaring in a tweet Sunday he will be focused on deciding who he will nominate to succeed Kennedy. Media reports, however, cast the President as ready for a fight with Democrats over his pick. On ABC World News Tonight (7/ 1, story 4, 2:50, Llamas, 14.63M) , for example, Tara Palmeri said Trump is "preparing for battle tonight over his highly anticipated Supreme Court pick." Trump: "It's probably going to be vicious because the other side, all they can do obstruct and resist. You know, their whole thing is resist." NBC Nightly News (7/1, story 6, 2:00, Jackson, 8.26M) reported, "A vicious but fast fight. That's what President Trump says he expects once he announces the second Supreme Court nominee of his Administration" next week under "his selfimposed deadline." Kelly O'Donnell said the Pre~ident, ~ho is "on the trail this week, is already touting the influence of his high court selection to rally his own base." .. The CBS Weekend News (7/ 1, story 4, 2:40, Qu1Jano , 5.32M) reported that while Trump "voiced confidence that his yet-to-be-announced Supreme Court nominee will be confirmed soon," his choice Russians Protest Pension Age Hike. Reuters (7/ 1) reports that although "thousands of Russians protested on Sunday over a government decision to increase the retirement age ...there were no demonstrations in the cities hosting the World Cup because of security restrictions in force during the tournament." Published photos of the prot_ est featured . individuals with signs saying Raise the pension, not the pension age!" and "Han_ds off our pensions!" A "close ally of President Vladimir Putin" last month stated "that the government wanted to raise the retirement age for men by five years, to 65 from 60, and for women by eight years, to 63 from 55," which supposedly is "to ease intense pressure on state co~ers," per ~euters , while "critics say the retirement age 1n many regions is higher than life ex~ectancy." Some polls reported Putin's approval rating dropped from 75 to 69 percent following the announcement. Son Debates Assisted Dying Amid Mother's Alzheimer's Diagnosis. Bernard Lyall writes in The Guardian (UK) (7/1, 4.0~M) about his mother's Alzheimer's diagnosis, saying that "she who has lived entirely by her wits ~as _no';:' lost them" to a w~rd carrying "the ring of finality. Lyall says despite several emotional "blows," his mother retained "her instinct to put on a brave face, try to ignore it and muddle through 38 T " " EXT-18-248-D-000467 that opposes abortion. So he already knows how anyone on the list will vote on abortion, meaning he doesn't have to ask their views on the issue." The Washington Free Beacon (7/1, Kugle, 67K) notes that "all four names Leo mentioned are on Trump's list of potential Supreme Court justices ," but when asked if they are the front runners, Leo said, "No, I don't think it's fair to say that, and here's why . The president is really in the driver's seat along with the assistance of White House counsel Don McGahn. Those are people who are under very serious consideration." Sen. Richard Blumenthal said on CBS' Face the Nation (7/1, Brennan, 3.28M), "The President has said that he will appoint someone only if he or she would 'automatically overturn Roe v. Wade."' He added, "This decision will shape the Court for years to come and it could lead to criminalizing reproductive rights, as they were prior to Roe v. Wade when women were prosecuted and women died." The AP (6/30, Harrisburg (PA), PatriotNews), meanwhile, reports that "some evangelical leaders are downplaying their fortune on an issue that has defined their movement for decades." Jerry Falwell Jr. told the AP, "What people don't understand is that if you overturn Roe v. Wade, all that does is give the states the right to decide whether abortion is legal or illegal. My guess is that there'd probably be less than 20 states that would make abortion illegal if given that right." Sources: White House Officials Eyeing Exits Likely To Stay Through Confirmation. ABC News (7/1, Palmeri, 1.85M) reports on its website that "top White House officials worn out from the chaos of the Trump administration and eyeing the exits in the coming weeks are now considering staying on through the confirmation of a Supreme Court justice, three White House officials and two outside advisors" say. White House Counsel Don McGahn, Legislative Affairs Director Marc Short and Domestic Policy Director Andrew Bremberg "have told colleagues in the days following Supreme Court Justice Kennedy's retirement announcement that they plan to stay on staff through the confirmation process." Cantwell: Wrong Vote On Nominee Could Be "Career-Ending Move." The Washington Times (7/1, Richardson, 460K) reports Sen. Maria Cantwell (D-WA) "warned her colleagues Sunday that a wrong decision" on President Trump's nominee could become a "career-ending move." Cantwell told NBC's Meet the Press, "I think that "needs the backing of nearly all Senate Republicans." According to the Wall Street Journal (7/1, Armour , Nicholas, Subscription Publication, 6.13M) , White House officials are also meeting with Democrats, including the three who voted last year for Justice Neil Gorsuch: Sens. Joe Manchin, Heidi Heitkamp and Joe Donnelly. USA Today (7/1, Estepa, 11.4M) reports that while Trump said he is "going to pick someone who is outstanding," the "eventual nominee already faces a hurdle: Republicans hold a slim 51-49 majority in the Senate, and Sen. John McCain is out as he battles brain cancer. That means the president needs to cater to senators on both sides of the aisle if he hopes to get a majority to vote in favor of his pick." Reports also continue to cast the issue of abortion as likely to be a focal point of the eventual nominee's confirmation hearings. Breitbart (7/1, Key, 1.28M) says Trump "hinted at the possible overturning of Roe v. Wade" during his interview with Fox News, saying the legality of abortion "could very well end up with states at some point." Asked if abortion rights should be decided by the states, Trump said, "Well, maybe someday it will be to the states. You never know how that's going to turn out. That's a very complex question. The Roe v. Wade is probably the one that people are talking about in terms of having an effect. But we will see what happens. But it could very well end up with states at some point." TIME (7/1, Langone, 19.27M) reports that in the interview with Fox News, "Trump acknowledged that the status of Roe v. Wade is one of the key issues in the public's mind," but Newsweek (7/1, Fearnow, 2.18M) says he "hesitantly added, however, that he's not going to be 'so specific with the questions' used to query" candidates. Yahoo! News (7/1, Walsh, 12.44M) reports Trump, however, told Fox News, 'They 're all saying, 'Don't do that. You don't do that. You shouldn't do that.' But I'm putting conservative people on and I'm very proud of Neil Gorsuch. He's been outstanding. His opinions are you know so well written, so brilliant. And I'm going to try and do something like that but I don't think I'm going to be so specific in the questions I'll be asking. And I'm actually told I shouldn't be." NJ News (7/1, Salant, 1.17M), however, notes that Trump "has pledged to nominate justices who will overturn Roe v. Wade," and "said he would choose from a list of people vetted by the Federalist Society, a conservative legal group 39 EXT-18-248-D-000468 of the Special Counsel investigation and the probability of the justice Trump appoints ruling in the case, said, "I think that is a ridiculous argument that is made as just an attempt to make way for the real position, which is that President Trump should never be able to confirm a vacancy." He added, "I don't remember hearing the Democrats making that argument when President Bill Clinton was in fact personally under investigation when a vacancy occurred. My understanding is that President Trump is not himself personally the subject of the investigation even. I think that is a non-argument." my colleagues on both sides of the aisle know that this vote could be one of the key votes of their entire career. And they know that no matter what spin comes out of the White House, if they vote for somebody who's going to change precedent, it could be a career-ending move." The Hill (7/1, Birnbaum, 2.71 M) also reports Cantwell's comments. A Washington Times (7/1, McLaughlin, 460K) analysis, meanwhile, says "red-state Democrats seeking re-election this fall were already facing the difficult task of navigating between their own virulently anti-Trump national party and the Republican-leaning voters needed to win back home. But that narrow path has become even more of a tightrope now that incumbents will be asked to take sides" on the President's nomination. The Times says if Republicans "hold firm, the Senate is likely to vote on a Supreme Court nominee just as the midterm campaign season hits full stride." But it "also means vulnerable Democrats in states such as West Virginia and North Dakota will have to choose between a president who easily won their states in 2016 and a frenzied liberal base intent on blocking anyone he chooses." Seung Min Kim of the Washington Post said on CNN Inside Politics (7/1, 733K), "For Senate Democrats, this is their one chance to really get their base to care about the Court. What we've seen last several years, perhaps the last decade is that conservatives are better at the court issue than Democrats in terms of just getting the base involved, getting their base excited," but "now with potentially the future of Roe v. Wade on the line, Democrats, this is their chance to really get their voters excited and that's why you're seeing the Democratic messaging on the Supreme Court already focusing on not only abortion, but future of the Affordable Care Act." Michael Shear of the New York Times said on CNN Inside Politics (7/1, 733K), "I think one of the things you're going to see is that the Democrats are going to try to make the case that to their base" that abortion and the Affordable Care Act are "something that you have to be united on ...because what the Democrats need is to hold their entire - all 49 and then they only have to peel off one Republican." Toomey: Special Counsel Investigation Should Not Prevent Trump Nomination. Sen. Pat Toomey (R-PA), asked on CBS' Face the Nation (7/1, Brennan, 3.28M) about the question Trump Retweets Elder Joke About Reporter Fired Over False MAGA Hat Claim. The New York Post (7/1, Perez, 4.46M) reports that President Trump on Sunday retweeted "a tweet by conservative radio host Larry Elder...which poked fun at a newspaper reporter who lost his job after he falsely claimed that the Capital Gazette shooter wore a 'Make America Great Again' hat during the massacre." Elder sent the tweet, which read, "BEWARE! #TrumpDerangementSyndrome can be career ending," in response "to an article published by The Hill, which covered the resignation of Conor Berry, a former reporter at The Republican in Springfield, Mass." Hemingway: Press Sought To Tie Trump Mollie To Maryland Newspaper Shooting. Hemingway of The Federalist said on Fox News MediaBuzz (7/1, 1.61M), "It's very difficult when something like this happens. You are desperate for information and speculation runs rampant. I think it's important for journal ists to make sure they are not speculating without evidence. It wasn't just bad that people started trying to tie President Trump to the shooting. It was that after the news came out showing that the shooter had a longstanding grudge against the publication dating back to 2011, many journalists kept saying that they thought this was somehow the responsibility of President Trump ." Waters: People Want Democrats To Be "More Confrontational" Against Trump. Breitbart (7/1, Key, 1.28M) reports that Rep. Maxine Waters told MSNBC AM Joy Sunday that weekend protests over the President's immigration policies show that "the people" want Democrats to be "more forceful" and "more confrontational" in their opposition. Waters said, 40 EXT-18-248-D-000469 "Well, let me just tell you this, first of all, the people of this country, no matter Republican or Democrat, do not like the idea that children have been separated. Republicans are making a mistake thinking they can hold on to that constituency, that so-called belongs to Donald Trump. On this issue, Republicans and Democrats, Independents alike are opposed to what is going on. And yes, people do want to see us being stronger and more forceful and to confront them on these policies." Fox News (7/1, Chamberlain, 16.38M) reports on its website that Waters said she was "surprised" by criticism from Democratic leaders over her call for people to "push back" against members of the Administration. Waters said, "One of the things I recognize, being an elected official, is in the final analysis, leadership ... will do anything that they think is necessary to protect their leadership and so what I have to do is not focus on them." Waters added, "I was blessed with courage. And I was blessed with the kind of strength that does not allow me to be intimidated by the likes of Donald Trump .... Let him call me whatever he wants to call me. Let him say whatever he wants to say. He will not stop me." The Hill (7/1, Wise, 2.71 M) also reports on Waters' comments. Ocasio-Cortez: Democratic Socialism Just "Part Of What I Am." The Washington Times (7/1, Richardson, 460K) reports that in an interview with NBC's Meet the Press Sunday, Alexandria Ocasio-Cortez, who defeated Rep. Joe Crowley in last week's primary in NY14, "downplayed ...her affiliation with democratic socialism," saying , "It's part of what I am. It's not all of what I am. And I think that that's a very important distinction .. .. I'm an educator, I'm an organizer. ... And I believe that what we're really seeing is just a movement for health care housing and education in the United States." Ocasio-Cortez added, "Democrats are a big tent party.... I'm not trying to impose an ideology on all several hundred members of Congress, but I do think that once again it's not selling an -ism or an ideology or a label or a color. It's about selling our values." The New York Post (7/1, Moore, 4.46M) reports that Ocasio-Cortez "faulted Crowley, a 10term incumbent, for not being more closely connected to the community," saying, "I do think there was certainly a lack of presence, and that was a big part of my win . ... There was a lack of listening on the ground. A lack of going to the grocery store and saying 'Hey, how you doi~g?,'. That is an important work of representation. Ocasio-Cortez also "said the Democrats must have a unified message that people can rally around , especially in the fight over President Trump's nominee to the Supreme Court." She said, 'This Supreme Court seat is extremely serious. There is a federal investigation going on with direct implications to the presidency and that presidency is talking about nominating a Supreme Court pick that is going to essentially hear this case out." Todd: Trump Is "Winning," Democrats Are "Reeling." Breitbart (7/1, Key, 1.28M) reports that Chuck Todd, host of NBC's Meet the Press, said Sunday that President Trump is "winning" and Democrats are "reeling." Todd said, "The announced retirement of Supreme Court Justice Anthony Kennedy this week helped make one political reality clear: Despite his overall unpopularity, President Trump is winning, and the Democrats right now are reeling . ... How about the Republican Party? The president's approval rating among Republicans is around 90 percent. Elected Republicans fear criticizing him, and the party has become a cult of personality: his." Todd continued, "Still, much of Mr. Trump's success is superficial. While he's more popular among Republicans, the party overall is shrinking. His trade war, North Korea, or the Mueller investigation all could turn against him and, frankly, turn against him now like North Korea has. But if the Democrats' reaction to the Kennedy retirement proved anything, it's that the Democratic Party has not figured out how to succeed in the Trump era." 1' Alf ll Al\ ,(Q'!ERS~G~T Duckworth: Democrats Can't Go Too Far Left An Win Nationwide. The Washington Examiner (7/1, Ayers , 340K) reports that Sen. Tammy Duckworth warned Sunday that the Democratic Party should not move further to the left if they want to win the presidency. Following the surprising defeat of Crowley by Ocasio-Cortez, an "avowed Democratic socialist," Duckworth told CNN's State of the Union Sunday that "she doesn't foresee that being a winning strategy in the Midwest." Said Duckworth, "I think that you can't win the White House without the Midwest. ... And I don't think you can go too far to the left and still win the Midwest - coming from a 41 EXT-18-248-D-000470 ABC World News Tonight (7/1, story 9, 0:20, Llamas, 14.63M) reported that according to police, at least four people were hurt "when right-wing demonstrators and counter-protesters broke out in brawls," and "at least nine people [are] facing charges." The CBS Weekend News (7/1, story 9, 0:20, Quijano, 5.32M) reported that officials "say they seized knives, clubs, and chemical sprays." Midwestern state." Duckworth urged dialogue with the "industrial Midwest," and said, "You need to listen to the people there in order to win an election nationwide." The Washington Post (7/1, Scherer, 15.68M) says Democratic leaders are "scrambling to keep the political outrage they'd counted on to fuel midterm election wins from becoming a liability for the party." Internal debates "have broken into public view over maintaining civility and the usefulness of liberal slogans like 'abolish ICE,' which some Republicans have embraced to argue falsely that Democrats oppose immigration enforcement." Meanwhile, "liberal activists have begun to argue for more radical measures to counter the president, who they assert presents an immediate threat to the republic." Rachel Bade of Politico said on CNN Inside Politics (7/1, 733K) that Ocasio-Cortez's primary win over Crowley "was a clear message to the top of Democratic leadership in the House that Democrats want change in their hierarchy and they want the establishment out, they want new blood at the top and they are ready to see somebody else lead beyond Pelosi." John King said on CNN Inside Politics (7/ 1, 733K), "If there's a giant blue wave and Democrats win the House by 20 seats, Nancy Pelosi will be okay. She still is the party's premier fundraiser. She still has a lot of loyalty in the caucus. However, if they just squeak by and a whole bunch of candidates promised in their TV ads I won't vote for her, she's going to have to negotiate either a temporary speakership ...or she may have to go." NYTimes Analysis: Supreme Court Ruling Against Unions A Blow To Liberal Groups. The New York Times (7/1, Scheiber, 19.33M) reports that the Supreme Court's ruling "striking down mandatory union fees for government workers" will "hit hard at a vast network of groups dedicated to advancing liberal policies and candidates." Groups that "work for immigrants and civil rights," or "produce economic research" or "turn out voters or run ads in Democratic campaigns," have "benefited from tens of millions of dollars a year from public-sector unions - funding now in jeopardy because of the prospective decline in union revenue." According to liberal activists, cutting off that funding "was a crucial goal of the conservative groups that helped bring the case, known as Janus v. American Federation of State, County and Municipal Employees," and conservatives "have acknowledged as much .... Even President Trump took notice of the justices' ruling, declaring on Twitter that it was a 'big loss for the coffers of the Democrats!"' Trump Says He Wants To Stay "Uninvolved" In Russia Probe, "At Least For Now." President Trump was asked Portland Police Declare Riot, Revoke Permit As Antifa Disrupts Protest. in an interview that aired on Fox News Sunday Morning Futures (7/1, Bartiromo, 1.79M) about Russia investigation. Trump said, "So, I have this country running like a top, Mike Pompeo is doing great." He said, "We have a great group of people" and "the one thing I want to stay uninvolved in at least for now I may get involved but I have been told by so many people don't get involved." He said, "There's no collusion with me ...honestly it is a disgrace but I purposely said I'm not getting involved" and "you know, they found nothing." He said, "By the way, this is the most transparent thing ever done with the White House... I think I gave them a million 400,000 documents I told them don't even read them; there's no Russia mentioned or anything like that." Breitbart (7/1, Huston, 1.28M) reports that Portland, Oregon police "revoked a permit for a pro-America march and declared the scene a riot when counter-protesters erupted in violence on Saturday." The permit had been "secured by the Patriot Prayer group that had planned a march entitled the 'Freedom and Courage' rally. But a large number of members of a local violent, blackclad Antifa group also gathered along the march route and began a series of confrontations with the marchers." According to The Oregonian, the Antifa group "initiated hostilities by throwing eggs, bottles, and other items at the Patriot group, the paper noted." 42 EXT-18-248-D-000471 Judge Rules Rosenstein's Order Gives The Mueller Wide Investigative Latitude. Washington Times (7/1, Scarborough , 460K) reports that understanding the reason special counsel Robert Mueller has expanded his investigation beyond the 2016 presidential race "may require perusing a federal judge 's opinion on June 26 in the Paul Manafort case." District Court Judge T.S. Ellis Ill "dissected Deputy Attorney General Rod Rosenstein's May 2017 appointment order to Mr. Mueller," and "concluded that the prosecutor is empowered to look at virtually any Russian contact." According to Ellis, Rosenstein's guidelines "state that Mr. Mueller is to investigate any links between the Russian government and Trump campaign associates," which means "indirect links" or "potential links," giving Mueller "wide latitude when deciding whether to target a Trump person." customers to accept a high-interest loan on an impulse - just sign the check." Median Prime For A Single-Family Home In San Francisco Bay Area Is $935,000. The CBS Weekend News (7/1, story 8, 2:10, Quijano, 5.32M) reported that "a recent report says the median price for a single-family home in the [San Francisco] Bay area is $935,000. In the city it's even higher." CBS (Strassmann) added that market "is fueled by thousands of well-paid tech workers who have driven up the median price of a San Francisco home to $1.6 million, the highest in the country. And while housing prices are rising faster than incomes nationwide, nowhere is it more evident than in the Bay area, where home values have soared a staggering 64% over the last five years." High Schools Clamp Down On Student Journalists Covering Sensitive Subjects. The New York Times Judge Extends Program Paying For Hurricane Maria Victims' Hotel Stays. The CBS Weekend News (7/1, story 11, 0:30, Quijano, 5.32M) reported that Hurricane Maria evacuees living in hotels have gotten a "short reprieve" as a federal judge "temporarily extended the program that's been paying for their stay." The program was "set to expire at midnight Sunday, but will now end on Tuesday." (7/1, Peiser, 19.33M) reports that high schools across the nation have been pushing back against student journalists "who have reported on sensitive subjects, like the reaction to school shootings and adolescent sexuality." Since a 1988 Supreme Court ruling "that a Missouri school district had acted lawfully in removing a two-page spread on divorce and teenage pregnancy from a student newspaper, administrators have been able to censor work in school publications that they consider poorly written or 'inconsistent with the shared values of a civilized social order."' The Times cites a number of examples but also notes that in some places, "student reporters have delved into difficult subjects without interference or complaint from administrators." Private Equity Group Offer HighInterest Loans To Cash-Strapped The Washington Post (7/1, Americans. Whoriskey, 15.68M) reports that the company Mariner Finance "enables some of the nation's wealthiest investors and investment funds to make money offering high-interest loans to cashstrapped Americans." The company "is owned and managed by a $11.2 billion private equity fund controlled by Warburg Pincus, a storied New York firm," whose president is Timothy F. Geithner, "who, as treasury secretary in the Obama administration, condemned predatory lenders." The Post says the market for "'consumer installment loans,' which Mariner and its competitors serve, has grown rapidly in recent years, particularly as new federal regulations have curtailed payday lending, according to the Center for Financial Services Innovation, a nonprofit research group. Private equity firms, with billions to invest, have taken significant stakes in the growing field." Mariner "stands out for the frequent use of mass-mailed checks, which allows Seattle Bans Plastic Straws, Utensils In Restaurants. NBC Nightly News (7/1, story 8, 2:30, Jackson, 8.26M) reported that Seattle on Sunday joined "the growing list of cities banning plastic straws and plastic forks and knives in local restaurants. They're almost never recycled, meaning they end up in landfills, creating more of a pollution problem." NBC (Fryer) added that "28 cities around the country that have banned or limited plastic straws or are considering it. California and Hawaii are even exploring statewide policies." 43 EXT-18-248-D-000472 per week in order to receive support" or risk being locked out of the program for three years. They note that the Senate version does not include the requirement "that will leave more kids hungry ," and argue that while President Trump "offered his support," for stricter work requirements , the program "should not be restricted" but "expanded, so that fewer families - and especially kids - are hungry." Murdoch Turning Much Of The Company He Built Over To Disney. The Washington Post (7/1, Ellison, 15.68M) reports that 21st Century Fox and News Corp. founder and co-executive chairman Rupert Murdoch is "selling the bulk of the company to Disney." It is "a seminal moment for Murdoch, who is turning over the power to run the company he has spent his career building." The Post adds that with President Trump's election, Murdoch is "at the height of his political influence in the United States, a position he has long sought. Murdoch has a direct line to Trump and close relationships with several Fox News personalities who act as unofficial advisers to the White House." Murdoch and the President "talk weekly and sometimes daily, according to people close to both men." Moreover, with "former Fox News executive and Sean Hannity confidant Bill Shine ...expected to take the job of White House deputy chief of staff in charge of communications," it "only adds to the personal connections between Trump and the Murdoch-controlled news network." In an editorial, the New York Times (7/1, 19.33M) questions the speed with which the Justice Department approved the Disney-Fox deal, saying it took "about half the time that regulators usually need to evaluate deals of this size." Noting that the Department "spent nearly two years investigating AT&T's acquisition of Time Warner and bringing an ultimately unsuccessful lawsuit against the deal," the Times says that while the Administration "has denied that politics plays a role in its antitrust enforcement decisions," it is "hard not to be skeptical of the possible motivations behind the Justice Department's approach to these deals." WPost Welcomes Transfer Of Background Checks From OPM To DOD. In an editorial, the Washington Post (7/1, 15.68M) says the Administration's proposal to transfer responsibility for background investigations for security clearances from the OPM to the Defense Department is change that is "a long time com ing." The Post cites criticism of OPM's "slow processing of background checks" as well as "security concerns" stemming from the agency 's handling of the investigations and says the "transfer of security-clearance responsibilities makes sense." However, the Post says Defense Department must "address these concerns and ensure that the background-check process is efficient, secure and accurate going forward." WSJournal Criticizes Individual, Corporate Tax Hikes In New Jersey. A Wall Street Journal (7/1, Subscription Publication, 6.13M) editorial criticizes New Jersey Gov. Phil Murphy and State Senate leader Steve Sweeney for agreeing to increase New Jersey's state's income tax on residents making more than $5 million and the corporate rate on companies with more than $1 million in income, giving the state the fourth highest income tax rate on individuals and the second highest corporate rate in the nation. Professors Oppose Stricter Work Requirements For SNAP. In an op-ed for EDITORIAL WRAP-UP the New York Times (7/1, 19.33M), Sarah Bowen, Sinikka Elliott And Annie Hardison-Moody, professors who have conducted a study on child hunger, write that the nation's policies "have long reflected, imperfectly, the moral imperative that children deserve adequate food. Until now." Although SNAP already includes work requirements for able-bodied adults without children, the House-passed farm bill "an even harsher policy and extends it to parents of schoolage children. It would require that most adults provide monthly proof that they are working or enrolled in at least 20 hours of work force training New York Times. "Your Credit Card Will Pay For The Next Recession ." The New York Times (7/1, 19.33M) says in an editorial that Federal Reserve forecasters' "median prediction is that the federal funds rate is headed to 3.4 percent by the end of 2020 from the current 1.9 percent," meaning consumers will be "paying more to get a mortgage , a new-car loan or to carry a balance on your credit card. How much more? Possibly enough to absorb whatever extra income you might be enjoying from lower tax rates or 44 EXT-18-248-D-000473 "What Are The Park Police Hiding?" A Washington Post (7/1, 15.68M) criticizes the "epic stonewalling campaign" by US Park Police concerning Park Police officers' fatal shooting of Bijan Ghaisar, "a young accountant in Northern Virginia who appeared to pose no threat to them or anyone else." The Post says "it has been 225 days - and counting" and the Park Police response "has been characterized by brazen arrogance and in-your-face unaccountability on a grand scale." The Post concludes that "after so many months of official nonresponsiveness, there is one overarching question the public is entitled to ask: What are the police trying to hide?" higher wages." The Fed's job of keeping "inflation in check by raising rates," has been "made more urgent by the Republicans' $1.5 trillion tax giveaway to the wealthy and corporations." Now, "Trump supporters who benefited the least from the Republican tax cut...will now have to pay the bulk of the bill to mitigate the damage it caused to the economy." "The Disney-Fox Deal Sails Through, A Bit Too Easily." In an editorial, the New York Times (7/1, 19.33M) questions the speed with which the Justice Department approved the Disney-Fox deal, saying it took "about half the time that regulators usually need to evaluate deals of this size." Noting that the Department "spent nearly two years investigating AT&T's acquisition of Time Warner and bringing an ultimately unsuccessful lawsuit against the deal," the Times says that while the Administration "has denied that politics plays a role in its antitrust enforcement decisions," it is "hard not to be skeptical of the possible motivations behind the Justice Department's approach to these deals." Wall Street Journal. "The War On Admissions Testing." In an editorial , the Wall Street Journal (7/1, Subscription Publication, 6.13M) takes issue with a growing movement to eliminate he ACT and SAT tests for college admissions. The Journal argues that although no test is ideal, the ACT and SAT are good predictors of how a student will perform in college. "New Jersey's Tax Gi'ft To Florida." A Wall Street Journal (7/1, Subscription Publication, 6.13M) editorial criticizes New Jersey Gov. Phil Murphy and State Senate leader Steve Sweeney for agreeing to increase New Jersey's state's income tax on residents making more than $5 million and the corporate rate on companies with more than $1 million in income, giving the state the fourth highest income tax rate on individuals and the second highest corporate rate in the nation. "North Korea Keeps Enriching Uranium." A Wall Street Journal (7/1, Subscription Publication, 6.13M) editorial says evidence of North Korea's continuing nuclear-fuel production suggests Pyongyang intends to drag out openended talks with the US for as long as possible in hopes of extracting new concessions along the way. The Journal says if President Trump does not call Kim Jong-un out on these activities, then Kim will conclude that he can get away with this behavior. Washington Post. "This Piece Of Trump's Federal Shake-Up Has Been A Long Time Coming. Get It Right." In an editorial, the Washington Post (7/1, 15.68M) says the Administration 's proposal to transfer responsibility for background investigations for security clearances from the OPM to the Defense Department is change that is "a long time coming." The Post cites criticism of OPM's "slow processing of background checks" as well as "security concerns" stemming from the agency's handling of the investigations and says the "transfer of security-clearance responsibilities makes sense." However, the Post says Defense Department must "address these concerns and ensure that the background-check process is efficient, secure and accurate going forward. " "The Malaria Fight Stalls As Children Die By The Hundreds Of Thousands." A Washington Post (7/1, 15.68M) editorial says that while the number of malaria cases and deaths have declined steadily for a decade and a half as "global public-health officials have been at war" with the disease , the "battle shows signs of stalling." In 2016, "the number of malaria cases went up to 215 million, from 210 million the year before." The Post says that the fight against malaria will be won "by action on many fronts . A stall, after so much promise, would be terrible and costly." THE BIG PICTURE Headlines From Today's Front Pages. WALL STREET JOURNAL: Trump Cites Threat Of Auto Tariffs As His Biggest Leverage 45 EXT-18-248-D-000474 Facebook Gave Firms Special Access To Users' Personal Data North Korea Expands Key Missile-Manufacturing Plant Taiwan's Technology Secrets Come Under Assault From China Judge: Rosenstein's 'Any Links' Mandate Empowers Mueller To Look At Virtually Any Russian Contact After Trump Yields On Family Separation, Immigration Activists Demand End To Detentions, ICE NEW YORK TIMES: STORY LINEUP FROM LAST NIGHT'S NETWORK NEWS : Supreme Court Defeat For Unions Upends A Liberal Money Base Bulwark Against An Abortion Ban? Medical Advances In Denmark, Harsh New Laws For Immigrant 'Ghettos' Leftist Wins Mexico Presidency In Landslide With Mandate To Reshape Nation As Bolton Says North Korea Could Disarm In A Year, Reality Lags Promises Behind Lincoln Center's White Travertine Facade: Infighting And Indecision ABC: Severe Weather; Bahamas-Boat Explosion; Idaho-Man Goes On Stabbing Spree; TrumpSCOTUS Pick; France-Murderer Escapes Prison; Mexico-Elections; India-Bus Accident; OregonPolice Shooting; Australia-Shark Bites Woman; Portland-Protest Becomes Riot; China-Road Collapses; Reagan National Airport-United Express Flight Forced To Deplane; Food RecallWishbone Italian Dressing; Best Buy Stops Selling CDs; Police Lip Sync. CBS: Severe Weather; Wildfires; Bahamas-Boat Explosion; Trump-SCOTUS Pick; Reagan National Airport-United Express Flight Forced To Deplane; Maryland-Capital Gazette Memorial; USRussia Relations; Mexico-Elections; San Francisco-Housing Market; Portland-Protest Becomes Riot; Thailand-Missing Boys' Soccer Team; Puerto Rico-Hurricane Maria Evacuees; Long Island-Father Son Sock Business. NBC: Idaho-Man Goes On Stabbing Spree; Severe Weather; Weather Report; Wildfires; Bahamas-Boat Explosion; Trump-SCOTUS Pick; Mexico-Elections; Plastic Straw Bans; Opioid Crisis-France's Solution; France-Murderer Escapes Prison; Family's Monster Truck Business. WASHINGTON POST: Unsolicited Checks Can Be A Lifeline - And An Albatross Trump Stays Firm On Trade As Foreign Tariffs Kick In Democrats' Bad Week Highlights A Big Rift Two Bristols, Two Fiscal Realities Mexico Turns Left In Election Emails Reveal Ties Between Top EPA Aides And Lobbyists FINANCIAL TIMES: Arnio Seals Comfortable Victory In Mexico Election EU Warns Of $300BN Hit To US Over Car Import Tariffs Alphabet Adds To Transport Bets With Scooter Deal Activist Loeb Demands More Urgency At 'Complacent' Nestle NETWORK TV AT A GLANCE: Severe Weather - 7 minutes, 35 seconds Trump-SCOTUS Pick - 7 minutes, 30 seconds Bahamas-Boat Explosion - 4 minutes, 50 seconds Mexico-Elections - 3 minutes, 0 seconds WASHINGTON TIMES: Swing-Vote Collins Keeps Open Mind On Trump's Supreme Court Pick Despite Leftist Pressure Political Pickle: Supreme Court Vacancy Puts Red-State Democrats In A Big Campaign Quandary Trump's 'Down The Road' Deadline To Lift North Korea Sanctions Frustrates Nations Eager For Trade Trump's Pressure Against Regime Adds Strength To Iran's Largest Dissident Group STORY LINEUP FROM THIS MORNING 'S RADIO NEWS BROADCASTS: ABC: Trump-SCOTUS Pick; Idaho-Man Goes On Stabbing Spree; NBA News. CBS: Idaho-Man Goes On Stabbing Spree; Severe Weather; Wildfires; Mexico-Elections; NBA News. FOX: NBA News; Congress-SCOTUS Pick; Mexico-Elections. NPR: Trump-SCOTUS Pick; Idaho-Man Goes On 46 EXT-18-248-D-000475 John Oliver: "I'm happy to say, there is some good news. It turns out there's a constitutional loophole that allows Democrats to - I'm obviously lying here. There's no good news. Everything is terrible now." Stabbing Spree; Guatemala-Volcano-Health Issues; Canada-Tariffs On US. LAST LAUGHS Late Night Political Humor. John Oliver: "Barring some massive screw-up from Trump, the only thing anyone can really do is vote. And there are actually two key elections you should really try and vote in: One in 2016 and one in 2014. Because that is what got us into this mess." John Oliver: Supreme Court Justice Anthony Kennedy's retirement "is obviously huge news, and for anyone who believes that the Constitution protects things like reproductive and LGBT rights, this is bad. And we know it's bad because Donald Trump Jr. was happy, tweeting 'OMG just when you thought this week couldn't get more lit, I give you Anthony Kennedy's retirement from #scotus .' And I'm afraid I'm going to have to disagree with Mr. Junior on this, because I personally don't think this was lit at all. I mean, it's obvs cray af. No one is denying that, fam. But I would argue that this news was neither lit nor on fleek. Nor was it three fire emojis. Now, granted, I am still a little shook, jsyk, but I personally believe Kennedy's retirement is super werpt. And I'm happy to announce that, in saying that, all the slang words I just used are now officially dead forever. And that includes 'werpt,' a term that doesn't even exist, but which I have preemptively ruined just in case." Copyright 2018 by Bulletin Intelligence LLC Reproduction or redistribution without permission prohibited. Content is drawn from thousands of newspapers, national magazines, national and local television programs, radio broadcasts, social-media platforms and additional forms of open-source data. Sources for Bulletin Intelligence audience-size estimates include Scarborough, GfK MRI, comScore, Nielsen, and the Audit Bureau of Circulation. Data from and access to third party social media platforms, including but not limited to Facebook, Twitter, lnstagram and others, is subject to the respective platform's terms of use. Services that include Factiva content are governed by Factiva's terms of use. Services including embedded Tweets are also subject to Twitter for Website's information and privacy policies. The HHS News Briefing is published five days a week by Bulletin Intelligence, which creates custom briefings for government and corporate leaders. We can be found on the Web at Bulletinlntelligence.com , or called at (703) 4836100. John Oliver: "The big question here is, who is going to replace Kennedy? And the Administration has made their plans pretty clear, with Mike Pence tweeting, 'Thank you to justice Anthony Kennedy for your long career of service. Trump will nominate a strong conservative in the tradition of the late Justice Scalia.' Which is a little weird. You don't generally stand up at someone's retirement party and say, 'Thank you for everything you did for this company , Robert, and rest assured that we will replace you with someone exactly like that other guy who used to work here that we always liked much more than you ."' John Oliver: "There's a fundamental problem there, and that is that Republicans have 51 seats in the Senate, and they need 51 votes to confirm the new justice. So unless Democrats can convince their entire party to oppose the nomination and persuade a number of Republicans over to their side, they are ...out of luck, meaning it's time for Democrats' favorite game: 'Hope Susan Collin Flips And Be Disappointed When She Doesn't!' It's America's most depressing game show." 47 EXT-18-248-D-000476 To: "White, Jonathan (ACF) " "Bowman, Matthew (HHS/OGC)"; "Wagner, Steven (ACF)" Subject: RE:TOP request Date: 2017/11/30 14:20:59 Priority: Normal Type: Note Jonathan, Please make sure the program proceeds with confirming the pregnancy with OB/GYN according to SOP.Also, the program should confirm that the termination is not medically indicated. At the same time, the program should request permission of the UAC to contact parents and notify them of the pregnancy and the request for termination. The UAC can raise From: White, Jonathan (ACF) Sent: Wednesday, November 29, 2017 7:16 PM To: Lloyd, Scott (ACF) Subject: Fwd: TOP request See below. Jonathan White Commander , US Pub lic Health Service Deputy Director for Children's Programs Office of Refugee Resettlement Administration for Children and Families Jonath an.White@acf.hhs.gov (202) 570-8916 From: "Bartholomew, Michael (ACF)" Subject: RE : TOP request /\MERICAi\ pVERSIGHT EXT-18-248-D-000477 Date: 29 November 2017 19:08 To: "White, Jonathan (ACF)" Cc: "Misegades, Lara (ACF)" , "Somerville, Nicholas J (ACF)" Hi Jonathan, b)(5) Michael Michael L. Bartholomew, M.D., FAAP CDR, U.S. Public Health Service /\MERICAi\ pVERSIGHT EXT-18-248-D-000478 Director, Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Building 330 C St SW, MS 5123 Washington, DC 20201 Phone: 202-401-5375 michael. bart holomew@acf.hhs.gov www. acf.hhs .gov From: White, Jonathan (ACF) Sent: Wednesday, November 29, 2017 6 :30 PM To: Bartho lomew, Michael (ACF) Subject: TOP request Importan ce: High Michael, Just finished speaking with Scott about the most recent TOP request. b)(5) Jonathan /\MERICAi\ pVERSIGHT EXT-18-248-D-000479 Jonathan White Commander, US Pub lic Health Service Deputy Director for Children's Programs Office of Refugee Resettlement Administration for Children and Famili es Jonathan.White @acf.hhs.gov (202) 570-8916 "White, Jonathan (ACF) "; " Bowman, Matthew (HHS/OGC) "; "Wagner, Steven (ACF) " Sent Date: 2017/11/30 14: 18:21 Delivered Date : 2017/11/30 14:20:59 Message Flags: Unsent /\MERICAi\ pVERSIGHT EXT-18-248-D-000480 " Marriott, Brian (ACF) "; "Wolfe, Kenneth (ACF) "; To: "Yoest, Charmaine (OS/ASPA) "; "Wagner, Steven (ACF) " " Bowman, Matthew (HHS/OGC) "; "Wynne, Maggie (HHS/IOS) "; "Stevenson, Sarah-Lloyd (HHS/IOS) " Subject: Not e to file Date: 20 17/12/19 19:28:23 Priority: Urgent Type: Note (b)(5) Thank yo u, Scott *** E . Scott Lloyd Director Office of R efugee Reset tlemen t U.S. Depart ment of Health and Human Services (202) 40 1-7269 (202) ~l (b)~(6)~~1 /\MERICAi\ pVERSIGHT ( cell) EXT-18-248-D-000481 scott.l loyd@acf.hhs.gov "Marriott, Brian (ACF) "; "Wolfe, Kenneth (ACF) "; "Yoest, Charmaine(OS/ASPA)"; "Wagner, Steven (ACF) "; " Bowman, Matthew (HHS/OGC)"; "Wynne, Maggie (HHS/IOS) "; "Stevenson, Sarah-Lloyd(HHS/IOS) " Sent Date: 2018/01/02 20:23:30 Del ivered Date: 2017/12/ 19 19:28:23 Message Flags: Unsent /\MERICAi\ pVERSIGHT EXT-18-248-D-000482 CHIIirREN ~ FAMILIES Office of Refugee Resettlement www .acf.hhs.gov/programs/orr I 330 C Street, S.W., Washington, DC 20201 NOTETO FILE December 16, 2017 Scott Lloyd, Director b)(5) Administration for Children and Families /\Mlf ll Al\ pVERSIGHT I Office of Refugee Resettlement I www.acf.hhs.gov/programs /orr EXT-18-248-D-000483 Page 515 of 738 Withhe ld pursuant to exemption (b)(5) of the Freedom of Information and Privacy Act /\Mlf ll Al\ pVERSIGHT EXT-18-248-D-000484 Page 516 of 738 Withhe ld pursuant to exemption (b)(5) of the Freedom of Information and Privacy Act /\Mlf ll Al\ pVERSIGHT EXT-18-248-D-000485 Page 517 of 738 Withhe ld pursuant to exemption (b)(5) of the Freedom of Information and Privacy Act /\Mlf ll Al\ pVERSIGHT EXT-18-248-D-000486 To: "White, Jonathan (ACF) " "Bowman, Matthew (HHS/OGC)"; "Wagner, Steven (ACF) "; "Wynne, Maggie (HHS/IOS) " Subject: RE: UACwith TOP request: Instructions from leadership Date: 2017/12/01 18:16: 12 Priority: Normal Type: Note Jonathan , Am I correct that there is an appointment scheduled for Monday? What is the purpose of the appointment? The threats of self-harm are troubling. Please remind me the SOP when these occur and From: White, Jonathan (ACF) Sent: Friday, December 01, 2017 12: 13 PM To: Lloyd, Scott (ACF) Subject: FW: UAC with TOP request: I nstructions from leadership Importance: High Updated information just received : Note: Minor disclosed to treating MD that she believes pregnancy is a result of rape. SIR on that disclosure expected shortly. Minor also stated that she would prefer to harm herself than continue with pregnancy , which may const itute a medical risk of denying her the reque sted procedure . /\MERICAi\ pVERSIGHT EXT-18-248-D-000487 Please advise next steps . From: Mansilla, Karla (ACF) Sent: Friday, December 01, 2017 12:07 PM To: White, Jonathan (ACF) Cc: De LA Cruz, James (ACF); Sualog, Jallyn (ACF); Bartholomew, Michael (ACF); Volovar, Jill (ACF) Subject: Re: UAC with TOP request: I nstructions from leadershi p Good Morning, There are a couple of updates on the case: 1 - As per the physician, any pregnancy at this age is risky; however , it is unknown how the pregnancy will affect the minor or if it's threatening her life or health. 2 - The minor disclosed to the MD that she believes that the pregnancy is a product of the rape. A SIR will be submitted within the next few minutes with the new information. This is the response I received from the program: "As part of the examination, the Child/Minor received an interview in the presence of an Interpreter , MD and Nursing Staff-(Mt Sinai Medical Center, NYC). The Child/Minor claims that the pregnancy was a product of a rape by an unknown man. She was quite verbal during the interview session that she did not want to complete her pregnancy. She stated to the MD that she prefers to harm herself rather than continue with the pregnancy , with that in mind her mental health is at threat. There are no contraindications for the termination. However , if the procedure is accepted/approved by ORR and the HQ, it should be perform soon." Thank you, Karla Mansilla, MA, MP A Federal Field Specia list - NY U.S. Department of Health and Human Services Administration of Children and Families /\MERICAi\ pVERSIGHT EXT-18-248-D-000488 Office of Refugee Resettlement Division of Unaccompan ied Children's Operations (C): ~(b)_(6~) --~ Karla.Mansi a acf.hhs. ov http ://www.acf .hhs.gov /programs / orr/programs /ucs From: White, Jonathan (ACF) Sent: Friday , December 1, 2017 11:16:34 AM To: Mansi lla, Karla (ACF) Cc: De LA Cruz, James (ACF); Sualog, Jallyn (ACF); Bartholomew, Michael (ACF); Volovar, Jill (ACF) Subject: RE: UAC with TOP request: Instructions from leadershi p Karla, Thank you. I will follow up with the ORR Director for next steps direct ion. b)(5) Hope this helps. Jonathan From: Mansilla, Karla (ACF) Sent: Friday, December 01, 2017 9:55 AM To: White, Jonat han (ACF) Cc: De LA Cruz, James (ACF); Sualog, Jallyn (ACF); Bartho lomew , Michael (ACF); Volovar, Jill /\MERICAi\ pVERSIGHT EXT-18-248-D-000489 (ACF) Subject : RE: UAC with TOP request: Instructions from leadership I just received information the OB/GYN examination revealed 20 weeks gestation (fetal size/weight etc), not 9 weeks as originally reported . A follow up examination is scheduled for this coming Monday, December 4th, 2017. The program still wants clarification about the question about the termination not medically indicated. Is it the pregnancy or the termination that does not pose a threat to her health, or both? She does not have a sponsor at this time . The program is trying to obtain more information from her family in home country. 5 Please note that the minor's primary language isfb><> ~nd the program need s to use an interpreter , which has caused some delay in obtaining some information . At the examination with the OB/GYN the minor , with the assistance of a translator, requested a tennination again. Thank you, Karla Mansilla, MA , MP A Federa l Field Specia list - NY U.S. Department of Health and Human Services Administration of Children and Families Office of Refugee Resettlement Division of Unaccompanied Ch ildren's Operations (h)-/C) _ (C): l(b)(6)...._: I __,I Karla.Mansilla @acf.hhs.gov http://ww w.acf.hh s.gov/program s/orr/programs /ucs /\MERICAi\ pVERSIGHT EXT-18-248-D-000490 From: White, Jonathan (ACF) Sent: Thursday, November 30, 2017 5:02 PM To: Mansilla, Karla (ACF) Cc: De LA Cruz, James (ACF); Sualog, Jallyn (ACF); Bartholomew, Michael (ACF); Volovar, Jill (ACF) Subject: Re: UAC with TOP request: Inst ruct ions from leadership The next question is for my own awareness: what's this minor's reunification picture look like? Is there a sponsor identified ? Jonathan White Commander, US Public Hea lth Service Deputy Director for Children's Programs Office of Refugee Resettlement Admin istration for Children and Fam ilies Jonathan.White@ac f.hhs.gov (202) 570-8916 On: 30 November 2017 16: 15, "Mansilla , Karla (ACF)" wrote: Thank you. The pregnancy has been confirmed. She has nine weeks of gestation. Today she has her first appointment with the OB/GYN at Mt. Sinai hospital. The minor decided to notify her mother in home country about the pregnancy. The mother discouraged the minor to have a termination , but the minor continues wanting to terminate . Thank you, Karla Mansilla, MA, MPA Federal Field Specia list - NY U.S. Department of Health and Human Services Administration of Children and Families Office of Refugee Resettlement Division of Unaccompanied Children's Operations /\MERICAi\ pVERSIGHT EXT-18-248-D-000491 (C): l(b)(6>: 11 Karla.M ansilla@acf. hhs.gov http ://www.acf .hhs.gov/programs / orr/programs /ucs From: White, Jonathan (ACF) Sent: Thursday , November 30, 2017 2:47:40 PM To: Man silla, Karla (ACF) Cc: De LA Cruz , James (ACF); Sualog, Jallyn (ACF); Bartholomew , Michael (ACF); Volovar, Jill (ACF) Subject: UAC with TOP request: Instruction s from leader ship Karla, Please see below the instructions from the ORR Director for the UAC at Abbott Hou se who has made a reque st for TOP: Please make sure the program proceeds with confirming the pregnancy with OB/GYN according to SOP . Also, the program shou ld confirm that the termination is not medically indicated . At the same time, the program should request permission of the UAC to contact parents and notify them of the pregnancy and the request for termination. The UAC can make the notification herself or have the program do it according to the UAC's wishes . If you have any questions or need any clarification , don't hesitate to reach out to me. Jonathan Jonathan D. White Co mmander , U.S. Public Health Service Deputy Director for Children's Programs /\MERICAi\ pVERSIGHT EXT-18-248-D-000492 Office of Refugee Resettlement Adm inistration for Children and Fam ilies U.S. Department of Health and Huma n Serv ices 330 C Street SW (202) 690-6984 j onathan. white@acf.hhs. gov "White, Jonathan (ACF) "; "Bowman, Matthew (HHS/OGC)"; Recipient: "Wagner, Steven (ACF) "; "Wynne, Maggie (HHS/IOS) " Sent Date : 2017/12/0118:16 : 14 Delivered Date: 2017/12/01 18:16: 12 Message Flags: Unsent /\MERICAi\ pVERSIGHT EXT-18-248-D-000493 From: Bulletin Intell igence To: "HHS@bulletinintelligence .com" Subject: HHS News Briefing for Wednesday, October 18, 2017 Date: 2017/10/18 07:32 :33 Priority: Normal Type: Note HHS NEWS BRIEFING This document and searchable archives are available at hhs .bulletin intelligence.com. TO: THE SECRETARY AND SENIOR STAFF DATE: WEDNESDAY, OCTOBER 18, 2017 7:30 AM EDT TODAY'S TABLE OF CONTENTS LEADING THE NEWS: + Senators Reach Bipartisan Agreement To Fund ACA Subsidy Payments. THE SECRETARY IN THE NEWS : + Trump May Be Considering Alex Az.ar To Replace Price As HHS Secretary , Sources Say . + Trump Says He Will Nom inate A New HHS Secretary Soon . + Democratic Lawmakers Want Trump Admin istration To Just ify Decision To End ACA Subsidy Payments. HHS IN THE NEWS: + Trump Adm inistration Reportedly Preventing Undocumented Minors Who Were Raped From Obtaining Abortions . + HHS To Hold National Conference On Small Business Grants In Milwaukee. /\MERICAi\ pVERSIGHT EXT-18-248-D-000494 + Benefits Of Implementing Value-Based Care In Question . + Opinion: HHS Should Use Emergency Prescription Assistance Program To Help Those Affected By Recent Hurricanes . + Indian Health Service Defends Contract Awarded To Former NextCare CEO. + Health Experts Call For Changes To Food Environment As CDC Research Shows Rising Obesity Rates. + Brennan: NLM Is A "Safe Harbor'' For Information. + Opinion: US Should Fund More Research On How To Care For People With Alzheimer 's Disease. + More Researchers Keeping Primates In Shared Cages Rather Than Alone. HEAL TH REFORM: + Trump Calls On Congress To Fix "ObamaCare Mess" At Heritage Foundation Event. + President Trump May Have To Lobby For Bipartisan Healthcare Deal. + Trump Says Senate GOP Will Resume Work On ACA Repeal Bill After Tax Reform . + Trump Blames Dems For Premium Hikes For ACA Plans. + Sens. Bennet, Kaine Unveil Proposal To Add Public Option To ACA . + Some States , Insurers Scrambling To Raise Rates Following Trump's Decision To End ACA Subsidy Payments. + Senate GOP 's Slim Majority Threatened By The Age And Illnesses Of Certain Lawmakers. +Sens.Toomey , Cotton Unveil New Bill To Exempt Certain People From ACA 's Individual Mandate. + Insurers May Lose About $1 Billion During The Remainder Of 2017 If ACA Subsidy Payments End , Analysis Indicates. + Federal Funding For Indiana's ACA Navigators Cut By 82%. + Pittsburgh, Erie Roman Catholic Dioceses Settle Lawsuits Over ACA's Contraception Mandate . + Democratic Candidates In Minnesota's Gubernatorial Race Unanimously Support Single-Payer Healthcare System . + North Dakota Insurance Commissioner Says He Will Not Allow More Rate Hikes For ACA Plans . + Centene Raises Premiums In Arkansas By 21.4 Percent. + Celtic lnsurance/MHS To Raise Average ACA Plan Premiums In Indiana By 35.7 Percent. /\MERICAi\ pVERSIGHT EXT-18-248-D-000495 + New Jersey Regulators Approve Premium Increases For Individual ACA Plans. + Massachusetts State Senators Propose Wide-Ranging Healthcare Reform Bill. + Vermont Joins Lawsuit Against Trump To Maintain ACA Subsidies. + Senate Healthcare Bill Could Rescue MinnesotaCare Funding Cuts. + McCain, Murkowski Say They Support Bipartisan Healthca re Deal. + Bipartisan Healthcare Deal Includes Provisions For Democrats And Republicans. + Sen. Johnson To Question OPM Nominees On Congressional Healthcare Contributions. + Key Questions Surround The Senate's Bipartisan Healthcare Proposal. + Commentary Considers Health Reform. OPIOID NEWS: +Rep .Marino Withdraws From Consideration For Drug Czar Position After Criticism. + Trump Says He'll Formally Declare National Emergency To Combat Opioid Epidemic Next Week. + DOJ To Consider Repeal Of Law Blocking DEA From Halting Opioid Shipments. + Investigation Of Alleged Fentanyl Shipping Operation Leads To Multiple Indictments. + Opioid Crisis Causing Increase In Hepatitis C Cases. + Hospitals Move Forward On Opioid Response Strategies Despite Lack Of Federal Funding. + PhRMA Calls For Repeal Of Law Limiting DEA's Opioid-Response Capabilities. + Healthcare Providers Seek Alternative Pain Treatments In Response To Opioid Epidemic. + Beaver County Becomes Third In Pennsylvania To Sue Pharmaceutical Companies Over Opioid Crisis. HEALTHCARE NEWS : + UnitedHea lth Posts Higher 03 Earnings , Beats Analysts' Expectations. + Columnist Warns Federal Retiree Health Premiums Could Increase Markedly If House Budget Proposal Becomes Law. + Wisconsin Bill Would Prohibit University Of Wisconsin Employees From Working At Planned Parenthood. + Arkansas Health Care Association Joins Coalition To Support Limits On Payouts For Lawsuits. /\MERICAi\ pVERSIGHT EXT-18-248-D-000496 + Pennsylvania Regulators Issue More Nursing Home Citations But Understate Incidents ' Severity , Experts Say. EMERGENCY RESPONSE AND PANDEMIC PREPAREDNESS : + Vulnerable Elderly Increasingly Becoming Victims Of Emergencies , Disasters. NUTRITION &OBESITY: + Google Maps Pulls Experimental "Calorie Counting " Feature From App After Criticism. MEDICARE: + Expanded Medicare Enrollment Options Give Sen iors More To Sort Out. + Opinion: CMS Proposal To Exempt Rural Phys icians From MIPS W ill Do More Harm Than Good . MEDICAID &CHIP: + "Bickering " Over CHIP , Community Health Centers Reportedly Harming Nation 's Healthcare. + Arkansas Governor Says Insurance Rate Hikes Will Not Threaten State Medicaid Expansion. + Michigan Democrats Say Proposed Medicaid Cuts "Devastating " For Vulnerable People . HEAL TH &MEDICAL NEWS: + Pharmaceutical Companies Deny Responsibility For Drug Pricing At Senate Hearing . + Senator Questions Pharmaceutical Industry About Doing Away With Rebates. + Families Of Deceased Troops Allege Pharmaceutical Companies "Knowingly Financed " AntiAmerican Militia In Iraq. + Massachusetts Senate Considers Bill To Require Data Submissions From Drug Companies . + Appeals Court Vacates Verdict In Talcum Powder Cancer Case . + Gene Tumor Boards Increas ingly Providing Guidance On Cancer Care . + Mouse Study Finds Link Between Stress And Digestion In Fema le Mice. + New Hampshire Gov. Removes Member From Cancer Cluster Panel. /\MERICAi\ pVERSIGHT EXT-18-248-D-000497 + Scient ific American Editors Voice Support For Cosmetics Safety Bill. + Transenter ix CEO Says Senhance Won 't Compete Directly With Intuitive Surg ical's Da Vinci . + Johnson &Johnson's Animas Closure , Cessation Of Insulin Production Are Reflective Of Broader Healthcare Issues. + DC Council Disapproves Of Extending Contract To Manage City's Only Public Hospital. + People With Adverse Childhood Events Found More Likely To Suffer Health Problems As Adults. + Second TB Case Reported In Durham County, North Carolina. + VA Facility In Omaha Maintained Secret Wait ing List Of Veterans Seeking Mental Health Appointments. + Hepatitis A Deaths Now Up To 19 In San Diego County. + Researchers Trying To Identify Early Signs Of Brain Damage In Professional Fighters . + US District Judge Orders Flint To Pick A Long-Term Water Source . + Researche rs Identify Four Genes In Humans , Dogs , And Mice That May Be Linked To OCD . + Excessive Exercise May Be Linked To Higher Risk Of Buildup Of Plaque In Heart Arteries By Middle Age In Caucasian Men, Study Suggests . + NAFLD , Nonalcoholic Steatohepatitis The Fastest-Growing Reasons For Liver Transplants In Young Americans, Research Indicates. + lmpax Laboratories Inks Deal To Merge With Amneal Pharmaceuticals. + Column: Allergan Restasis Case Exemplifies How Companies Manipulate Patent System. + Troy University Researchers Developing Anti-Depressants Through Zebrafish Studies. + District Judge Invalidates Allergan 's Restasis Patents. + Distr ict Judge Refuses Pharmaceutical Companies ' Request To Block Nevada Drug Pricing Law. + Experts Consider Whether lgnyta Pharmaceuticals ' Cancer Treatment Can Be Compared To Pfizer's. + Study Reveals Associat ion Between Depress ion, Sagg ing Testosterone Levels In New Fathers . + Men Who Receive Blood Donated By Previously Pregnant Women May Face Increased Risk Of Death Following The Transfusion , Study Indicates . + Physician Warns Of Dangers Of Online Compan ies Sell ing Designer Substances. + Oversized Eyedrops Waste Patient's Money And Medicine By Design . + More Hosp itals Investing In Housing And Support For Homeless To Reduce ER Visits. /\MERICAi\ pVERSIGHT EXT-18-248-D-000498 GLOBAL HEAL TH : + China Confirms H5N6 Bird Flu Outbreak In Central Province. + Op-Ed : Canada Must Push For National Registry Of Payments From Companies To Physicians. NATIONAL NEWS: + House Panel Sets Puerto Rico Recovery Hearing For Next Week . + Puerto Rican Delegate: Trump Has Given Everyth ing We've Asked For. + Desperate Puerto Ricans Turning To Wells At Superfund Site For Water . + Discussing Obama And Slain Soldiers, Trump Cites Death Of Kelly's Son. + Trump Says He Was "Surprised " By The "Dishonesty In The Media ." + Trump Warns McCain , "I Fight Back And It Won 't Be Pretty ." + White House Urges Corker To "Get Out Of The Name-Calling ." + White House Denies Trump Joked Pence Wanted To "Hang " Gays. + Senate Committee Subpoenas Page, Seeks Informat ion From Flynn's Son. + Obama UN Ambassador Says Unmasking Requests We re Made In Her Name . + Trump Says Fed Chairman Pick Coming Soon , Source Says Early November . + Dow Tops 23,000 For First Time . + Trump Calls On Americans To Say "Merry Christmas " During Holidays. + Trump Drops In Forbes 400 Ranking . + Trump DC Judicia l Nominee Addresses Judiciary Comm ittee . + Pruitt Seeks To Assure Senators Over Biofuels Mandate. + Sessions Creates Watchdog For Asset Forfeiture Program . + Zinke Booster Now Expresses Concerns About His Public Land Policies . + Chao Silent On Federal Money For Miami 's Metrorail. + Fox News Poll: Jones , Moore Tied At 42% In Dec. 12 Special Election. + Three Polls Show Virginia Governor 's Race "Within The Margin Of Error." /\MERICAi\ pVERSIGHT EXT-18-248-D-000499 + Two Polls Show Democrat Murphy Up Double Digits In New Jersey Governor 's Race. + Pence 's Fundraiser Benefiting Collins Draws "About 80" Protesters . + Californ ia House Republicans Get Large Financial Boost From PAC 's Fund raiser With Pence. + Endorsing Flake Primary Foe Ward , Bannon Rips McConnell , Senate Republicans. + Hill Analysis: Trump 's Support Gives Barletta Edge In Crowded Primary. + Eight Democrats On CNN's List Of " 10 Senate Seats Most Likely To Switch Parties" In 2018. + Hawley Spokesman Sidesteps Question On Whether Candidate Would Back McConnell. + SLF Unveils Microsite Targeting Democrat Donnelly On Outsourcing. + Nelson Raises Nearly $1.8M In Q3, Has $6.3M Banked For Reelection Race. + Testimony Continues In Menendez's Federal Corruption Trial. + New Wildfires Emerge In Santa Cruz Mountains. + Weinstein Resigns From His Company; Amazon Exec Steps Down . + Women Denounce Harassment In California 's State Legislature. + NYTimes A 1: Secretive "Self-Help" Group For Women Requires Members To Be Branded . + Trump Accuser Describes Earlier Harassment Experience. + Pence Says Walking Out Of Colts Game Was "Right Thing To Do." + NFL Owners, Players Meet To Discuss Anthem Protests. + Google Serves "Fake News" Ads On Fact-Checking Sites, NYTimes Finds. + Nationa l Archives Warned Administration To Preserve Documents . + Bipartisan Group To Urge Trump To Alter Policing Policies. + Open Society Discloses $18 Billion In Donations From Georges Soros . + Duckworth: Congress Seeking To Remove Protections For Disabled. + WSJournal Decries Court Ruling Absolving Prosecutors For Using False Information . + WSJournal Applauds Gov . Brown 's Veto Of Campus Sexua l Assault Bill. + WPost Offers Farewell To Former Communications Vice President. EDITORIAL WRAP -UP: + New York Times. /\MERICAi\ pVERSIGHT EXT-18-248-D-000500 + Wash ington Post. + Wa ll Street Jou rnal. THE BIG PICTURE : + Headlines From Today's Front Pages . LAST LAUGHS: + Late Night Political Humor. Leading the News: SENATORS REACH BIPARTISAN AGREEMENT TO FUND ACA SUBSIDY PAYMENTS. The New York Times (10/17 , Kaplan , Subscr iptio n Publication , 13.56 M) reports on its front page that Sens . Lamar Alexander (R-T N) and Patty Murray (D-WA) "have reached a bipartisan dea l to provide fund ing for critical subs idies to health insu rers that Pres ident Trump sa id last wee k that he wou ld cut off," Alexander said on Tuesday . This agreement aims "to stab ilize health insurance markets under the Affordable Care Act. " Unde r the agreement, "the subs idies would be funded for two years , a step that would provide at least short-term certainty to insurers. " The article says Trump called the dea l a "short term " solution. USA Toda y (10/ 17, Jackson, 8.62M) reports that Trump aga in criticized the ACA on Tuesday , saying , "Obamacare is a disgrace to our nation . ... We are solv ing the prob lem of Obamacare ." He also sa id the ACA was "dead" in his opinion . But after being told about the bipartisan deal , Trump said lawmakers "are working togethe r and I know very much what they 're do ing , OK?" In a front-page article , the Wall Street Journal (10/17, A1, Armo ur, Peterson , Subscription Publ ication, 6.45M) quotes Alexander as saying , "Sen . Murray and I have an agreement. ... Democrats feel like there are protections there ...at the same time we give significant flex ibility to states ." The AP (10/ 17, Fram) reports that Trump "spoke favorably about the bipartisan compromise, wh ich is still likely to face opposition in Congress ." Alexa nder added that Trump had been encourag ing, and that he "likes this idea ." The article says that although the dea l "is a breakthrough, they still need to secure the support of fellow Republicans and Democrats." The piece adds that Senate Maj ority Leader Mitch McCon nell (R-KY) "was noncommittal , while Minority Leader Chuck Schumer, D-N.Y., we lcomed the agreemen t as a step forward that will provide stab ility for insurance markets in the short-term ." /\MERICAi\ pVERSIGHT EXT-18-248-D-000501 On its front page, the Washington Post (10/17, A1, Sullivan, Eilperin, 10.38M) reports "Republican leaders did not immediate[ly] endorse the Alexander-Murray framework, raising new questions about whether it would find any tract ion." The article adds that for now, "many Republican senators are distancing themselves from the emerging Alexander-Murray plan." Bloomberg News (10/17, Edney, Wasson, Litvan, 4.52M) reports that if the proposal "becomes law, it could end a chaotic week that saw the White House move to dismantle parts of the Affordab le Care Act even as Trump took credit for pushing lawmakers to work out the fixes ." Reuters (10/17, Abutaleb, Cowan) reports that Murray said about the deal, "We are ironing out a few of the last detai ls right now but I am very optimistic that we will be able to make an announcement with all the details very soon." For his part, Alexander stated, ''This takes care of the next two years." He added, ''This is a small step. I'd like to undersell it, not overse ll it." Also covering the story are ABC World News Tonight (10/17, story 2, 2:35, Muir, 14.63M), NBC Nightly News (10/17, story 2, 0:30, Holt, 16.61M), USA Today (10/17, Berry, 8.62M) in a second story, the Los Angeles Times (10/17, Levey, Mascaro, 4.49M) , the Washington Times (10/ 17, Boyer, 541 K), the New York Post (10/17, Fredericks , 4.31 M), Politico (10/17, Haberkorn, 3.6M), CNBC (10/17, Mangan, Pramuk , Coombs, 3.48M), The Hill (10/17, Sullivan, 1.68M), the Huffington Post (10/17 , Fuller, Bobic, Cohn, 5.74M), NPR (10/17, Kodjak, 2.4M) , the Washington Examiner (10/17, Leonard, 465K), Roll Call (10/17, McIntire, 134K), and Modern Healthcare (10/17, Meyer, Subscription Publication, 238K). Mark Walker Calls Bipartisan Deal "An Affront To GOP Promises To Repeal" ACA. The Hill (10/17, Sullivan, 1.68M) reports that in response to the announcement about the bipartisan deal, Rep. Mark Walke r (R-NC), chairman of the conservative Republican Study Committee in the House , dismissed it "as an affront to GOP promises to repeal President Obama's signature legislation." Walker said, "Anything propping [ObamaCare] up is only saving what Republicans promised to dismantle ." The Washington Examiner (10/17, King, 465K) reports that Walker tweeted, "The GOP should focus on repealing &replacing Obamacare , not trying to save it. ... This bailout is unacceptable." In a separate article, the Washington Examiner (10/17, King, 465K) reports that Sen. Lamar Alexander (R-TN) "shrugged off criticism from House conservatives Tuesday that it was a 'bailout."' He said, "I appreciated President Trump's encouragement and his recommendation that it was important to continue the cost-sharing payments for two years in order to avoid harming millions of Americans .... That is kind of comment that I welcome, and I think his support is important." /\MERICAi\ pVERSIGHT EXT-18-248-D-000502 Another article in The Hill (10/17, Roubein, 1.68M) also covers the story. Heritage Foundation Fellow Slams Bipartisan Deal To Fund ACA Subsidy Payments. The Hill (10/17, Greenwood, 1.68M) reports that on Tuesday, Ed Haislmaier, a senior research fellow in healthcare policy for the Heritage Foundation, "ripped a bipartisan deal ...that would provide funding for" ACA subsidy payments to insurers. He stated, "For Congress , the most important thing is to recognize that funding the cost sharing reduction subsidies - as many are now calling for - would prop up the subsidized ObamaCare exchange market, but would do absolutely nothing to stabilize the broader , unsubsidized individual market." Mark Meadows Calls Bipartisan Deal A" Good Start." The Hill (10/17, Weixel , 1.68M) reports that on Tuesday , Rep. Mark Meadows (R-NC), chairman of the House Freedom Caucus, "said more work needs to be done to get conservatives to support a bipartisan Senate deal to extend critical ObamaCare payments to insurers , but he called it a starting point." Meadows is quoted as saying, "There are elements in the Alexander-Murray plan that we can build on, but much more work needs to be done." He characterized the agreement as a "good start." The Washington Examiner (10/17, Weaver, 465K) also covers the story . Connecticut Lawmakers Praise Bipartisan Deal. The Connecticut Mirror (10/17, Radelat) reports that the bipartisan deal "would also restore $106 million in funding for advertising and marketing of t he Affordable Care Act that helps people enroll in insurance plans." Commenting on the agreemen t, Sen. Richard Blumenthal (D-CT) said, "Th is bipartisan agreement is a victory for American patients and consumers , showing how we can work together across party lines .... Extend ing payments for critical healthcare subsidies ensures that countless Americans will retain access to their healthcare , in spite of the president's repeated attempts to sabotage insurance markets." Meanwhile, Sen. Chris Murphy (D-CT) "called the agreement 'good news."' The Secretary in the News: TRUMP MAY BE CONSIDERING ALEX AZAR TO REPLACE PRICE AS HHS SECRETARY, SOURCES SAY. Politico (10/17, Restuccia , Johnson, Karlin-Smith, Dawsey , 3.6M) reports President Trump "is leaning toward nominating Alex Azar, a former pharmaceutical industry executive and George W. Bush administration official, to serve as Health and Human Services secretary, according to two White House officials." If confirmed, Azar would replace former HHS Secretary Tom Price who resigned last month following criticism about his use of private je ts and military planes. The article adds that according to several unnamed sources, other possible candidates for the post, includ ing CMS Administrator Seema Verma and FDA Commissioner Scott Gottlieb, "are no longer under consideration." Reuters (10/17 , Walsh) reports that Azar served as "deputy secretary at HHS during the administration of President George W. Bush before joining drugmaker Eli Lilly and Co, first as /\MERICAi\ pVERSIGHT EXT-18-248-D-000503 senior vice president of corporate affairs and commun ications , and later as president of Lilly USA, its U.S. affiliate ." The Washington Post (10/ 17, Eilperin, Goldstein, 10.38M) reports that "both of the HHS secretaries for whom Azar worked are supporting him for the position." Mike Leavitt on Tuesday said Azar was "an experienced, competent conservat ive who is confirmable. " Tommy Thompson praised Azar 's "record of proven competence" and combination of private- and public-sector management and "deep substant ive health-care knowledge." The New York Daily News (10/17 , Silverstein, 3.61 M) reports that while Azar has experience working at HHS, he spent most of the last decade "working for the same drug industry he would be expected to oversee while leading the department." The Hill (10/17, Savransky, 1.68M) the Washington Times (10/17, Persons, 541K) , the India napolis Star (10/17, Groppe, 479K) , and the Indianapolis Business Journal (10/17, 37K) also cover the story . TRUMP SAYS HE WILL NOMINATE A NEW HHS SECRETARY SOON. The AP (10/ 17) reports that on Tuesday , President Trump said he is '"more than close' to naming a new health and human services secretary. " He added that if his choice for HHS Secretary is confirmed , "it will be ...fantastic ." DEMOCRATIC LAWMAKERS WANT TRUMP ADMINISTRATION TO JUSTIFY DECISION TO END ACA SUBSIDY PAYMENTS. The Wash ington Examiner (10/17, Leonard, 465K) reports that on Tuesday , congressiona l Democrats "demanded that the Trump administration justify its decis ion to end insurer payments, accusing him of doing so not for legal reasons , but to 'sabotage' Obamacare ." They wrote to President Trump and Acting HHS Secretary Eric Hargan, seeking "documentation to show which factors were considered in Trump's decision to end the payments , known as cost-sharing reduction, or CSR, subsidies ." The lawmakers "asked for any analyses that were conducted, including what impact his decision would have on health insurance costs , access to coverage, and federal spending. " HHS in the News: TRUMP ADMINISTRATION REPORTEDL Y PREVENTING UNDOCUMENTED MINORS WHO WERE RAPED FROM OBTAINING ABORTIONS. The Huffington Post (10/17 , Foley, 5.74M) reports, "Many undocumented immigrant girls seeking safety in the United States are raped during their journeys, " but when "they arrive, they are put in custody of a government that is now obstructing access to abortion. " The article says earl ier this year , the Trump Administration implemented new rules "to prevent undocumented minors in government custody from getting abortions . Since March, the government has required shelters to get its approval before releasing girls for abortion-re lated services - approva l that officials have refused to grant." The piece adds /\MERICAi\ pVERSIGHT EXT-18-248-D-000504 that officials are demanding that "minors be sent to crisis pregnancy centers that discou rage them from seeking abortions, and at times have intervened directly to discourage girls from terminating their pregnancies ." The Office of Refugee Resettlement said in a statement , "The re is no constitutional right for a pregnant minor to illegally cross the U.S. border and get an elective abortion wh ile in federal custody. " Undocumented Immigrant Minor Files Another Lawsuit Seeking Permission For An Abortion . The Wash ington Post (10/17 , Sacchetti, Somashekhar, 10.38M) reports, "The Ame rican Civil Liberties Union is accusing the Trump administration of illegally blocking a 17year-old Central Amer ican immigrant from having an abortion and will urge a federal judge in Washington on Wednesday to clear the way for her and other young immigrants to terminate their pregnanc ies." The Dallas Morning News (10/17, Wang, 984K) reports that "Jane Doe," a 17-year-old undocumented and unaccompa nied immigrant in Texas, has filed another lawsu it seeking permission for an abortion. The article explains that Doe's previous lawsuit was dismissed, but that she has filed another federa l lawsuit in a different court against the heads of the Department of Health and Human Services , the Administration for Children and Families , and the Office of Refugee Resettlement. The American Civil Liberties Union is representing Doe in the lawsuit, and "has requested a temporary restraining order to allow Doe to have an abortion ." The New Yor k Daily News (10/17 , Cullen, 3.61 M) reports that the Adm inistration for Childre n and Families said in a statement that under federal law, the Office of Refugee Resettlement can "decide what is in the best interests of a minor in the unaccompanied alien chi ldren program and, in this case , her unborn baby." The Daily Caller (10/17, Carr, 521 K) reports that Texas Attorney General Ken Paxton said that ruling in favor of Doe would "create a right to abortion for anyone on earth who enters the US illegally. And with that right, countless others undoubtedly would follow. Texas must not become a sanctuary state for abortions." CNN (10/17 , Levenson , Burnside , 33.59M) also covers the story . HHS TO HOLD NATIONAL CONFERENCE ON SMALL BUSINESS GRANTS IN MILWAUKEE. The Milwaukee Journal Sentinel (10/ 17, Hauer, 628K) reports the Department of Health and Human Services will hold a national conference on the Small Business Innovation and Research and Small Business Technology Transfer grants in Milwaukee from November 7 to November 9. During the conference , "around 100 program managers from " the Centers for Disease Control and Prevention , the Food and Drug Administration , and the National Institutes of Health will be in Milwaukee , and "attendees will be able to meet one-on-one with the program managers to learn how to submit successful applications ." Walter Koroshetz, the director of the National Institute of Neurological Disorders and Stroke , will give one of the keynote addresses at the conference . BENEFITS OF IMPLEMENTING VALUE-BASED CARE IN QUESTION . STAT (10/ 17, 43K) reports that "the implementation of value-based care is a flop so far ," as "costs have continued to skyrocket ," Medicare "has lost money on accountab le care organizations ," and "forecasted quality /\MERICAi\ pVERSIGHT EXT-18-248-D-000505 gains have not materia lized." The article explains that Centers for Medicare and Medicaid Services Director Seema Verma has begun "began soliciting new ideas last month for changing how care is delivered and paid for by the government. " According to STAT , Verma 's request "charted a new course for the agency's innovation center , saying it wants to cut red tape , empower consumers , and 'allow physicians and other providers to focus on providing high-qua lity healthcare to their patients."' OPINION : HHS SHOULD USE EMERGENCY PRESCRIPTION ASSISTANCE PROGRAM TO HELP THOSE AFFECTED BY RECENT HURRICANES. Brian Nyquist , the executive director of the National Infusion Center Associat ion, writes in an opin ion piece in The Hill (10/17 , 1.68M) that the Department of Health and Human Services should enact the Emergency Prescription Assistance Program to help those who are struggling to obtain their prescriptions because of recent hurricanes. Nyquist explains that "the program provides a mechanism for more than 70 ,000 enrolled retail pharmacies nationwide to process claims for certain kinds of prescription drugs, spec ific medical supplies, vaccines and some forms of medical equipment for uninsured individuals in a federally-identified disaster area." INDIAN HEALTH SERVICE DEFENDS CONTRACT AWARDED TO FORMER NEXTCARE CEO . "The federal Indian Health Service agency is defending a contract it awarded " in September to Arizona-based Tribal Emergency Medicine, "whose CEO formerly led a firm that paid $10 million to settle allegations of submitting false claims to government health programs ," the AP (10/17) reports . "Tribal Emergency Medic ine CEO John Shufe ldt previously led NextCare Inc., a multistate chain of urgent-care clinics, " the article explains . In 2009, a former employee filed a lawsuit against NextCare "on behalf of the U.S. government alleg ing the company conducted hundreds of unnecessary allergy and respiratory tests on patients and then submitted bills for the tests to government programs .... The lawsuit also alleged the company inflated billings as part of a practice known as upcoding." HEAL TH EXPERTS CALL FOR CHANGES TO FOOD ENVIRONMENT AS CDC RESEARCH SHOWS RISING OBESITY RATES. With obesity rates in the US at "a new high," public health experts are cal ling for "an aggressive shift in strategy - one that would change the food environment through initiatives such as soda taxes," USA Today (10/17 , Toy, 8.62M) reports. Traditional "public health efforts have centered on communicating messages about what is healthy in the hopes of changing people's behavior," but new research by the Centers for Disease Control and Prevention 's National Center for Health Statistics shows a steady increase in obes ity rates among US adults , up from 30.5 percent in 1999-2000 to 39.8 percent in 2015-2016 . The article cites "Craig Hales, the study 's lead researcher and a medical epidemiologist at the CDC," and notes that "phys ician Jerome Adams, who was sworn in as surgeon general in August , on Monday cited obesity as among the Department of Health and Human Services ' three top priorities ," with the other two being mental health and addiction . BRENNAN : NLM IS A "SAFE HARBOR " FOR INFO RMATION . STAT (10/17, Blau , 43K) interviews National Library of Medicine Director Patricia Brennan, who discusses efforts to improve the accessibility of data. ''The library is a safe harbor for informat ion," Brennan told STAT. "We are counted on to openly curate the important health knowledge of an era - and preserve it across eras." Brennan insists that the NLM, part of the Nationa l Institutes of Health , "has not received any directive to restrict our information or change the information we have available ," unlike other agencies which have restricted public access to certain information under /\MERICAi\ pVERSIGHT EXT-18-248-D-000506 the Trump Administration . "I have a buffer between me and the political ," she said during a recent talk to journalists at the NLM, referring to Dr. Francis Collins, head of the NIH, an Obama appointee who has kept his job under the new Administration . OPINION : US SHOULD FUND MORE RESEARCH ON HOW TO CARE FOR PEOPLE WITH ALZHEIMER 'S DISEASE . Rob Egge, the chief public policy officer of the Alzheimer 's Assoc iation, writes in an opin ion piece in The Hill (10/17, 1.68M) that "this week, leading experts in dementia care and services are gathered at the National Institutes of Health (NIH) for the Nationa l Research Summit on Care, Services and Supports for Persons with Dementia and Their Caregivers." Egge argues that while funding for research to prevent or cure Alzheimer 's disease is crucial , the federal government shou ld also fund research on how to better care for those already living with the disease. MORE RESEARCHERS KEEPING PRIMATES IN SHARED CAGES RATHER THAN ALONE . The NPR (10/17, Greenfieldboyce, 2.4M) "Shots" blog reports that more researche rs are keeping primates in shared cages rather than alone . According to a survey, the percentage of research labs that kept primates in cages alone decreased from 59% in 2003 to 35% in 2014. The article reports that the Nationa l Institutes of Health's Office of Laboratory An imal Welfare's Guide for the Care and Use Of Laboratory Animals says shared cages should be the "defau lt" for primates . Health Reform: TRUMP CALL S ON CONG RESS TO FIX "OBAMACARE MESS" AT HERITAGE FOUNDATION EVENT. The Hill (10/17 , Bowden, 1.68M) reports President Donald Trump told a conservative gather ing at the Heritage Foundation that he "commends " the bipartisan legislation negotiated by Sens. Lamar Alexander (R-TN) and Patty Murray (O-WA) to stabilize the healthcare system and said Congress should fix the "ObamaCare mess." Trump also said, 'Tm pleased that Democrats have finally responded to my call for them to take responsibil ity for their ObamaCare disaster and work with Republicans to provide much needed relief to the American people." The Hill adds that "the bipartisan dea l got a cold shoulder from Republicans on Tuesday, suggesting it faces a rocky path to become law." PRESIDENT TRUMP MAY HAVE TO LOBBY FOR BIPARTISAN HEALTHCARE DEAL. Politico (10/17, Haberkorn, Cancryn , 3.6M) reports that a bipartisan deal negotiated between Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA) to stabi lize health insurance markets may rely on President Trump's support. The President praised the legislation as "a very good solution" Tuesday, but also said later to the Heritage Foundation, "While I commend the bipartisan work done by Sens . Alexander and Murray - and I do commend it - I continue to believe Congress must find a solution to the Obamacare mess instead of providing bailouts to insurance companies. " Sen. Mike Rounds (R-SD) said, "The fact that the president has indicated a real interest in seeing a bipartisan fix like this move forward for a short-term fix is critical." Senate Majority Leader Mitch McConnell added that a vote has not been scheduled on the legislation, saying, "We haven't had a chance to think about the way forward yet." /\MERICAi\ pVERSIGHT EXT-18-248-D-000507 TRUMP SAYS SENATE GOP WILL RESUME WO RK ON ACA REPEAL BILL AFTE R TAX REFORM . The Wash ington Examiner (10/17 , Morrongiello , 465K) reports that on Tuesday , President Trump predicted that "Senate Republicans will return to healthcare reform as soon as Congress passes tax cuts, cla iming GOP leaders still have the votes to pass a bill that would redirect federal funding for Obamacare to the states ." He is quoted as saying, "We are very close." The article says Trump also endorsed the bipartisan deal that seeks to shore up ACA marketplaces. U.S. News &World Report (10/17, 1.73M) also covers the story. TRUMP BLAMES DEMS FOR PREMIUM HIKES FOR ACA PLANS. The Hill (10/17 , Weixe l, 1.68M) reports that on Tuesday, President Trump "blamed Democrats for any premium spikes for ObamaCare plans, even as key senators announced a bipart isan deal aimed at saving the insurance markets from actions taken by the administration. " Trump tweeted, "Any increase in Obama Care premiums is the fault of the Democrats for giving us a 'product' that never had a chance of working." SENS . BENNET , KAINE UNVEIL PROPOSAL TO ADD PUBLIC OPTION TO ACA . The Hill (10/17, Sullivan, 1.68M) reports that on Tuesday, Sens. Michael Bennet (D-CO) and Tim Kaine (D-VA) unveiled a bill which seeks "to add a government-run 'public option' plan to ObamaCare, modeled on Medicare ." The article says the proposal , "part of a long-running debate in the Democratic Party about how far to go in expanding government-run health insurance , would move ObamaCare to the left, but does not go as far as Sen. Bernie Sanders's (I-Vt.) 'Medicare for all' plan." The piece adds that rather than eliminate the ACA and replace with Medicare for everyone, this bill "would provide an option mode led on Medicare as a choice alongside private plans offered through the existing ObamaCare system ." SOME STATES , INSURERS SCRAMBLING TO RAISE RATES FOLLOWING TRUMP 'S DECISION TO END ACA SUBSIDY PAYMENTS. Caro lyn Y. Johnson writes in the Washington Post (10/ 17, 10.38M) "Wonkblog" that state insurance regulators and insurers "scramb led to raise premiums for insurance plans sold on the Affordable Care Act exchanges Monday, after the White House announced it was ending key federal subsidy payments." The piece says some insurers are only now raising prices following President Trump's decision to end ACA subsidy payments. However, in severa l states, "insurance companies had already priced in a possible end of CS Rs to their rate requests , anticipating President Trump 's move." SENATE GOP'S SLIM MAJORITY THREATENED BY THE AGE AND ILLNESSES OF CERTAIN LAWMAKERS . The AP (10/17 , Fram) reports , "Top Republicans coping with a razorthin majority in the Senate as they try pushing a partisan agenda are running smack into another complication - the sheer age and health issues of some senators." The article adds that Sen. Thad Cochran (R-MS), aged 79, returned to Washingto n, DC on Tuesday "after a month of treatment at home. A statement said he still had urological issues and his treatment 'could affect his work schedule. "' The piece also mentions Sen. John McCain (R-AZ), 81, who is receiving treatment for brain cancer, and says that in July, the Senate delayed a vote to repea l the ACA for a week so that McCain could participate. /\MERICAi\ pVERSIGHT EXT-18-248-D-000508 SENS . TOOMEY, COTTON UNVEIL NEW BILL TO EXEMPT CERTAIN PEOPLE FROM ACA'S INDIVIDUAL MANDATE . The Hill (10/17 , Weixe l, 1.68M) reports Sens. Pat Toomey (R-PA} and Tom Cotton (R-AR) have unveiled legislation that "would exempt certain people from ObamaCare's requirement that everyone must purchase health insurance or pay a fine ." The lawmakers said the ACA 's individual mandate is "cruel ," and "they want to exempt working class Ame ricans from the requirement. " The measure "would exempt anyone who earns less than the national median household income : lives in a state where the average premium increased by more than 10 percent year over year : or anyone who lives in a county with only one insurer." INSURERS MAY LOSE ABOUT $1 BILLION DURING THE REMAINDER OF 2017 IF ACA SUBSIDY PAYMENTS END, ANALYSIS INDICATES. The Washington Examiner (10/17, King, 465K) reports a new analysis conducted by Avalere Health indicates ACA plans "will post losses of up to $1 billion for the rest of 2017 due to President Trump's decision to cut off insurer payments." These losses differ "from state to state , with North Dakota plans losing the least with $1.2 million for the rest of 2017 and Florida losing the most with $200 million." The article says the analysis highlights the impact of Trump's decision , and the possible effect on ACA insurers if Congress fails to take action. FEDERAL FUNDING FOR INDIANA 'S ACA NAVIGATORS CUT BY 82%. The Indianapolis Star (10/17, Rudavsky , 479K) reports the Trump Administration recently cut "funds to support its Navigator program, wh ich helps consumers find coverage through the marketp lace and enroll for Medicaid. " The move deep ly impacted Indiana, which "saw an 82 percent cut in its funding , going from $1.6 million in 2016 to $296 ,704 for 2017 ." The article says these decreases have caused concern that peop le will be unab le to find assistance to enroll in ACA plans. The piece adds , however, that in many cases , "federally qualified health centers have their own navigators and other entities also support individuals who can assist with enrollmen t." PITTSBURGH , ERIE ROMAN CATHOLIC DIOCESES SETTLE LAWSUITS OVER ACA 'S CONTRACEPTION MANDATE . The AP (10/17, Mandak) reports, "The Pittsburgh and Erie Roman Catholic dioceses have settled laws uits seeking to overturn an Affordab le Care Act mandate that would have forced them to provide contraceptive and abortion-inducing drugs or services as part of their employee health care plans." Earlier this month, the Trump Adm inistration announced it was rescinding the ACA 's contracep tion mandate, and issued new rules which "broadened 'conscience protections ' to include nonprofits and certain other businesses that claim a moral objection to contracept ion or abortion, even if it's not religiousbased." The article says the US Supreme Court had ordered the plaintiffs and the US government to settle the suits , and on Tuesday , Pittsburgh Bishop David Zubik , the lead plaintiff in the case , announced the settlement, saying that it "restores religious freedom granted by the First Amendment. " DEMOCRATIC CANDIDATES IN MINNESOTA 'S GUBERNATORIAL RACE UNANIMOUSLY SUPPORT SINGLE-PAYER HEALTHCARE SYSTEM . The St. Paul (MN) Pioneer Press (10/ 17, Stassen , 527K) reports that as debate over the fate of the ACA continues , "Minnesota Democrats who would be governor are near united in their prescriptions: Universal and single-payer is the way forward." The article says during a recent debate , "the half-dozen Democratic-Farmer-Labor candidates gave nods to supporting universal health care." Four of them "proudly said they /\MERICAi\ pVERSIGHT EXT-18-248-D-000509 supported a single-payer health care model, meaning a publicly financed system ." NORTH DAKOTA INSURANCE COMMISSIONER SAYS HE WILL NOT ALLOW MORE RATE HIKES FOR ACA PLANS . The AP (10/17, Nicholson) reports that on Tuesday , North Dakota Insurance Commissioner Jon Godfread said "he will deny any additiona l rate increases " for ACA plans being offered for 2018. Godfread warned last week that President Trump 's decision to end ACA subs idy payments to insurers could raise rates by up to 10 percent. On Tuesday , Godfread wrote to Blue Cross Blue Shield of North Dakota, Medica and Sanford Health Plan, saying he would not allow any more increases . He stated that "this is an issue that is between insurance carriers and the federal government ," and that it was his "duty to look out for those consumers who have had to absorb multip le rounds of increases to their health insurance premiums without receiving any assistance from the federal government. " CENTENE RAISES PREMIUMS IN ARKANSAS BY 21.4 PERCENT. The Arkansas Democrat Gazette (10/17, Davis, 319K) reports that Arkansas Gov. Asa Hutchinson (R) said additional premium increases for plans on the state's exchange will have a "minimal impact" on the cost of the state's expanded Medicaid program. Due to the increases, "the state will pay higher premiums next year to provide coverage under Arkansas Works ," but the costs are likely to be offset by the elimination of cost-sharing reduction payments . The article explains that Cente ne has raised its average premium in the state by 21.4 percent. CELTIC INSURANCE/MHS TO RAISE AVERAGE ACA PLAN PREMIUMS IN IN DIANA BY 35.7 PERCENT . The Indianapolis Business Journal (10/17, 37K) reports that Celtic Insurance Co./MHS is increasing its average premiums for ACA exchange by 35.7 percent to $496 per month. The article points out that the company "is one of two insurers that have committed to the Obamacare exchanges for Indiana next year ." NEW JERSEY REGULATORS APPROVE PREMIUM INCREASES FOR INDIVIDUAL ACA PLANS . The Philadel phia Inquirer (10/17, Brubaker, 1.71 M) reports that the New Jersey Department of Banking and Insurance approved average rate increases for individual ACA plans for next year . Horizon Blue Cross Blue Shield of New Jersey will increase rates 24.3 percent and Ame riHealth New Jersey rates will rise by 17.1 percent. The Inquirer adds, "Were it not for uncertainty over federal policy, such as the elimination of payments to insurers to cover out-of pocket costs for consumers and weakened enforcement of the requirement that individua ls buy health insurance, the increases would have been significantly lower, Horizon said." The AP (10/17) reports that AmeriHealth has expanded its service and will offer plans in 13 of the state's 21 count ies under the new rates next year . MASSACHUSETTS STATE SENATORS PROPOSE WIDE-RANGING HEALTHCARE REFORM BILL. The AP (10/17 , Salsberg) reports Massachusetts Senate leaders filed a bill Tuesday to which "aims to squeeze out between $475 million and $525 million in overal l health care savings by 2020." The "wide-ranging proposal" includes provisions to "curb price increases for prescription drugs , reduce the numbe r of unnecessary visits to hospital emergency rooms and /\MERICAi\ pVERSIGHT EXT-18-248-D-000510 smooth out vast disparities between payments made to smaller community hosp itals and their large Boston counterparts ." The AP reports that the measure is "likely to undergo changes as it makes its way through the legislative process ." VERMONT JOINS LAWSUIT AGAINST TRUMP TO MAINTAIN ACA SUBSIDIES . VTDigge r (VT) (10/ 17, Mansfie ld, 3K) reports Vermont Attorney Genera l T J Donovan announced Tuesday that his state will join a lawsuit along with 17 other states and DC against President Trump over his "decision to cut off federal health insurance subsid ies designed to help low-income sick people ." Donovan explained, 'There's got to be some sort of process here ... . You just can't say one day , 'We're going to stop making these payments from the federa l government. ' That would be too arbitrary. It comes down to process." The article reports that 13,000 Vermont residents receive federal cost-sharing reduction subsidies. SENATE HEALTHCARE BILL COULD RESCUE MINNESOTACARE FUNDING CUTS. The Minneapolis Star Tribune (10/17, Brooks, 1.27M) reports that the bipartisan legislation proposed by Sens . Patty Murray (D-WA) and Lamar Alexander (R-TN) clarifies that lowering premiums in the state insurance marketplace , as Minnesota has done , will not cause a reduction in federa l healthcare subsidies . The measure is in response to the Centers for Medicare and Medicaid Service's decision on the state's ACA waiver application, wh ich determined that the state would lose $742 million in funding for its MinnesotaCare program . Sen. Amy Klobuchar (D-MN) said, "They want to encourage things like what Minnesota did ," adding , "What we did was set a path for other states to do the same thing , and if you cut us off, you cut off other states ." MCCAIN , MURKOWSKI SAY THEY SUPPORT BIPARTISAN HEALTHCARE DEAL. The Hill (10/17, Carney, 1.68M) reports Sens . John McCain (R-AZ) and Lisa Murkowski (R-AK) both gave their support behind a bipartisan healthcare bill Tuesday. McCa in said, "While this deal certainly doesn 't solve all the problems caused by Obamacare, it shows that good faith, bipartisan negotiations can achieve consensus on lasting reform .... I look forward to voting in support of this bill." Murkowsk i called it a "short-term deal" and added that it was "an important step as we work towards long-term solutions." The Hill added, however , that it is "not clear if the Alexander-Murray dea l can get the 60 votes needed in the Senate, much less win over the more conservative House GOP caucus." BIPARTISAN HEALTHCARE DEAL INCLUDES PROVISIONS FOR DEMOCRATS AND REPUBLICANS. The Wall Street Journal (10/17, Hackman , Mathews , Subscription Publication, 6.45M) examines the compromise between Democrats and Republicans in the healthcare proposal announced Tuesday by Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA) . The Journa l observes that Democrats secured restored funding for cost-sharing payments for two years and funding for ACA outreach , while Republicans added increased flex ibility for waivers and catastroph ic plans. SEN . JOHNSON TO QUESTION OPM NOMINEES ON CONGRESSIONAL HEALTHCARE CONTRIBUTIONS. Roll Call (10/17, Lesniewski, 134K) reports Sen . Ron Johnson (R-WI) , Senate Homeland Security and Governmental Affa irs Chairman , plans to question nominees for the Office of Personnel Management Wednesday on the agency 's policy of paying "employer contributions for members of Congress and staffers who were moved from the Federal Employee /\MERICAi\ pVERSIGHT EXT-18-248-D-000511 Health Benefits system to the District of Columbia exchange set up under" the ACA . The nominees , Jeff T.H. Pon for director and Michael Rigas for deputy directo r, were informed that the comm ittee sought documents regarding that topic as part of the confirmation process . Joh nson added , "I've already spoken to both the nominee for director and for the deputy director .... They're fully aware of it, and you can expect that quest ion coming up in the hearing tomo rrow as we ll." KEY QUESTIONS SURROUND THE SENATE 'S BIPARTISAN HEALTHCARE PROPOSAL. The Washington Examiner (10/ 18, King, Leonard, 465K) examines some key questions about the bipartisan plan circulated by Sens. Lamar Alexande r (R-TN) and Patty Murray (D-WA) . The piece discusses whether the plan cou ld pass in the House given the Republican Study Committee's tweet that the deal was a "bailout," and whether the President will support it. The Examiner also assesses how states will benefit from the measure , including whether 2018 rates will be affected, and the piece asks whether the Administration might delay open enrollment which is set to start November 1. COMMENTARY CONSIDERS HEALTH REFORM . Several outlets offer opinions on health reform . Matt O' Brien writes for the Wash ington Post (10/17 , 10.38M) "Wonkb log" that President Trump is taking a "three-pronged approach to undermin ing Obamaca re" wh ich includes cutting back on outreach , letting people buy "bare-bones coverage " again , and "pulling the plug on Obamacare 's cost-shar ing reduction payments ." O' Brien discusses Trump's statements in support of a bipartisan bill that would contin ue the CSRs, but concludes , "The only thing that is clear is that right now Trump is threatening to take steps to make insurance more expensiv e and markets less stable than they were before." Brian Balogh writes in a Wash ington Post (10/17 , 10.38M) piece that last week , President Trump again sought to erase "his biggest humiliation since taking office: the failure to repeal and replace Obamacare ." The executive order he signed includes a provision to expand access to "Associat ion Health Plans." Balogh wonders if Trump understands what comprises an association , and adds, "We really can't blame the president for not knowing the scope of associations, though . Few Amer icans understand how associations affect every facet of their dai ly lives ." Aaron Blake writes for the Washington Post (10/17, 10.38M) "The Fix" blog that President Trump first just ified his decision to stop paying ACA subsid ies to insurers because the insurance companies were "getting rich" off of them , pointing to their stock prices . Blake adds that Trump was "cherry-pick ing his data" from the date the ACA passed, not when it was "actually implemented ," and leaves out the fact that insurers are "generally taking losses from their Affordab le Care Act plans." The piece concludes , "Very little of it makes sense , and coming from a president who seemed to vacillate daily on what he wanted from an Obamacare replacement , it suggests Trump doesn 't really have a game plan or unde rstanding of how all of this works." /\MERICAi\ pVERSIGHT EXT-18-248-D-000512 Joshua Jamerson writes in a Wall Street Journal (10/17, 6.45M) "WashWire " piece that President Trump has indicated he would sign a bipartisan effort to shore up ACA marketplaces . Jamerson adds that Sens . Lamar Alexander (R-TN) and Patty Murray (D-WA) are working on such a measure . It would authorize funding for ACA subs idy payments to insurers, and provide states with more flexibi lity to reshape the healthcare law. Bloomberg View (10/17, 4.52M) editorializes that the bipartisan agreement reached by Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA ) to shore up the health insurance system is "exactly the kind of rationa l comprom ise that Washington needs more of." The editor ial urges President Trump to "get his own party , especially in the House of Representatives, to help pass it." The piece concludes that "by demonstrating how readily the law can be tweaked in productive ways that appea l to both Democrats and Republicans , it cou ld begin to lay a bipartisan foundation for the U.S. health-care system." Michael Katz, a pediatric anesthesiologist, writes in The Hill (10/17, 1.68M) that the healthcare debate in Wash ington is "missing a fundamenta l point: the real problem with American health care is the fundamentally flawed business structure underlying its delivery. " Katz explains that the "system is exceptionally good at caring for the very sick , injured and dying but poorly equipped to promote a healthy society and the healthy lifesty les that consume less care ." The piece recommends that the President and Congress enact policies to "develop a conso lidated and integrated health system" and concludes that we need leaders who recogn ize "our society 's moral obl igation to achieve health equality ." David 0. Barbe , President of the Amer ican Medical Association , wri tes in the U.S. News &Wo rld Report (10/17, 1.73M) that the Trump Adm inistration's "decision to end cost-sharing reduction payments not only disrupts the health insurance market , but contradicts many of the health reform priorities expressed this year by both the president and members of Congress." The decis ion will "not increase competition or consumer cho ice" of health insurance plans, will "cause average premiums to rise by 20 perce nt in 2018 ," and will "increase the federa l deficit by $194 billion from 2017 through 2026, " according to Congressional Budget Office analyses . Barbe concludes, "Clearly , the recent action taken by the administration has created a crisis point where partisan differences must be set aside in favor of a bipartisan agreement to maintain the stability of the non-group insurance market place" and that "our patients are counting on Congress to do the right thing ." The New York Daily News (10/ 18, 3.61M) editoria lizes that the bipartisan legislation authored by Sens . Lamar Alexander (R-TN) and Patty Murray (D-WA) is a "modest bill" that is a "no-bra iner fix ." The piece observes that the bill is a "bipartisan remedy" to a "health-insurance crisis of the President's own making - restoring subsidies that enable insurance compan ies to offer plans with affordable copays , and taking other steps to stabilize , not sabotage , Obamacare markets ." Despite being a "no-brainer ," the piece says that it has no "guarantee that it has any chance of passage in the Republican-controlled House." John Stoehr, in a U.S. News &World Report (10/17 , 1.73M) column, calls for "constitutiona l conservatives " to recognize that President Trump 's announcement to end payments to health insurers that help cover out-of-pocket costs for low-income Americans "is actual tyranny ." The /\MERICAi\ pVERSIGHT EXT-18-248-D-000513 piece discusses the Anti-Federalist papers during the found ing era which "understood a nation is a social contract. " The column conc ludes that "self-described constitut ional conservati ves are not conside ring the fullness of the Constitution " and "are focusing on one vital aspect - which is that Congress has the power of the purse - while overlook ing another vital aspect - which is the goal of protect ing and defend ing against the state of nature." Abbe Gluck , professor at Yale Law School's Solomon Center for Health Law and Policy, writes for Vox (10/17, 1.54M) that "Modern Amer ican history has never seen as full-scale an effort to sabotage a valid law as we have with President Trump and the Affordable Care Act. " The "intentional, multi-pronged sabotage of the ACA ... violates both Trump 's constitutional obligations and quite possibly the obligat ions of his Department of Health and Human Services. " Gluck adds that the Const itution requires the President to "take Care that the laws be faithfully executed ," and concludes, "The president has a right not to like the ACA. But so long as it is the law of the land, he does not have the right to undermine it through the use of executive power." Jay Bookman writes in the Atlanta Journal-Constitution (10/17, 1.16M) that when President Trump claims that "Obamacare is finished, " what he means is that he "is ensuring that the program helps as few Amer icans as possible , at as high a cost as possible to taxpayers , in hopes that by inflicting a lot of pain he can destroy the program 's grow ing popular ity ." Bookman continues , "Trump has taken a hostage with no real idea of what ransom he wants in return" because after more than two years, Trump has "offered up nothing in the form of a plan or a bill" aside from what congressional Republicans "vomited forth ." Bookman concludes that Trump's "'plan' is to cause as much chaos and pain to as many people as possible ," and that he is "doi ng it because he can destroy, but he cannot build." Eric Leenson and Dan Geiger, Co-Directors of the Business Alliance for a Healthy Californ ia, write in the San Diego Union-Tribune (10/ 17, 668K) that "small businesses are among the most negatively impacted by our nation's health care system 's runaway costs and corporate insurance system ." The column says that the Healthy California Act , SB 562 , provides for Medicare-for-all and would especially benefit small businesses by "lowering overall health expenditures," "freeing businesses from the burden and expense of managing and paying for employees ' health care, " and "the stress of administering " health insurance plans. The piece concludes by quoting a former Cigna vice president, Wendell Potter, who said, "When businesses understand the benefits of single payer and speak out, there will be no stopping the movement for universal health care ." Daniel Hemel, assistant professor at the University of Chicago Law School, in an op-ed in the Washington Post, reprinted in the Harrisburg (PA) Patriot-News (10/ 17, 553K) , calls for states to seize the "opportunity to restore order to their insurance markets" follow ing President Trump 's announcement his Adm inistration will not pay ACA subsidies . The states can make those subs idy payments themselves , encouraging "insurers to stay on the exchanges rather than rushing to the exits," then sue the Department of Health and Human Services for reimbursement. The states are likely to win such a suit, as "the Supreme Court has interpreted simi lar statutory language to require the federal government to make payments even in the absence of a congressional appropr iation." /\MERICAi\ pVERSIGHT EXT-18-248-D-000514 Ed Kilgore writes in the Daily Intelligencer (NY) (10/17, 519K) that "only legislation can bring back the payments that offset insurers ' obligation under the Affordable Care Act to ensure that low-income consumers can buy an individual health-insurance policy without ruinous out-ofpocket expenses ." While Sens. Lamar Alexander (R-TN) and Patty Murray's (D-WA) proposals had long included continuing cost-sharing reduction payments , their "negotiations were made both more urgent and more politically complicated last week when the president abruptly announced that he was canceling the payment" of the CSR reimbursements. Kilgore adds that the "main problem with this I-broke-it-so-Congress-can -fix-it approach is timing" because rates for 20 18 have already been set and the "damage may already be done." The Tulsa (OK) World (10/17, 320K) editorial izes that President Trump 's "most controversial move" to "halt federal payments for cost-sharing reductions that help millions of lower-income Ame ricans afford coverage" has caused "concern for the viability of the 'Obamacare' marketplaces." The editorial adds that President Trump "owns the political consequences" of the decision. The World concludes that "if the cost of that insurance skyrockets and the availability disappears because of Trump 's actions, the president will have a hard time blaming the implosion of Obamacare on Obama ." Opioid News: REP. MARINO WITHDRAWS FROM CONSIDERATION FOR DRUG CZAR POSITION AFTER CRITICISM . NBC Nightly News (10/17, story 4, 0:20, Holt, 16.61M) reported, "President Trump says his nominee to be the next US drug czar is withdrawing from consideration for the job." The CBS Evening News (10/17, lead story, 1:40, Mason, 11.17M) reported that "Congressman Tom Marino [R-PA] withdrew under pressure today as President Trump 's nominee to be drug czar" following a te levision report revealing his "role in legislation that makes it easier for drug companies to distribute opioids in the midst of an epidemic that's cla iming thousands of lives." The New York Times (10/18, A19 , Baker , Subscr iption Publication , 13.56M) reports , "The collapse of Mr. Marino's nominat ion highlighted the Trump administration 's troub les formulating a response to a crisis that the president has called unlike any" other in the history of the US. The Washington Post (10/17 , Gearan, Bernste in, Higham, O'Keefe, 10.38M) reports Trump announced the withdrawal of Rep. Tom Marino 's nominat ion as the head of the Office of National Drug Control Policy. The article points out that the announcement follows a Washington PosU"60 Minutes" investigation that found Marino had "helped steer legislation in Congress making it harder for the Drug Enforcement Administration to act against giant drug companies. " The Los Angeles Times (10/17, Lauter , 4.49M) reports Trump said that "we're going to be looking into" Marino's actions. /\MERICAi\ pVERSIGHT EXT-18-248-D-000515 Reuters (10/17 , Lynch , Brice) reports that "the legislation championed by Marino ...was the product of a drug industry quest to weaken the US Drug Enforcement Adm inistration 's author ity to stem the flow of painkillers to the black market." The article reports that "the law made it almost impossible for the DEA to freeze suspicious shipments of narcotics to prevent them from reaching the street." The Wall Street Journal (10/ 17, Nicholas, Subscr iption Publication , 6.45M) reports after the investigation 's findings were released , many members of Congress called for his nomination to be withdrawn and praised the President after he made the announcement. The AP (10/17, Superville, Daly) reports Sen. Claire McCaskill (D-MO) said that she will introduce legislation to repeal the law. The Philadelphia Inquirer (10/17, Whe lan, 1.71M) reports Reps. Brian Fitzpatrick (R-PA) and Kyrsten Sinema (D-AZ) are leading an effort to repeal the bill in the House . Fitzpatrick said in a press release, 'This legislation is about righting a wrong and upholding our commitment to keep our constituents safe." The Hill (10/17, Savransky, Roubein, 1.68M) points out that several agencies that "play a role in the federa l response to the opioid epidemic" lack Senate-confirmed leaders, including the Department of Health and Human Services , the White House Office of Nationa l Drug Control Policy, and the DEA. Also covering the story are Politico (10/17, Ehley, 3.6M), the Washington Examiner (10/17, Giaritelli , 465K), the ABC News (10/17, Stracqualurs i, 2.83M) website , CNN (10/17, Vazquez , 33.59M), Bloomberg News (10/17, Olorunnipa , 4.52M) , NPR (10/17, Chappell , 2.4M), The Atlantic (10/16 , Berman, 1.64M), the New York Daily News (10/17, Silverstein , 3.61M), and the Allentown (PA) Morning Call (10/17, Olson , 312K). Columnist: Withdrawal Of Marino Nomination Is An other Obstacle To Addressing The Opioid Crisis. Dan Janison writes in his column in Newsday (NY) (10/17, Jan ison, 1.64M) that the White House is facing "hurdles on the path to solutions" for the opioid crisis. Janison argues that the controversy surrounding Marino's nomination to head the DEA is one of those obstacles for the Trump Admin istration . Commentaries Address Opioid Crisis, Marino 's Withdrawal. A USA Today (10/17, 8.62M) editorial is critical of the President's delay in addressing the opioid epidemic, saying he said "he would declare the emergency " over the summer , "but didn't follow through ." USA Today says both Congress and the President need to do more, and in the wake of Rep. Tom Marino's withdrawal Tuesday as Trump's nominee to lead the ONDCP, the editorial urges Trump to nominate "a public health expert, not a politician ." John M. Gray, president and CEO of the Healthcare Distribution Alliance , argues in USA Today (10/17, 8.62M) that the 2016 law which prompted Marino's withdrawal, known as the Ensuring Patient Access and Effective Drug Enforcement Act, was "a bipartisan, commo nsense step forward to improve enforcement efforts and combat the opioid epidemic." He notes that it went into effect in April 2016, "well after the opioid epidemic took hold. Based on this timeline, the law /\MERICAi\ pVERSIGHT EXT-18-248-D-000516 had no bearing on any enforcement slowdown that occurred in prior years, as alleged by the reporting ." TRUMP SAYS HE'LL FORMALLY DECLARE NATIONAL EMERGENCY TO COMBAT OPIOID EPIDEMIC NEXT WEEK . USA Today (10/ 17, Korte, 8.62M) reports that after first promising "to declare a nationa l emergency to confront the epidemic 68 days ago," President Trump "now says he'll formally declare that emergency next week, a two-month delay that he said underscores the 'time-consuming work' behind his administration's response to the crisis." Neither the White House nor the President "would explain what's holding up the proclamation , though Trump suggested that he's wad ing through uncharted waters ." DOJ TO CONSIDER REPEAL OF LAW BLOCKING DEA FROM HAL TING OPIOID SHIPMENTS . USA Today (10/17, Johnson, 8.62M) reports the Justice Department is weighing whether to seek a repeal of the Ensuring Patient Access and Effective Drug Enforcement Act, legislation passed in 2016 "that ultimately undermined law enforcement's ability to stop suspicious shipments of opioids that have been driving surges in overdose deaths across the country ." That review follows "a joint investigation by The Washing ton Post and 60 Minutes" wh ich found "that the fede ral Drug Enforcement Administration was essentially handcuffed by the law pushed by Rep. Tom Marino ," President Trump's nominee to oversee national drug policy who has withdrawn his name from considerat ion in the wake of the investigation . Also report ing on the calls for review and repeal of the law are the Los Angeles Times (10/17, Bennett , Bierman, 4.49M), the Was hington Times (10/17 , Noble , 541K), and The Hill (10/ 17, Roubein, 1.68M). INVESTIGATION OF ALLEGED FENT ANYL SHIPPING OPERATION LEADS TO MULTIPLE INDICTMENTS . The Oregonia n (10/17, Bernstein , 878K) reports 38-year-old Jian Zhang has been "accused of shipping fentanyl from China into the United States, deliveries that resulted in multiple drug overdoses across the country , including four in Oregon in 2015 ." Along with Zhang , 20 other "people from China, Canada and the United States have been indicted" in connection with an alleged drug trafficking scheme that has been dubbed "Operat ion Denial." Members of the Portland High Intensity Drug Trafficking Interdiction Task Force have worked on the effort to bust the operation . The Oregonian mentions that OHS was involved in the investigation. The task force is not ment ioned by NBC Nightly News (10/17, story 5, 1:40, Holt, 16.61M), the St. Louis PostDispatch (10/17, 831 K), and the NPR (10/17, Lucas, 2.4M) website , which also highlight the indictment of Zhang and Xiaobing Yan , who are both Chinese nationals. NPR also mentions that HSI was involved in the investigation . NPR quotes Deputy Attorney General Rod Rosenstein as saying, "For the first time, we have indicted major Chinese fentanyl traffickers who have been using the Internet to sell fentanyl and fentanyl ana logues to drug traffickers and individual customers in the United States." OPIOID CRISIS CAUSING INCREASE IN HEPATITIS C CASES. The Washi ngton Post (10/17, Zez ima, 10.38M) reports that "the rampant spread of hepatitis C" is another consequence of the national opioid crisis. The article reports that new cases of the disease "have nearly tripled nationw ide in just a few years , driven largely by the use of need les among drug users in their 20s and 30s." /\MERICAi\ pVERSIGHT EXT-18-248-D-000517 HOSPITALS MOVE FORWARD ON OPIOID RESPONSE STRATEGIES DESPITE LACK OF FEDERAL FUNDING . Ahead of President Trump's expected announcement declaring the opioid epidemic a nationa l emergency , Modern Healthcare (10/17, Johnson , Subscription Publication , 238K) reports on the need for federal funding to address the issue, and how hospitals and health systems "say they're moving forward on strategies they have developed to respond to the crisis" even without that funding. One example cited in the article is Linden Oaks Behavioral Health, "a mental health and substance abuse treatment provider affiliated with Edward-Elmhurst Health system in the Chicago suburbs." According to Modern Healthcare , "Linden Oaks has deployed continuing education for clinicians to improve their prescrib ing habits ," and "has also altered its electronic medical record system to automatica lly prescribe naloxone when patients are over a certain high-dose threshold on their opioid prescriptions. Clinicians can also look up information from the state's prescription drug-monitor ing program within the EHR itself rather than having to go to an outside system." PHRMA CALLS FOR REPEAL OF LAW LIMITING DEA'S OPIOID-RESPONSE CAPABILITIES . The Hill (10/17, Delk, 1.68M) reports in its "Briefing Room" blog that the Pharmaceutical Research and Manufacturers of Amer ica (PhRMA) called Tuesday for the repea l of the Ensuring Patient Access and Effective Drug Enforcement Act of 2016 , whic h "has come under renewed scrutiny after a new joint report from the Wash ington Post and '60 Minutes ' that pointed to the law as undercutt ing the Drug Enforcement Adm inistration's ability to crackdown on the flow of the drugs into the market. " In additio n, PhRMA "urged Congress to recons ider the penalties for DEA-registered drug distributors who fail to ensure the safety of opioid distribution by reporting suspicious purchases of the drugs ." HEALTHCARE PROVIDERS SEEK ALTERNATIVE PAIN TREATMENTS IN RESPONSE TO OPIOID EPIDEMIC . U.S. News &World Report (10/17, 1.73M) reports healthcare providers are responding to the nation's opioid epidemic , and the related rise in drug overdose deaths, by "aggressive ly turning to new approaches " for treati ng patients with chronic pain. "Emerging trends focus on improving physical and emotio nal health and counse ling patients to realize their own role in relieving their pain, says Bhiken Naik, an anesthesio logy and neurosurgery professo r at the University of Virg inia Health System ," and the article notes that "Cente rs for Disease Control and Prevention guideli nes published in 20 16 recommend that physicians turn to cognitive behavioral therapy, exercise and patient educat ion," along with alternat ive medications , before resorting to opioids. In line with that "growing focus on the possibility of a psycholog ical component to pain that needs attention," the University of Virginia and the University of Pittsburgh Medical Center "are both expanding their Enhanced Recovery After Surgery programs to treat surgery pain using as little opioid medication as poss ible." BEAVER COUNTY BECOMES THIRD IN PENNSYLVANIA TO SUE PHARMACEUTICAL COMPANIES OVER OPIOID CRISIS . The AP (10/17) reports that Beaver County has become the third Pennsylvania county "to sue pharmaceutical companies for alleged ly contributing to an opioid addiction crisis that has resulted in thousands of overdoses nationally in recent years ." The county's lawsuit "against 14 drug companies and several doctors the county cla ims have contributed to 279 overdose deaths there since 2012 " was announced on Oct. 16 by attorney Bob Peirce, Jr. /\MERICAi\ pVERSIGHT EXT-18-248-D-000518 Healthcare News: UNITEDHEALTH POSTS HIGHER Q3 EARNINGS , BEATS ANALYSTS ' EXPECTATIONS. The AP (10/ 17, Murphy) reports that on Tuesday , UnitedHealth Group posted a 26-perce nt increase in third-quarter earnings , beating Wal l Street expectations . The largest insurer in the US "also raised its forecast for 2017 again , and signaled that it expects more growth next year ." As a result, the company 's shares "shot up past $200 to reach another all-time high after markets opened ." Data show UnitedHealth added almost "1 million more customers compared to last year's quarter , largely due to growth in its Medicare and retirement business ." The Wall Street Journal (10/ 17, Prang , Subscr iption Publication , 6.45M) reports that UnitedHealth said it earned $2.6 billion, or $2.66 per share for the third quarter, compa red to $2.1 billion a year ago. The company anticipates total earnings of about $10 per share for this yea r. It raised its forecast from $9.75 to $9 .90 per share from the previous quarter. Reute rs (10/17 , Humer) reports that UnitedHealth expects earn ings to grow by "13 to 16 percent in 2018 as medical costs remain low, even as it adjusts to new healthcare rules that U.S. President Donald Trump has promised to put in place ." The article says UnitedHea lth is considered "the bellwether for the industry ," and its gains on Tuesday also benefited companies "such as Anthem Inc, Aetna Inc, and Cigna Corp ." The piece adds that UnitedHea lth has largely exited ACA exchanges, and CEO Dave Wichmann "said the company only had about 30,000 customers receiving subsidies in four states , and that any impact" from Trump 's plans to end subsidy payments "would be 'extremely small."' The Minneapol is Star Tribune (10/ 17, Snowbeck , 1.27M} reports that UnitedHealth 's shares rose by five percent during trading on Tuesday . The company intends to "continue to focus investments going forward on its fast-growing Optum division for health services , including pharmaceutical benefits management, non-hosp ita l health care and technology ," according to Wichmann. Bloomberg News (10/16, Tracer, 4 .52M) also covers the story . COLUMNIST WARNS FEDERAL RETIREE HEALTH PREMIUMS COULD INCREASE MARKEDLY IF HOUSE BUDGET PROPOSAL BECOMES LAW. Columnist Joe Davidson writes in the Washington Post (10/17, 10.38M) "PowerPost" blog that along "with President Trump's earl ier budget plan, wh ich would slice and dice federal retirement, Capitol Hill and the White House have mounted a multi-front assault on federal worker compensation." He warns that if the Budget Resolution put forward by the House "becomes law, federa l retiree health insurance premiums could rise significant ly over time because growth in the government's subsidy would be limited to the increase in inflation ." /\MERICAi\ pVERSIGHT EXT-18-248-D-000519 WISCONSIN BILL WOULD PROHIBIT UNIVE RSITY OF WISCONSIN EMPLOYEES FROM WOR KING AT PLANNED PARENTHOOD . The AP (10/17) reports the Wiscons in state Senate 's health committee is expected to hold a public hearing on a bill that would prohibit University of Wisconsin employees from "from perform ing abortions or providing training at facilities where abortions are performed , other than hospita ls." The bill "ta rgets an arrangement between Planned Parenthood and UW in which faculty members work part-time at the organization's Madison clinic. " ARKANSAS HEALTH CARE ASSOCIATION JOINS COALITION TO SUPPORT LIMITS ON PAYOUTS FOR LAWSUITS. The Arkansas Democ rat Gazette (10/17, Moritz, 319K) reports multiple Arkansas business groups on Monday announced they will join a coalition to raise funding for and support a proposed state constitutional amendment to limit some kinds of payouts in lawsuits. State legislators "voted in the spring to have such rules put before voters as a proposed amendment to the Arkansas Constit ution ," and the proposal will be decided by constituents in the November 2018 general election. The coalition, Arkansans for Jobs and Justice, is supported by the Arkansas Health Care Association among other groups. PENNSYLVANIA REGULATORS ISSUE MORE NURSING HOME CITATIONS BUT UNDERSTATE INCIDENTS ' SEVERITY , EXPERTS SAY . The Harrisburg (PA) Patriot-News (10/17, Simmons-Ritch ie, 553K) says that after investigat ive reports showed Pennsy lvania regulators have neglected "to properly cite and pena lize nursing homes for serious fa ilures," the state Department of Health "appears to be tak ing a tougher line on nursing homes ," with the department issuing twice as many immediate jeopardy citations against homes as those over the past three years combined. Advocates for elder care "confirmed that the department appeared to have gotten tougher on bad homes ," but some "said ... the department was either still understat ing the severity of nursing home incidents or their inspectors were failing to uncover incidents to begin with." Emergency Response and Pandemic Preparedness: VULNERABLE ELDERLY INCREASINGLY BECOMING VICTIMS OF EMERGENCIES , DISASTERS . CNN (10/17, Nedelman , 33.59M) reports Californ ia wildfires and Florida, Texas , and Puerto Rico hurrica nes "have put a spotlight on vulnerable seniors - including a number of deaths that authorities have said were preventable." The article discusses the impact of each event on older adults in the affected communities, noting many experts "continue to grapp le with how best to protect the elderly, who face difficulties evacuating from disasters , more health issues on average and perhaps even a greater share of the psychological impact." Concerning the deaths of 14 residents of the Florida nursing home at The Rehabil itation Center at Hollywood Hills, the article says the Florida Health Care Association "instructed each facility to prepare seven to 10 days of medication , oxygen and other medical necessities for each resident , according to spokesperson Kristen Knapp." /\MERICAi\ pVERSIGHT EXT-18-248-D-000520 Nutrition &Obesity: GOOGLE MAPS PULLS EXPERIMENTAL "CALORIE COUNTING" FEATURE FROM APP AFTER CRITICISM . The New York Times (10/17, Victor, Subscript ion Publication , 13.56M) reports Google Maps pulled an exper imental "calor ie-counting" feature , which showed how many calories someone could burn by walking to a certain destination. Some criticized the feature as being insulting for suggesting that people needed exerc ise, while others said the feature was dangerous for people with eating disorders . Medicare: EXPANDED MEDICARE ENROLLMENT OPTIONS GIVE SENIORS MORE TO SORT OUT. The Palm Beach (FL) Post (10/ 17, Elmore, 273K) reports, "Hundreds of Palm Beach County residents are calling adv isors daily for help to sort out expanded options " for Medicare . "We definitely have more interest th is year than last year," said Desirae Mearns, lead project director for Serving Health Insurance Needs of Elders (SHINE), add ing that seniors in Palm Beach County have 46 plan options in 2018 compared to 43 last year. OPINION: CMS PROPOSAL TO EXEMPT RURAL PHYSICIANS FROM MIPS WILL DO MORE HARM THAN GOOD. Caravan Health CEO Lynn Barr writes in an op-ed for The Hill (10/ 17, 1.68M) that the Centers for Medicare and Medicaid Services' "proposed rule to exempt two-thirds of the nation's clinicians from the Medicare Incentive Payment System (MIPS) will do more harm than good" and furthermore wou ld "disable the infrastructure of electron ic health records (EHRs) that has been subsidized with $37 billion taxpayer dollars." Rural clinicians are exempt from quality reporting and "have provided lower quality care ," Barr writes , add ing that CMS ' proposa l to exclude reporting for pneumococcal and influenza vaccines - two particularly "important qua lity measures" - is shortsighted. "Our data clearly shows that more vacc ines means fewer patients going to the hospital and fewer pneumonia-related deaths, " particu larly for seniors. Medicaid &CHIP: "BICKERING " OVER CHIP, COMMUNITY HEALTH CENTERS REPORTEDLY HARMING NATION 'S HEALTHCARE. Paige Winfield Cunningham writes in the Washin gton Post (10/ 17, 10.38M) "The Health 202" about the ongoing discussions between Democrats and Republicans over how to pay "for states to keep running the Children's Health Insurance Program and for community health centers to care for low-income people," and for how long to extend the funding . Cunningham is critical of lawmakers for their "bickering ," arguing that "if Congress were serious about funding the two programs without causing crippling uncertainty for states and providers, it could have tackled the issue months ago ." She also criticizes President Trump for "signing an executive order that many health-care experts warned could destabilize the marketplace even further by allowing individuals and small-business employees to buy narrower coverage through trade associat ions ." /\MERICAi\ pVERSIGHT EXT-18-248-D-000521 ARKANSAS GOVERNOR SAYS INSURANCE RATE HIKES WILL NOT THREATEN STATE MEDICAID EXPANSION . The AP (10/17, DeMillo) reports Arkansas Gov. Asa Hutchinson (R) said Tuesday that the 14.2 percent to 25 percent insurance rate hike approved by state regulators after President Trump ended cost-sharing reduction payments will not imperil the state's hybrid Medicaid expansion . "Under Arkansas ' hybrid expansion program , Medicaid funds are used to purchase private plans for low-income residents through the insurance marketplace," the AP expla ins. State Democrats , however, "accused Hutchinson of glossing over the effect Trump's act ion will have." MICHIGAN DEMOCRATS SAY PROPOSED MEDICAID CUTS "DEVASTATING " FOR VULNERABLE PEOPLE . Mlive (Ml) (10/17, Slagter, 947K) reports on a panel of Democratic state and local officials that convened to discuss "the best way to push back against the president's proposed $700 billion cut to Medicaid funding in 2018." The group said the proposed Medicaid cuts would be "devastating" to senior citizens and people with disabi lities and that opponents shou ld emphasize the perso nal impact of the reductions. Health &Medical News: PHARMACEUTICAL COMPANIES DENY RESPONSIBILITY FOR DRUG PRICING AT SENATE HEARING. Bloomberg News (10/17, Edney, 4.52M) reports leading drug industry lobbyists at a Senate Health, Education, Labor, and Pensions hearing alleged pharmacy benefit managers (PBMs), hospitals, and other groups are to blame for prescription medicat ion prices. Groups test ifying , including the Pharmaceutical Research and Manufacturers of America (PhRMA) , continued to "say that the measures used to assess them are incorrect, and that they only get a portion of the profit their critics say they do ." PBMs at the meeting , however , "pointed the finger back at pharmaceutical compan ies, and said the cut they take as middlemen has no connection to how drugmakers set prices ." The Washington Examiner (10/17, King, 465K) reports the Pharmaceutica l Care Management Assoc iation, which represents PBMs , refuted PhRMA 's claims that PBMs and insurers foc us "on list prices, which are not reflective of actual spending trends ." The article notes Congress has passed bills intended to speed up generic approval at the FDA, and that Sen. Al Franken (D-M N) at the hearing questioned why drug prices are so high and "pointed out that taxpayers pay for research at the National Institutes of Health, and U.S. customers pay higher prices for the finished product." SENATOR QUESTIONS PHARMACEUTICAL INDUSTRY ABOUT DOING AWAY WITH REBATES . STAT (10/17 , Swetlitz, 43K) reports that Sen. Lamar Alexander (R-TN) "asked a panel of pharmaceutical industry representatives at a Senate committee hearing" about whet her drugmakers and pharmacy benefit managers would be willing to do away w ith rebates. "Why don't we just get rid of rebates and let you negotiate direct ly with manufactures, take that $100 billion a year, and just reduce the list price? Wouldn 't it be simpler for us to understand where the money goes?" Alexander asked Mark Merritt, preside nt and chief executive officer of the Pharmaceutical Care Management Association . Industry representatives said they would be /\MERICAi\ pVERSIGHT EXT-18-248-D-000522 willing to consider the proposal, although they expressed doubt about the feasibil ity of enacting such a reform . FAMILIES OF DECEASED TROOPS ALLEGE PHARMACEUTICAL COMPANIES "KNOWINGLY FINANCED " ANTI-AMERICAN MILITIA IN IRAQ. USA Tod ay (10/17 , Madhani, 8.62M) reports a group of famil ies of "dozens of U.S. troops killed or injured" during the Iraq war filed a federal lawsuit on Tuesday "against several U.S. and European pharmaceut ical and medical supp ly companies , alleging that the corporations knowing ly financed the anti-American militia Mahdi Army through bribes and kickbacks to officials at a government ministry contro lled by the group ." The lawsuit names "some of the biggest names in the industry - including GE Healthcare, Johnson &Johnson, Pfizer , AstraZe neca and Roche," and alleges they often paid kickbacks to officia ls in the Iraqi Ministry of Health, who "in turn used the proceeds to help fund the militia that carried out attacks against U.S. troops in Iraq." MASSACHUSETTS SENATE CONSIDERS BILL TO REQUIRE DATA SUBMISSIONS FROM DRUG COMPANIES. The Boston Globe (10/17, McCluskey , 969K) reports Massachusetts Senate legislators on Tuesday revealed "sweeping health care legislation " address ing issues such as prescription treatment costs and hospital prices, which "proponents say will improve the state 's health care system and curb medica l spend ing." The new bill would mandate that "drug companies for the first time to submit data to the state Health Policy Commission and be scrutinized by the watchdog agency," and "sets a target for controlling commercial spending on hospital care by slowing the rate of price growth at the most expensive hospitals ." APPEALS COURT VACATES VERDICT IN TALCUM POWDER CANCER CASE. Bloomberg News (10/17, Fisk, 4.52M) reports a Missouri appeals court has vacated the $72 million verdict in Fox v. Johnson &Johnson, ruling the case shouldn't have been tried in St. Louis. "The verdict to the family of Jacqueline Fox, who died in 2015 , was the first of a series of jury awards in the St. Louis court ," where juries "have awarded a total of $300 million in verdicts" related to claims that Johnson &Johnson's talc products cause ovarian cancer. According to the AP (10/17, Stafford) , "the appeals court cited a Supreme Court ruling in June that placed limits on where injury lawsuits could be filed, saying state courts cannot hear claims against companies not based in the state where alleged injuries occurred. " In response, "Jim Onder , who is represent ing many plaintiffs in the lawsuits, has argued that Missouri is a proper ju risdiction because Johnson &Johnson packages and labels some products in Missouri." Also reporting are Reuters (10/ 17, Raymond), the St. Louis Post-Dispatch (10/17, Currier , 83 1K), and Fierce Pharma (10/17 , Sagonowsky). GENE TUMOR BOARDS INCREASINGLY PROVIDING GUIDANCE ON CANCER CARE . The AP (10/18 , Marchione) reports that patients with cancer are increasingly "having their care guided by gene tumor boards ," panels of experts that study "the patient's cancer genes and match treatments to mutations that seem to drive the disease ." The gene tumor boards aim for "precision medic ine, the right drug for the right person at the right time, guided by genes ." The AP adds that "Some doctors worry that tumor boards' recommendi ng off-label treatments diverts patients from research that wou ld benefit all cancer patients ," and mentions that the "American Society of Clinica l Oncology's TAPUR study tests off-label drugs and shares results with their makers and federa l regulators ." /\MERICAi\ pVERSIGHT EXT-18-248-D-000523 MOUSE STUDY FINDS LINK BETWEEN STRESS AND DIGESTION IN FEMALE MICE. The New York Post (10/17, Steussy , 4.31M) reports new research published in Nature's Scientific Reports suggests stress may have the same effect on human digestion as a fattening diet. Researchers at Brigham Young University conducted the mouse study, wh ich looked at the mice's gut microbiota; they found that the gut microbiome of female mice subjected to stress tests "actually changed to resemble that of an obese mouse," which "suggests that stress might impact metabolism just as much as diet, the researchers wrote." Male rats, however , "didn't have the same microbiome shift, but they did become more anxious and less physically active ." NEW HAMPSHIRE GOV . REMOVES MEMBER FROM CANCER CLUSTER PANEL. The AP (10/17) reports New Hampshire Gov. Chris Sununu said Tuesday he's removed Steve Kenda, a past Republican candidate for state Senate and governor , from the Seacoast Cancer Cluster Commiss ion over an op-ed piece written by Kenda denying the existence of a cancer cluster . According to the AP , Sununu "said Kenda's participation has become too much of a distract ion" from the purpose of the 21-member commiss ion, wh ich has for several years "been investigating a greater-than -expected numbe r of cases of two types of rare childhood cancers in t he seacoast region: rhabdomyosarcoma and pleuropulmonary blastoma. " SCIENTIFIC AMERICAN EDITORS VOICE SUPPORT FOR COSMETICS SAFETY BILL. In an article for the November 2017 issue, the editors of Scientific America n (10/ 17, 878K) express support for the Persona l Care Products Safety Act, which Sens. Dianne Feinstein and Susan Collins reintroduced in Congress last May. "The bill would require , among other th ings, that all cosmetics makers pay annua l fees to the agency to help finance new safety studies and enforcement - tota ling approx imately $20 million a year," wh ich the FDA wou ld use to "assess the safety of at least five cosmetics chemica ls a year. " The legislat ion "also gives the agency the authority to pull products off the shelves immediately when customers have reported bad reactions, without waiting for a review that can take multiple years." The editors highlight the importance of the bill, and the issues it addresses , in light of a petition filed earlier th is year that called on the FDA to ban lead acetate from hair dyes. TRANSENTERIX CEO SAYS SENHANCE WON 'T COMPETE DIRECTLY WITH INTUITIVE SURGICAL 'S DA VINCI. Reuters (10/ 17, Banerjee ) reports Transenterix CEO Todd Pope on Tuesday "played down ...the threat posed by his company 's surgical robotic system," called Senhance, "to market leader Intuitive Surgica l Inc, saying he did not expect the two to compete head on." Transenterix 's share price surged - and Intuitive Surgical's fell - at the end of last week after the US Food and Drug Admin istration cleared Senhance for use, but "Pope said Senhance had a lot of ground to cover before it might have to compete directly with lntuit ive's Da Vinci device , which has dom inated robotic surgery purchasing since it was approved in 2000 ." JOHNSON &JOHNSON 'S ANIMAS CLOSURE , CESSATION OF INSULIN PRODUCTION ARE REFLECTIVE OF BROADER HEALTHCARE ISSUES . The Los Ange les Times (10/ 17, Lazarus , 4.49M ) discusses the recent announceme nt from Johnson &Johnson saying the company is closing its Animas subs idiary and ceasing its product ion of insulin pumps, which creates new challenges from J&J customers that the Times says "mirror problems all too common in the healthcare industry - the turmoil that can arise when a medical-device or drugmaker halts sales, or when an insurer decides to no longer cover a specific pill, gadget or treatment. " The article examin es how such problems can affect healthcare customers and offers insight on how to /\MERICAi\ pVERSIGHT EXT-18-248-D-000524 proceed . DC COUNCIL DISAPPROVES OF EXTENDING CONTRACT TO MANAGE CITY'S ONLY PUBLIC HOSPITAL. The Wash ington Post (10/ 17, ltkowitz , 10.38M) reports six members of the Washington , DC counci l "expressed disapproval " of the request by Veritas of Washington LLC to renew its $4.2 million consulting contract to manage the United Medical Center, which is "the city's only public hospital." The firm was hired last year "to stabilize the only full-service hosp ita l east of the Anacostia River," but has shown "little progress in improv ing the hospital's finances or quality of care." The Post adds the company is "led by campaign donors to D.C. Mayor Muriel E. Bowser (D)." Because of the disapproval , the council will have 45 days instead of 10 to review the contract. PEOPLE WITH ADVERSE CHILDHOOD EVENTS FOUND MORE LIKELY TO SUFFER HEALTH PROBLEMS AS ADULTS. The Denver Post (10/17, Baumann, 817K) reports on a study from the Colorado Department of Human Serv ices and the University of Denver find ing that "children who grow up in a dysfunctional or abusive home are more likely to deve lop depression and cancer as adults , and they 're more likely to one day have chi ldren with health issues as well." The study was based on a survey of 3,677 Colorado residents 18 and over, and "measured adverse childhood experiences , which are events that range from physical , sexual or emotiona l abuse and different types of househo ld dysfunctions such as fam ily member incarcerat ion." Overall, those who reported one such incident "were twice as likely to be diagnosed with depression , and those with four or more incidents were nearly twice as likely to suffer from cancer and almost six times more likely to experience depress ion." Their children also "we re two to five times as likely to be diagnosed with Attent ion Deficit Disorder. " SECOND TB CASE REPORTED IN DURHAM COUNTY , NORTH CAROLINA. The Durham (NC) Herald Sun (10/17, Johnson , 66K) reports on a second tuberculosis case in Durham County , North Carolina , explaining that "a student at Northern High Schoo l is being treated, " as is a student at UNC Chapel Hill. Both "are being treated at home and will remain off campus until the threat of spread ing the disease is over." The county health department will conduct "TB blood tests on people who were exposed at Northern." The Herald Sun adds , "Durham County reported 11 cases of active tuberculos is in 2016 ." VA FACILITY IN OMAHA MAINTAINED SECRET WAITING LIST OF VETERANS SEEKING MENTAL HEALTH APPOINTMENTS. The AP (10/ 17) reports the Department of Veterans Affairs ' Nebraska-Western Iowa Health Care System "maintained an unauthor ized, secret wa iting list of veterans for some Omaha mental health appointments , according to US Department of Veterans Affairs documents ." The article points out that "the VA set up strict requirements for establishing wait ing lists following a 2014 scanda l that showed VA employees were coveri ng up chronic delays with false paperwork and secret lists ," and that the facility in Omaha was not on a list of 40 facilities that reportedly still had secret lists in 2016 . VA officials declined to comment on how many employees were involved in maintaining the list or how many veterans were affected . HEPATITIS A DEATHS NOW UP TO 19 IN SAN DIEGO COUNTY . The San Diego UnionTribune (10/ 17, Sisson, 668K) reports there have now been 19 deaths and 507 confirmed cases in the ongoing hepatitis A outbreak in San Diego County, CA. Dr. Wilma Wooten, the county's /\MERICAi\ pVERSIGHT EXT-18-248-D-000525 public health officer, said that the county is also investigating anothe r 47 potential cases . RESEARCHERS TRYING TO IDENTIFY EARLY SIGNS OF BRAIN DAMAGE IN PROFESSIONAL FIGHTERS . STAT (10/17 , Robbins , 43K) reports researchers have found that "active fighters, " boxers and mixed martial arts fighters , have "higher levels of two brain proteins , called neurofilament light and tau, compared to retired fighters or non-fighters," and that "fighters with greater exposure to repetitive head trauma have lower brain volumes. " The findings are part of an ongo ing study, and "researchers have enrolled close to 700 mixed martial arts fighters and boxers, both active and retired , in the past six years ." The investigators are seeking "to identify early signs of trauma-induced brain damage from subtle changes in blood chemistry, brain imaging , and performance tests," which "may show up decades before visible symptoms such as cognitive impairment , depress ion, and impulsive behavior." US DISTRICT JUDGE ORDERS FLINT TO PICK A LONG-TERM WATER SOURCE. The Detroit Free Press (10/17, Matheny , 1.07M) reports US District Judge David M. Lawson issued a summary judgment ordering Flint to select a long-term water source . The ruling "comes after Flint's City Counci l has balked for months at entering into a long-term deal for water supp lies from the city of Detroit via the regiona l Great Lakes Water Authority ." RESEARCHERS IDENTIFY FOUR GENES IN HUMANS , DOGS , AND MICE THAT MAY BE LINKED TO OCD . The NPR (10/ 17, Chen, 2.4M ) "Shots" blog reports that researchers identified "four genes with the strongest links to OCD to date." The researchers compared the DNA of dogs and mice with compu lsive tendencies to the DNA of people with and without OCD. The findings were published online Oct. 17 in Nature Communicat ions. Newswee k (10/17, Firger, 991 K) reports that the study "may help scientists develop more precise and effective treatments for the psychiatric condit ion ." EXCESSIVE EXERCISE MAY BE LINKED TO HIGHER RISK OF BUILDUP OF PLAQUE IN HEART ARTERIES BY MIDDLE AGE IN CAUCASIAN MEN, STUDY SUGGESTS. The New York Daily News (10/17, Scotti, 3.61 M) reports that research suggests "Caucasian men who exercise three times above the US national guidelines for work ing out (150 minutes per week) are 86% more likely than black men, and those who exercise less, to develop a buildup of plaque in their hearts by the time they're middle aged." The New York Post (10/17, 4.31M) runs a SWNS article report ing that investigators "compared 25-year exercise patterns and made the surprising discovery that very active white men are 86 percent more likely to experience a buildup of plaque in the heart arteries by middle age ." However , "this didn't apply to black men, they discovered." The findings we re published in Mayo Clinic Proceedings. /\MERICAi\ pVERSIGHT EXT-18-248-D-000526 NAFLD , NONALCOHOLIC STEATOHEPATITIS THE FASTEST -GROWING REASONS FOR LIVER TRANSPLANTS IN YOUNG AMERICANS , RESEARCH INDICATES . Reuters (10/17, Crist) reports that research indicates "nonalcoholic fatty liver disease [NAFLD] and its more aggressive form , nonalcoholic steatohepatit is, have become the fastest-g rowing reasons for liver transplants in young Americans." Investigators found that "the number of liver transp lants performed for NASH increased from 0.53% in 2002 to 4.46% in 2012 , a nine-fold jump. " Reuters adds that "due to increasing childhood obesity, hypertension and diabetes ...more young adu lts are reaching end-stage liver disease early in life , researchers say." The findings were published onl ine in Journal of Clinical Gastroenterology. IMPAX LABORATORIES INKS DEAL TO MERGE WITH AMNEAL PHARMACEUTICALS . The Wall Street Journal (10/17, Rockoff, Cimilluca , Subscription Publication , 6.45M) reports lmpax Laboratories and Amneal Pharmaceut icals recently agreed to merge in a deal that would establish the US' fifth-largest generic medication producing company in terms of revenue . They said on Tuesday that the all-stock transaction would grant lmpax shareholders 25 percent of a new company, wh ile owners of Amneal would take the remainder. The new group will be called Amneal Pharmaceut icals and is expected to be worth as much as $6.4 billion. Reuters (10/17) reports Cantor Fitzgerald ana lysts wrote in a client note on the dea l that the merger increases chances for lmpax to grow from a mid-size drug maker to a leading generics and specialty medication company . The article says the combined company will produce "a diverse pipeline with more than 300 products either filed with the FDA or in active stages of development , Cantor analysts said." The San Francisco Business Times (10/17, Leuty, Subscript ion Publication, 904K) reports lmpax ran "into a string of issues in recent years" wh ile attempting to diversify beyond generic treatments , with FDA inspections exposing "problems a couple years ago" at a California facility. The Philadelphia Inquirer (10/17, Loyd, 1.71M) and Fierce Pharma (10/17, Helfand) also report. COLUMN: ALLERGAN RESTASIS CASE EXEMPLIFIES HOW COMPANIES MANIPULATE PATENT SYSTEM . Bloomber g View (10/ 17, 4 .52M) columnist Joe Nocera offers commentary on Allergan 's attempts to transfer its Restasis patents to the Saint Regis Mohawk Tribe --"a nowinfamous patent ploy" - positing that the legal maneuvering represents "trickery" undertaken by many compan ies in the industry "to keep generics off the market." According to Nocera, the "primary way" branded drug makers prevent generic competit ion "is by abusing the patent system ." He adds that a federa l judge who ruled the Allergan patents are invalid simply "called Allergan out on" its "scam ." Nocera mentions Allergan issued a number of "citizen 's petitions" to the FDA and sued compounding company lmprimis on allegat ions that it violated FDA regulations . TROY UNIVERSITY RESEARCHERS DEVELOPING ANTI-DEPRESSANTS THROUGH ZEBRAFISH STUDIES . The New York Daily News (10/17, Scotti , 3.61M) reports researchers at Troy University in Alabama are using zebrafish to deve lop anti-depressant treatments for humans /\MERICAi\ pVERSIGHT EXT-18-248-D-000527 because fish reportedly are "a reliable animal to use in identifying depression ." According to one university researcher , the "neurochemistry (between fish and people) is so similar that it's scary ." The National Institute of Mental Health estimates that nearly "16 million people had at least one major depressive episode in 2012 ." DISTRICT JUDGE INVALIDA TES ALLERGAN 'S RESTASIS PATENTS . Reute rs (10/17, Wolfe) reports US district judge William Bryson on Monday ruled against Allergan 's patents for its dryeye treatment Restasis , which the company transferred to New York state's Saint Regis Mohawk Tribe last month on cla ims that the tribe's status as a sovere ign nation would prevent the patents from being reviewed by the US patent office. Bryson invalidated the patents for the $1.5 billion treatment , calling it an attempt by Allergan to "rent" the tribe's sovereign immunity. Allergan , however, said the move was j ustified because the same patents were already under review in federal court, while critics "said it was a cynical attempt to prolong the company 's monopoly on Restas is." DISTRICT JUDGE REFUSES PHARMACEUTICAL COMPANIES ' REQUEST TO BLOCK NEVADA DRUG PRICING LAW. The Las Vegas Review-Journal (10/17, Bekker , 458K) reports that on Tuesday , US District Judge James Mahan refused a request by the Pharmaceutica l Research and Manufacturers of America and the Biotechnology Innovation Organization "to immediately block a Nevada law requir ing them to detai l diabetes drug prices and disclose manufacturing costs and research investments come July ." Mahan said he did not find "immediate and irreparab le harm" in the case because of the law's timeline . The companies allege in the lawsuit that the law violates federal patent and industry trade secret rules. EXPERTS CONSIDER WHETHER IGNYTA PHARMACEUTICALS ' CANCER TREATMENT CAN BE COMPARED TO PFIZER 'S. Forbes (10/ 17, 5.11M) contributor Matthew Herper considers lgnyta Pharmaceut icals' cancer treatment entrect inib that shrank one patient's tumors and "has kept them in check for more than a year," and , acco rding to research presented at the World Confe rence on Lung Cancer , "shrank tumors in 79% of patients and kept working for a median 28.6 months, about 10 months longer than the current drug, Pfizer's Xalkori, did in separate clinica l trials." Herper writes that nonetheless , the study "raises questions about whether it's possible to compare similar cancer medicines, and whether it's possible to keep innovating after a few gene -ta rgeted drugs have been invented." STUDY REVEALS ASSOCIATION BETWEEN DEPRESSION , SAGGING TESTOSTERONE LEVELS IN NEW FATHERS. In "Well," the New York Times (10/17 , Quenqua, Subscription Publication , 13.56M) reports research indicates that postpartum depress ion "may occur in from 7 percent to 10 percent of new fathers , compared to about 12 percent of new mothers , and that depressed dads we re more likely to spank their children and less likely to read to them ." Now, research published in the September issue of the journal Hormones and Behavior "has found a link between depress ion and sagging testosterone levels in new dads , adding physiologica l we ight to the argument that postpartum depression isn't just for women anymore ." In addition, the study revea led that "while high testosterone levels in new dads helped protect against depression in fathers, it correlated with an increased risk of depression in new moms." The study abstract points out some 149 couples took part in the study. /\MERICAi\ pVERSIGHT EXT-18-248-D-000528 MEN WHO RECEIVE BLOOD DONATED BY PREVIOUSL Y PREGNANT WOMEN MAY FACE INCREASED RISK OF DEATH FOLLOWING THE TRANSFUSION , STUDY INDICATES . STAT (10/17, Begley, 43K) reports, "Men who received a blood transfusion from a woman who had ever been pregnant had a higher risk of dying premature ly than men who got blood from a man or a never-pregnant woman ," researchers reported . Health Day ( 10/17, Thompson, 11K) reports researchers arrived at that conclusion after examining data on some 31,000 patients in Holland who "received 59,320 transfusions in all from one of three types of donors - men, never-pregnant wome n and women who'd been pregnant." Notably, "after receiving a single transfusio n, the three-year death rate among men was 13.5 percent fo r those who received male blood, 13.1 percent for those who got never-pregnant fema le blood , and nearly 17 percent for those who received blood from a previously pregnant fema le." The findings were published in the Journa l of the Amer ican Medical Association . Reuters (10/17 , Rapaport) and Scientific American (10/17, Weintraub , 878 K) also cover the sto ry. PHYSICIAN WARNS OF DANGERS OF ONLINE COMPANIES SELLING DESIGNER SUBSTANCES . In STAT (10/17 , 43K) "First Opinion," Abraham Nussbaum , MD, chief education officer at Denver Health, an assoc iate professor of psychiatry at the University of Colorado School of Medicine , writes about the dangers of online companies "selling compounds that have never been app roved for human use but that are so simi lar to existing drugs they attract users ...seeking an alternative to" physicians and dealers. Ostensibly these "designer" substances are sold for the purposes of "research ." Dr. Nussbaum believes such companies "sideline the doctor , the pharmaceutica l industry , and its regulators from the patient-physicia n relationship " and pose a danger to people buying substances from them . OVERSIZED EYEDROPS WASTE PATIENT 'S MONEY AND MEDICINE BY DESIGN. NPR (10/18, Allen, 2.4M) reports on its "Shots" page that ProPublica has found that pharmaceutical companies make eyedrops that overflow your eyes by design. The article says that for at least twenty-five years , those in the "eye care industry," including doctors, pharmaceutical officia ls, and researche rs, have known "that eyedrops are much larger than the eye can hold." The article tells the story of a project in the early 1990s as Alcon whe re the team created a "microdrop " that would reduce waste but still maintain effectiveness. The product was "killed" because of the cost of getting FDA approval and the risk that it would lead to decreased sales. NPR also reports of similar research on the efficacy of smaller eyedrops t hat was funded by Al lergan, yet Allergan does not make eyedrops in smaller sizes to date . MORE HOSPITALS INVESTING IN HOUSING AND SUPPORT FOR HOMELESS TO REDUCE ER VISITS . Kaiser Health News (10/ 18, Bartolone) reports on a "growing number of hospitals nationwide" that have "investe d in housing programs in recent years , from Florida to Chicago and farther west," with the goa l of ending the cycle of emergency room use by homeless people by providing them housing along with a case worker. Rand Corp. researcher Sarah Hunter says , "There's pretty good evidence that it's more cost-effective to provide housing with supports than have these people live on the streets and just cycle in and out of emerge ncy rooms and in-patient stays ." The piece reports that the nonprofit hospitals' investment in these programs helps them /\MERICAi\ pVERSIGHT EXT-18-248-D-000529 "meet their community service obligations in exchange for tax breaks." Global Health: CHINA CONFIRMS H5N6 BIRD FLU OUTBREAK IN CENTRAL PROVINCE . Reuters (10/ 17, Gu, Mason) reports China 's Ministry of Ag riculture confirmed that there is "an outbreak of bird flu at broiler chicken farms in" the city of Hexian in Anhui province . The outbreak in the central province has been caused by the H5N6 strain . OP-ED : CANADA MUST PUSH FOR NATIONAL REGISTRY OF PAYMENTS FROM COMPANIES TO PHYSICIANS . Nav Persaud of Toronto 's St. Michael's Hospital and the University of Toronto , Joel Lexchin of Toronto's University Health Network, and Andrew S. Boozary of the University of Toronto and the Harvard Public Health Review write in an op-ed in STAT (10/17, 43K) that Canadian province Onta rio "took a historic step" by introducing legislation to increase transparency on how drug companies interact with prescribers in an effort to understand how physicians receive payments from manufacturers . The authors advocate for this on a nationa l scale and suggest the establishment of a registry of payments similar to that which is in place in the US. National News: HOUSE PANEL SETS PUERTO RICO RECOVERY HEARING FOR NEXT WEEK. Reuters (10/17, Cowan) reports that a House panel said Tuesday that it has scheduled an Oct. 24 hearing "to examine Puerto Rico's hurricane recovery efforts and the role of a financia l overs ight board in those efforts. " The House Committee on Natural Resources , which last year worked on legislation creating the board to help Puerto Rico manage its debt, wil l hold the hearing. PUERTO RICAN DELEGATE : TRUMP HAS GIVEN EVERYTHING WE'VE ASKED FOR. Townhall (10/17 , Vespa, 523K) reports Puerto Rico's delegate , Jenn iffer Gonza lez-Colon , said in a recent interview with USA Today "that everything they've asked for , Trump has delivered ." Gonzalez-Colon told USA Today , "I will tell you that everything that the president said that he was going to send to the island , it's gett ing there. The resources are there . The help is there ." DESPERATE PUERTO RICANS TURNING TO WELLS AT SUPERFUND SITE FOR WATER . NBC Nightly News (10/17 , story 11, 1:40 , Holt, 16.61 M) reported on the "deepening and dangerous water crisis" in Puerto Rico in the aftermath of Hurricane Maria. The EPA says "the desperate are breaking into water wells" at a Superfund site in Dorado "that may actually be contaminated." NBC's Gabe Gutierrez reported from the town that "even though there's a clear ly marked danger sign, people were willing to risk it." He noted that "only 17 perce nt of the island has power , making it hard to pump and treat water as this crisis deepens." /\MERICAi\ pVERSIGHT EXT-18-248-D-000530 DISCUSSING OBA MA AND SLAIN SOLD IERS, TRUMP CITES DEATH OF KELLY'S SON. President Trump 's Tuesday remarks - in which he invoked the death of Chief of Staff Kelly's son while defending his claim one day earlier that former President Barack Obama and other presidents didn't always call the famil ies of slain military members - received widespread media coverage, includ ing reports on all three major network newscasts. Coverage was largely negative, highlighting that Kelly has been reluctant to publicly speak about his son's death . In the lead story for NBC Nightly News (10/17, lead story, 2:25, Holt , 16.61M), Peter Alexander reported that "as the body of one of the American soldiers killed in Niger this month returns home to Florida and the White House confirms President Trump spoke to all four families of the fa llen, the President's taking another swing at Barack Obama on the gravest of presidential obligations." NBC played an aud io clip of Trump saying in a Tuesday interview with Fox News Radio, "I think I've called every family of somebody that's died, and it's the hardest call to make . ... As far as other representatives, I don't know. You could ask General Kelly, did he get a call from Obama?" Alexander added, "The President invoking the memory of his chief of staff's son, Robert Kelly, a Marine killed in 201 O." On the CBS Evening News (10/17 , sto ry 5, 2:40 , Mason , 11.17M), Margaret Brennan reported , "White House officials claim to be unaware of whether Mr. Trump had spoken to Kelly before making the remark . The retired Marine Corps general has act ively avoided calling attention to his son's death , making it clear he does not want it to be explo ited ." Brennan added , 'Today, despite the President's prodd ing, Kelly dec lined to comment. But a Wh ite House official, who requested anonymity , told CBS News, 'I can tell you Obama did not call General Kelly after the death of his son.' But White House records show that Kelly and his wife did attend a closed-door breakfast with Mr. And Mrs. Obama to honor Gold Star fam ilies a year after their son's passing ." On ABC World News Tonight (10/17, story 3, 3:10 , 14.63M) , David Muir reported that "Kelly has indicated to the past in reporters that he did not want to talk publicly about the death of his son ." ABC's Cec ilia Vega added that "Kelly has repeatedly made it clear to reporters he does not want to talk about his son's death. And he would not go on the record today . But the White House tells us he never got a call from ...Obama. Obama aides do not dispute that. But they do say Kelly did atte nd a White House breakfast for Gold Star fami lies, where he sat at the first lady's table ." The Was hington Post (10/ 17, Parker , 10.38M) reports, "For the past seven years ...Kelly has gone out of his way to keep the death of his son free from politics." However , Trump on Tuesday "thrust [Kelly's] son into the public and political glare , invoking the younger Kelly as part of a continuing attack on ...Obama ." The Presiden t's "remark ...was unplanned , said two White House officials , who said they we re caught off-guard by Trump 's comments . One said Kelly may have mentioned some details surrounding his son's death to the president in private - and the president then repeated them in public, a relatively frequent occurrence with Trump .'' Similarly , under the headline "Top Genera l's Grief Becomes Political Talking Point For Trump ," the New York Times (10/17, Landler, Subscr iption Publication , 13.56M) reports that Trump "is testing" Kelly's "long-held reluctance to discuss his loss. Mr. Trump , in defending his handling of /\MERICAi\ pVERSIGHT EXT-18-248-D-000531 the deaths of four Green Berets in Niger, falsely claimed on Monday that...Obama did not contact the families of fa llen troops . And on Tuesday , Mr. Trump brought to light that Mr. Obama never called Mr. Kelly after the death of his son ." The Times adds that Kelly "has not addressed the dispute . But colleagues who worked with him at the Pentagon during that period said they did not recall him express ing unhappiness with the way Mr. Obama handled the death of his son. " Writing for McClatchy (10/ 17, 67K), Kate Irby says that "Kelly had to endure every parent's worst nightmare when his son ...stepped on a land mine in Afghanistan in 2010 and died. Now .. .Trump is calling into question w hether ...Obama ever called Kelly after that happened dragging Kelly into a spat Trump started between the two presidents over whether Obama called the families of fa llen soldiers ." The AP (10/17, Woodward, Lemire) simi larly reports that Trump "has pulled bereaved military fam ilies into a painful political fight of his own making, going so far Tuesday as to cite the death of' Kelly's "son in Afghanistan to question whether ...Obama and other presidents did enough to honor the military dead. He's boasted that ' I think I've called every family of someone who's died,' though AP found relatives of two soldiers who died overseas during Trump 's presidency who said they never received a call or a letter from him. The White House said he did telephone on Tuesday the fami lies of four soldiers who were killed in Niger nearly two weeks ago , the issue that had spawned the controversy this week ." Under the headline "After Trump Brings Chief Of Staff Into Controversy Over Condolence Calls, He Phones Families Of Killed Soldiers ," the Los Angeles Times (10/17 , Bierman, 4.49M) quotes White House Press Secretary Sarah Sanders as saying in a Tuesday statement , "President Trump spoke to all four of the families of those who were killed in action in Niger. He offered condo lences on behalf of a gratefu l nation and assured them their family 's extraordinary sacrifice to the country will never be forgotten. " Under the headline "Twelve Days Of Silence , Then A Swipe At Obama: How Trump Handled Four Dead Soldiers," the Washington Post (10/17, Rucker, Lamothe , 10.38M) reports , "The White House did not receive detailed information from the Defense Department about the four ...soldiers" - slain Oct. 4 in Niger - "until Oct. 12, and that information was not fully verif ied by the White House Military Office until Monday , according to a senior White House official who spoke on the condition of anonymity to comment on the internal process. At that point , the official said, Trump was cleared to reach out to the four fami lies - both in letters that were mailed Tuesday and in personal phone calls to fam ily members that day." Politico (10/ 17, McCaskill , 3.6M) reported that Trump "has faced an onslaught of criticism most notably from former Obama aides - since making the accusation against Obama on Monday afternoon in a Rose Garden news conference when asked about his silence regarding the death of four Green Berets related to an Oct. 4 ambush in Niger. 'The traditional way , if you look at President Obama and other presidents , most of them didn't make calls,"' Trump "alleged without evidence Monday . 'A lot of them didn't make calls. I like to call when it's appropriate, when I think I'm able to do it."' The Hill (10/17, Greenwood , 1.68M) and the Daily Caller (10/17, Pfeiffer , 521 K) also report on Trump's remarks from Tuesday and Monday. /\MERICAi\ pVERSIGHT EXT-18-248-D-000532 Regarding his comment that past presidents did not call fallen soldiers' kin, Trump on Tuesday called the story "fake news," telling Fox News (10/17, 12.87M}, "I don't know what Obama's policy was. I write letters and I also call." Trump touted the support he said he was receiving in the polls in spite of negative media coverage. During a Tuesday appearance on Fox and Friends (10/17, 8:40 a.m. EDT, 2.04M), counselor to the President Kellyanne Conway defended Trump's comment that previous presidents have not called fallen soldiers' families, saying that he was "making the point that there's many different ways to reach out" to the kin, and "not everybody calls." Conway also said, "The President made very clear ...what he meant and what he is saying," adding that Trump 's "focus is always on the grieving , on the famil ies, on the loss of life, and on protecting our soldiers." Responding to Trump 's comment about past presidents calling fallen soldiers' kin, Sen. Ed Markey (D-MA) told CNN 's Situation Room (10/17, 5:25 p.m. EDT, 988K) that he was with Obama when the then-President was visiting families of soldiers who lost their lives in Benghazi. Florida Democrat Criticizes Trump's "Insensitive" Remarks To Widow Of Slain Soldier. The Miami Herald (10/17, Cohen, 701 K) reports, "Sgt. La David T. Johnson of Miami Gardens, the soldier and father who was killed in Niger, returned home Tuesday afternoon ." He "was saluted with a ceremonial homecoming at Miami International Airport ." The Herald adds that Trump "called Johnson 's pregnant widow Tuesday afternoon. " The President "told his widow, who was in a car heading to the airport with her family and US Rep. Frederica Wi lson, D-Miami Gardens, that 'he knew what he signed up for ...but when it happens it hurts anyway,' according to Wilson, who heard the call on speakerphone in the car." Wilson told the Herald, "I think it's so insensitive. It's crazy . ... You don't say that to someone who lost family , the father , the breadwinner. You can say, 'I'm so sorry for your loss. He's a hero."' WPost's Von Drehle Questions Trump's Patriotism. In his Washington Post (10/17 , 10.38M) column , David Von Drehle says that Trump's "impulsive attack on his predecessors " relating to the calling of the families of slain soldiers "has raised again a question that has haunted me since his inaugural address . Is Trump patriotic?" Von Drehle adds , "Patriotism doesn't require us to praise what is not praiseworthy. Like any other American, Trump is free to criticize as he sees fit. But when an elected leader disparages , without cause , the good faith of other elected leaders, he is tearing the country down . ... I don't think we've ever been led by a person with such a low opinion of America ." TRUMP SAYS HE WAS "SURPRISED" BY THE "DISHONESTY IN THE MEDIA ." Politico (10/17, Nelson, 3.6M) reported that during a Tuesday interview with radio host Chris Plante, President Trump said "that he was 'surprised' by what he perceived as the media's continued antipathy towards him after last year's election , character izing CNN and NBC News 'a joke ' and 'a total joke,' respectively ." Said Trump, "Actually, dishonesty in the media is one of the things that surprised me the most. I thought after I won , the media would become much more stable and much more honest. They've gone crazy." Trump added , "CNN is a joke. NBC is a total joke. You watch what they report, it bears no relationship to what I'm doing. But the media is absolutely /\MERICAi\ pVERSIGHT EXT-18-248-D-000533 dishonest and frank ly, I've never seen anything quite like it." In Project Veritas Video, New York Times Editor Rips Trump, Pence. The Washington Times (10/17, Richardson, 541 K) reports , "A New York Times senior staff editor called President Trump an 'oblivious idiot' and Vice President Mike Pence 'horrible' and 'worse than Trump ' in an undercover video released Tuesday by the watchdog group Project Veritas ." The Times says that in the video, "London-based homepage editor Desiree Shoe" rips Trump and Pence "while acknowledging that 'our main stories are supposed to be objective. ' I feel like Trump is a just a sort of an idiot in a lot of ways, just an oblivious idiot,' she" says "in the hidden-camera footage apparently taken at a bar." Shoe added, "If you impeach him, then Pence becomes president, Mike Pence, who's f- ing horrible , I think maybe worse than Trump. I'm speaking off the record." The Times says that Shoe "has worked for the NYT since 2009 ." Professor: New York Times ' New Social Media Policy "Hide[s] Reporter Biases." The Washington Times (10/17 , Richardson , 541 K) reports that the New York Times ' "new policy on socia l media may rid the paper of perceived bias, but critics say it leaves unchecked the actual bias permeating" its "reliably liberal pages." Said Cornel l Law School professor William A . Jacobson, "I believe in transparency, and The New York Times ' new social media guidelines achieve the opposite . The guidelines are designed to hide reporter biases that makes it harder for the public to judge the credibility of reporting. Particularly in an age where we are asked to accept anonymous ly sourced reporting on the Trump administration, the public should know more about the political biases of those asking us to trust them on sourcing ." The New York Times ' new "policy prohibits reporters from making socia l media posts that 'express partisan opinions, promote political views, endorse candidates , make offensive comments or do anything else that undercuts The Times' journalistic reputation ."' TRUMP WARNS MCCAIN , " I FIGHT BACK AND IT WON'T BE PRETTY ." The CBS Evening News (10/17, story 4, 2:40, Mason , 11.17M) reported that after Sen . John McCain "blast[ed] President Trump 's ideas with words like 'half-baked' and 'unpatriotic."' The President on Tuesday "warned McCain to 'be careful.' The Vietnam war hero shot back, ' I've faced tougher adversaries. "' The AP (10/17 , Thomas) reports that in a radio interview, Trump said, "I'm being very , very nice but at some point I fight back and it won't be pretty ." The New York Post (10/ 17, Fredericks , 4.31M) reports that the President also said that McCain's deciding vote against the recent Republican healthcare measure was a "shocker." USA Today (10/17, Cummings, 8.62M) reports that McCain "did not mention the president by name" in his Monday speech , but Politico (10/17, Nelson, 3.6M) says that the remarks "were wide ly interpreted as a shot at Trump 's political style, a mix of nationalism , populism and conservatism." The AP (10/17, Thomas) reports that McCain said, "To abandon the ideals we have advanced around the globe, to refuse the obligations of international leadership for the sake of some half-baked, spurious nationalism cooked up by people who would rather find scapegoats than solve problems, is as unpatriot ic as an attachment to any other tired dogma of the past that Ame ricans consigned to the ash heap of history." On Fox News' Fox &Friends (10/17, 8:38 a.m. EDT, 2.04M) , Kellyanne Conway denied McCain 's assertion that Trump engenders "half-baked, spurious nationalism." Conway said, "We hope we can rely on Sen. McCain's vote" on a number of issues. Fox News' Special Report (10/17 , 2.32M) briefly reported on McCain's Monday night remark and Trump's response on Tuesday. /\MERICAi\ pVERSIGHT EXT-18-248-D-000534 Biden: Trump 's Behavior "Absolutely Bizarre." The AP (10/17) reports that former Vice President Joe Biden, who was presenting a medal to McCain at the National Constitution Center event on Monday, on Tuesday "called Trump's behavior 'abso lutely bizarre."' Biden said , "Violating the norms of personal conduct generates more anxiety and fear than any policy prescription that this president has enunciated . This breaking down of international and national norms is the glue that holds the liberal world order together , and holds together our system ." The Washingto n Times (10/17, Miller, 541K) reports that Biden and Ohio Gov. John Kasich were appearing togethe r at a Delaware event to promote bipartisansh ip. The Wash ington Post (10/17, Kane, 10.38M) looks at the long relationship between Biden and McCain, who "have been on oppos ite sides of many crucial national security debates over the last 30 years ," but who now find themse lves to be "closely aligned ...elder statesmen ." WPost Analysis: Trump Creates, Then Shoots Down Series Of "Political Villains." Michael Scherer writes in the Washington Post (10/17, 10.38M) that President Trump has a practice of "conjuring and then belittling a political villain with little more than taps on a phone .... In just the past few weeks, Trump has started , w ithout any clear provocation , fights w ith football players who kneel during the national anthem , departments stores that declare 'happy holidays' instead of 'Merry Christmas ,' and late-night telev ision hosts for their 'unfunny and repetitive material."' He has also gone after "individua l targets " including Senate Minority Leader Schumer , Sen . Bob Corker, Hillary Clinton, Kim Jong-un , ESPN's Jemele Hill, "and a shifting array of reporters , newspapers and networks he labels as the 'fake news."' Scherer says that Trump has used the tactic "for years - defin ing himself aga inst a negative space, as a tough truth teller who opposes others." WHITE HOUSE URGES CORKER TO "GET OUT OF THE NAME-CALLING. " Politico (10/ 17, McCaskill , 3.6M) reports that White House press secretary Sarah Sanders , in a radio interview with Hugh Hewitt, said she was open to speaking with Sen. Bob Corker . Sanders said, "Sadly , Sen. Corker hasn't called me, but if he'd like to visit , I'd be happy to ta lk to him and certainly see if we could get him back on board and do, frankly, what the people of Tennessee elected him to do . ... Hopefully, he'll get out of the name-calling and get back to work here pretty soon." WHITE HOUSE DENIES TRUMP JOKED PENCE WANTED TO "HANG" GAYS. Politico (10/17, Nussbaum, 3.6M) reports that the White House is denying that President Trump has joked that Vice President Pence "wanted to 'hang' homosexuals as well as other details reported" in a New Yorker profile of Pence. In a statement , White House press secretary Sarah Sanders said , "From start to finish the article relied on fiction rather than facts .... The suggest ion that he would make such outrageous remarks is offensive and untrue ." The New Yorker said it "stands by its reporting ." SENATE COMM ITTEE SUBPOENAS PAGE, SEEKS INFORMAT ION FROM FLYNN' S SON . USA Today (10/17 , Kelly, 8.62M) reports that the Senate Intelligence Committee "has issued a subpoena to compel testimony and documents from former Trump campaig n adviser Carter Page,'' accord ing to a congressiona l aide. Investigators "have raised questions about Page's /\MERICAi\ pVERSIGHT EXT-18-248-D-000535 alleged ties to Russia, whic h were detai led in a controversia l doss ier by former British spy Christopher Steele." Reute rs (10/ 17, Hosenba ll, Layne) reports that the panel has also asked Michael G. Flynn , the son of ex-National Secur ity Adviser Michael Flynn, "to provide documents and testimony ." Mueller 's Team Intervie ws Spicer. Politico (10/17, Karni, Dawsey, 3.6M) reports that specia l counsel Robert Mueller's team met Monday with former White House press secretary Sea n Spicer "for an interview that lasted much of the day." According to people fami liar with the meeting , Spicer was asked about President Trump's firing of FBI Director James Corney and Trump's meetings with Russians officials including Foreign Minister Serge i Lavrov . Mueller Interviewed Cybersecurity Researcher Tait. Business Insider (10/17 , 3.83M) reports that Mueller himself has interv iewed cybersecur ity researcher Matt Tait, "who described being recruited to vet hacked Hillary Clinton emails last year by a GOP operat ive tied to" the Trump campaign team. The interview took place "several weeks ago." Kushner Add s Harder To Legal Team. The Washington Examiner (10/ 17, Correll, 465K) reports that Jared Kushne r has added attorney Charles Harder to his legal team . Harder "has represented Hulk Hogan and Melania Trump" and "previously represented Harvey Weinstein but discontinued represent ing him amid mounting sexua l harassmen t and assault revelations ." Democrats Reporte dly Imp atient With Pace Of Russia Probes. Bloomberg News (10/ 17, Dennis, House, 4.52M) reports, "Some Democrats in Congress are growing impatient with how the GOP is handling" the Russia probes . Senate Judiciary Comm ittee Democrats "say they want to see more urgency in that panel's efforts ," while House Intelligence Committee ranking member Rep. Adam Schiff (D-CA) "says the Trump administration is trying to pressure Congress into end ing its investigations prematurely ." BuzzFeed Offers Some Information On Dossier, But Does Not Reveal Source. The Daily Caller (10/17 , Ross, 521 K) reports that BuzzFeed News has "provided a few new detai ls about how it obtained the infamous Trump dossier ," but it "is still refusing to identify its source " for the document. BuzzFeed reporter Ken Bensinger "revealed that he was granted access to the dossier in December after he became aware of 'intelligence reports alleging that there were connections between the Trump presidential campaign and the Russian government ,' accord ing to a declarat ion filed in fede ral court Monday in Miami ." FBI Uncovered Russian Bribery Plot Prior To US Approval Of 20 10 Uranium Deal. Fox News ' Tuc ker Carlson Tonight (10/ 17, 2.78M) reported "the FBI has uncovered evidence of a major Russian bribery effort just before the Obama Adm inistration's approva l of a deal back in 2010 that gave Russia control over large amounts of American uranium." The Hill (10/17, Solomon , Spann , 1.68M) reports that the FBI "had gathered substant ial evidence that Russian nuclear industry officia ls were engaged in bribery, kickbacks, extortion and money laundering designed to grow Vladimir Putin's atomic ene rgy business " inside the US. /\MERICAi\ pVERSIGHT EXT-18-248-D-000536 Dan McLaughlin writes in the National Review (10/17, 892K) that this "could be a very big news story , if anyone is willing to follow up on it." Newt Gingrich said on Fox News' Hannity (10/17, 9:25 p.m. EDT, 4.05M) that this story indicates "levels of corrupt ion and dishones ty on a scale that I can't remember in American history." OBAMA UN AMBASSADOR SAYS UNMASKING REQUESTS WERE MADE IN HER NAME. The Daily Caller (10/17, Ross, 521 K) reports that Obama Administration UN Ambassador Samantha Power told the House Intelligence Committee last week that someone inside the Administration 's "intelligence apparatus made requests to unmask the identity of Americans named in intelligence reports" in her name. Rep. Trey Gowdy (R-SC) told Fox News , "She would say those requests to unmask may have been attributed to her, but they greatly exceed by an exponential factor the requests she actually made ." TRUMP SAYS FED CHAIRMAN PICK COMING SOON , SOURCE SAYS EARLY NOVEMBER. USA Today (10/17 , Jackson, 8.62M) reports President Trump said Tuesday he will select the next Federal Reserve Board chairman "over the next fairly short period of time." Addressing reporters at a joint news conference with Greek Prime Minister Alexis Tsipras, Trump also "all but confirmed" the reported list of five finalists: Former Fed governor Kevin Warsh, Stanford University economist John Tay lor, current Fed Governor Jerome Powell, National Economic Counci l Director Gary Cohn, and current Chair Janet Yellen . He said, "I would say within those five you'll probably get the answer." Reuters ( 10/17, Holland) reports Trump will likely announce his choice for next Fed chair before his trip to Asia in early November, accord ing to a "source fam iliar with the situation. " The source "said announcing the choice by the time Trump leaves for Asia on Nov. 3 would give the Senate time for the confirmation process." WPost: Yellen Deserves A Second Term. In an editorial , the Wash ington Post (10/17, 10.38M) writes that President Trump should select Janet Yellen for a second term as Federal Reserve Chairman because of her experience with steadily raising interest rates and with the unwinding of the Fed's asset purchasing program , her encouragement and defense of safeguards on financial institutions, and her relative flexibi lity compared with the other candidates. The Post concludes that her selection would signal the preservation of the Federal Reserve's independence from politicizat ion and "would send a reassuring message of continuity ." DOW TOPS 23,000 FOR FIRST TIME . NBC Nightly News (10/17, story 3, 2:20 , Holt, 16.61M) reported the Dow Jones topped 23,000 for the first time on Tuesday before closing just shy of the 23 ,000 mark . The Dow has grown 16 percent since January 1, and the market altogether has climbed 28 percent since the election of President Trump. USA Today (10/17, Shell, 8.62M) reports that Wall Street observers say the Dow's continued rise has been driven by five key factors : rebounding econom ies around the world, strong US /\MERICAi\ pVERSIGHT EXT-18-248-D-000537 corporate earnings , low borrowing costs , anticipation of tax cuts, and large US companies ' benefiting from a weak dollar and stronger fore ign economies . TRUMP CALLS ON AMERICANS TO SAY "MERRY CHRISTMAS " DURING HOLIDAYS. The Washingto n Times (10/17 , Dinan , 541K) reports President Trump said Tuesday that Amer icans should be comfortab le saying "Merry Christmas. " Commenting on stores that don 't use "Merry Christmas" in their displays , Trump said, "I want them to say Merry Christmas everybody, Happy New Year, Happy Holidays, but I want Merry Christmas. " TRUMP DROPS IN FORBES 400 RANKING. USA Today (10/17, McCoy , 8.62M) reports President Trump dropped in the annua l Forbes magazine rankings of the wealthiest Americans after his fortune shrank by $600 million, to $3.1 billion - "dropping him from 156th place to 248th place in the 2017 Forbes 400 ranking, the magaz ine reported Tuesday." Trump now is tied with Snapchat creator Evan Spiegel in the magazine 's 2017 ranking . TRUMP DC JUDICIAL NOMINEE ADDRESSES JUDICIARY COMMITTEE . The Wash ington Post (10/ 17, Marimow , Sullivan , 10.38M) reports that Gregory G. Katsas - President Trump 's j udicial nominee for the US Court of Appeals for the D.C. Circuit and current dep uty White House counsel - on Tuesday "told senators cons idering his nomination that he advised the Trump admin istration on the travel ban on residents of certain majority Muslim countries , ending protections for young undocumented immigrants and the president's voter fraud commission ." During a two-hour hearing, Katsas also "sought to assure the Senate Judiciary Committee that he would recuse himself from any cases involving his work as a government lawyer. " The Post observes that Tuesday 's hearing comes as Senate Majority Leader Mitch McConne ll "is intensifying efforts to install conservative jur ists on the federal bench." PRUITT SEEKS TO ASSURE SENATORS OVER BIOFUELS MANDATE. The Hill (10/ 17, Henry, Cama, 1.68M) reports EPA Administrator Pruitt "sought to reassure " Midwestern lawmakers on Tuesday that he supported the federa l biofuels mandate . In a nearly hour-long meeting in Sen. Chuck Grassley 's Senate office that included Sens. Joni Ernst (R- IA), Ben Sasse (R-NE), and Deb Fischer (R-NE), Pruitt "made a politica l case for the ethanol mandate ." The meeting came amid concerns from lawmakers in both parties about proposed changes to the Renewable Fuel Standard. SESSIONS CREATES WATCHDOG FOR ASSET FORFEITURE PROGRAM. The Washi ngton Post (10/ 17, Horwitz , 10.38M) reports Attorney Genera l Sessions is establishing a Justice Department watchdog to oversee the department's asset forfe iture program . In a memo Tuesday , Sessions "directed Deputy Attorney Genera l Rod J . Rosenstein to hire a directo r to review all aspects of the department's policy and take action if problems arise ." Rep. Darrell Issa, who crit icized the departmen t last summer when Sessions announced the asset forfe iture program , said Tuesday of the move, "It's nice to see at least some acknowledgment that civil forfeiture is in need of increased oversight, but the changes really don't go far enough and the core problem still remains." /\MERICAi\ pVERSIGHT EXT-18-248-D-000538 ZINKE BOOSTER NOW EXPRESSES CONCERNS ABOUT HIS PUBLIC LAND POLICIES . The Washington Post (10/17, Grandoni , 10.38M) reports that Backcountry Hunters &Anglers Executive Director Land Tawney backed fellow Montanan Ryan Zinke 's nominatio n to lead the Interior Department , but is now raising concerns about Zinke 's stance on public lands and his "approach to national monuments." Tawney "still has kind words for Zinke , calling him 'a proven leader."' But "as to the question of whether he still regards him as an ally , Tawney split the difference. " He said, "What we 've always done is we've app lauded [Zinke] for the th ings that we think he's doing that are beneficial to hunters and anglers , then we've held him accountab le on the other end of that." CHAO SILENT ON FEDERAL MONEY FOR MIAMI'S METRORAIL. The Miami Herald (10/17, Hanks, 701 K) reports that Transportation Secretary Chao on Tuesday "deftly avoided " providing information about federa l money for Miami's Metrora il during a press conference at Miami International Airport. Chao said, "Resources are an issue. It's a resource issue for all of us .. .. From the whole country 's point of view , the needs exceed the resources ." Chao "didn't mention the issue" of money for expanding Metrorail but "did say the Trump administration may provide help to Miami-Dade beyond money." FOX NEWS POLL : JONES, MOORE TIED AT 42% IN DEC. 12 SPECIAL ELECTION . On its website , Fox News (10/17, Blanton , 12.87M) reported that a Fox News poll of 80 1 Alabama voters , taken Oct. 14-16, shows ex-US Attorney Doug Jones (0) and ex-state Supreme Court Justice Roy Moore (R) tied at 42% each in the Dec. 12 special election for the former seat of now-US Attorney General Jeff Sess ions . Fox News added "that among just the 53 percent of Alabama registered voters who are extremely or very interested in the race, Jones " leads Moore 46%-45%. Fox News said that President Trump carried "Alabama by 28 points in 2016, yet the Steve Bannon-backed Moore defeated the president's favored candidate, incumbent Luther Strange , in the GOP primary. " The Hill (10/17, Thomsen , 1.68M) reported that the survey "also found that 42 percent of Moore's supporters had some doubts about the candidate, while 48 percent said they strong ly support him in the race. Republicans were also less likely to support their nominee than Democrats were to support Jones, with 77 percent of GOP voters saying they'd back Moore. Eight-five percent of Democrats said the same for Jones. Twenty-eight percent of Jones' backers said they had some reservations about him. But 21 percent of his supporters said they were vot ing against Moore rather than for Jones. " Rand Paul Backs Moore. The Hill (10/17 , Shelbourne , 1.68M) reported that Sen . Rand Paul on Tuesday backed Moore's bid , saying in a statement, "Judge Roy Moore has spent a lifetime defending and standing up for the Constitution while fighting for the people of Alabama . We need more people in Wash ington, D.C. that will stand on principle and defend the Constitution ." Writing for the Washington Examiner (10/ 17, Bedard , 465K), Paul Bedard described Paul's endorsement of Moore as "a huge show of support ." Bedard added that Paul's backing "puts a stamp of approval on Moore's anti-Washington campaign which he rode to victory recently in a primary aga inst Sen. Luther Strange, appointed earlier this year to replace former Sen. Jeff Sessions when he became the Attorney General." /\MERICAi\ pVERSIGHT EXT-18-248-D-000539 TH REE POLLS SHOW VIRGINIA GOVERNO R'S RACE "WITHIN THE MARGIN OF ERROR. " Three weeks before next month's election to succeed term-limited Virginia Gov . Terry McAuliffe (0), Politico (10/17, Shepard, 3.6M) reported that a trio of "new public polls show" the battle between ex-RNC chief Ed Gillespie and Lt. Gov. Ralph Northam (D) "within the margin of error." A Monmouth University survey of 408 Virginia likely voters , taken Oct. 12-16, shows Gillespie leading Northam 48%-47%, with Libertarian Cliff Hyra at 3% and 3% undecided. Northam led 49%-44% in last month's poll. Meanwhile, a Christopher Newport University survey of 642 Virginia likely voters, taken Oct. 9-13, shows Northam leading Gillespie 48%-44%, with Hyra at 3% and 5% undecided. Northam led 49%-42% in last week's poll. And a Roanoke College poll of 607 Virginia likely voters, taken Oct. 8-13, shows Northam leading Gillespie 50%-44%, with Hyra at 2% and 4% undecided . Northam led 47%-43% in last month's poll. The Hill (10/17, Hagen, 1.68M) reported that the Monmouth survey "is the first public poll that shows Gillespie leading." The Washington Free Beacon (10/17, Crookston , 158K) also reports on the results of three polls released on Tuesday . Democrat Northam Has Over Twice As Much Cash On Hand Than Gillespie. The AP (10/17, Suderman) reports that Northam holds "a hefty cash advantage over" Gillespie ahead of next month's election. Northam collected over "$7 million in September and had about $5.7 million in the bank at the end of the month." Gillespie , meanwhi le, raised "$4.4 million, with $2.5 million cash on hand for the same period." Gillespie "enjoyed a cash advantage over Northam after the June primaries but has strugg led to match the Democrat's fundra ising prowess in recent months." The Washington Post (10/17, Nirappil, 10.38M) reports, "Republicans attributed the fundraising lag to a variety of reasons, including donors who were tuned out after the presidential contest and an unfavorable political climate for the GOP in Virginia ." TWO POLLS SHOW DEMOCRAT MURPHY UP DOUBLE DIGITS IN NEW JERSEY GOVERNOR 'S RACE. NJ News (10/17, Brodesser-Akner, 1.21M) reported that a Farleigh Dickinson University PublicMind poll of 658 New Jersey likely voters, taken Oct. 11-15, shows exGoldman Sachs executive Phil Murphy (D) leading Lt. Gov. Kim Guadagno (R-NJ) 47%-32% in next month's election to succeed term- limited Gov. Chris Christie (R-NJ) . On its website , Fox News (10/17, Balara, 12.87M) reported that a Fox News poll of 679 New Jersey likely voters, taken Oct. 14-16, shows Murphy leading Guadagno 47%-33%. Obama Joining Parade Of Democrats Who 've Stumped For Murphy . The New York Times (10/17, Corasanit i, Burns, Subscription Publication , 13.56M) reports, "An Obama administration reunion tour is unfolding in New Jersey, as a cava lcade of Democratic luminaries has paraded into the state in recent days, including former Vice President Joseph R. Biden Jr., former Secretary of Labor Thomas E. Perez and former Secretary of State John Kerry, urging voters to" back Murphy's bid. The Times adds that President Obama is slated to stump with Murphy "on Thursday at a rally in Newark, making his first public foray on the campaign trail in support of a Democratic candidate since leaving office. And Hillary Clinton will be a guest of honor at a closeddoor fund-raiser for Mr. Murphy on Sunday in Harrison, N.J., her first campaign event since last year's election." Murphy served as ambassador to Germany in the Obama Administration. Democrats Blast Guadagno Over "Bridgegate." The AP ( 10/17) reports that the Murphy camp on Tuesday received "a boost from the mayor whose town was gridlocked in the so-called Bridgegate scandal. Democratic Mayor of Fort Lee Mark Sokolich joined fellow Democrats Rep. Bill Pascrell, state Sen. Loretta Weinb erg and Hoboken Mayor Dawn Zimmer Tuesday to /\MERICAi\ pVERSIGHT EXT-18-248-D-000540 attack ...Guadagno " on "the same day Murphy unveiled a new 30-second TV spot that says Christie and Guadagno's biggest triumph 'was a traffic jam.' Two former allies of Christie's were convicted in federa l court in the 2013 political payback scheme that saw local access lanes to the George Washington Bridge closed ." PENCE 'S FUNDRAISER BENEFITING COLLINS DRAWS "ABOUT 80" PROTESTERS. The Buffalo (NY) News (10/17 , O'Brien, 362K) reports , "About 80 people protested outside a suburban Buffalo restaurant Tuesday as Vice President Pence arrived to raise" cash for Rep. Chris Collins (R-NY), "one of the Trump administration 's staunc hest backers in Congress ." The News adds that Collins , "with Pence's help, expects to raise $400 ,000 at [the] event." CALIFORNIA HOUSE REPUBLICANS GET LARGE FINANCIAL BOOST FROM PAC'S FUNDRAISER WITH PENCE. The Los Ang eles Times (10/17, Mai-Due, 4.49M) reports, "Californ ia Republican House members have received more than $1 million from a comm ittee that recently benefited from a fundraiser with Vice President Pence. California Victory 2018 - a joint fundraising committee that helps" PACs "belonging to Pence and Rep. Kevin McCarthy as well as congressional campa ign accounts of McCarthy and seven California Republicans - received proceeds from a string of Pence fundraise rs across the state last week ." ENDORSING FLAKE PRIMARY FOE WARD , BANNON RIPS MCCONNELL, SENATE REPUBLICANS . The AP (10/ 17, Beaumont , Christie) reports that ex-White House chief strategist Steve Bannon on Tuesday "doubled down on his criticism of the GOP establ ishment" during a fundraising event benefiting ex-state Sen. Kelli Ward (R-AZ) , who is mounting a 2018 primary challenge to Sen. Jeff Flake (R-AZ). Appeari ng in Scottsda le, Bannon "heaped disdain on Senate Majority Leader Mitch McConnell and other incumbent Republicans, saying they failed President Donald Trump by not backing his agenda and are openly critical of their own president. " Said Bannon, who was joined at Tuesday 's event by conservative talk show host Laura Ingraham , "If you saw how they try to rip him apart every day , how they are trying to destroy him every day . And yes , I'm talk ing about Mitch McConnel l and the Senate Republicans ." The Arizona Republic (10/ 17, Nowicki, 968K) reports that Bannon's appearance "was the biggest indicator to date that the allies of ...Trump are settling on Ward as their preferred challenger to Flake." The Republic adds that Bannon blasted McConnell, "and vowed that the Republican elite are destined to 'reap the whir lwind' and 'that whirlwind is Kelli Ward.' " The "remarks were another salvo in the 'war' Bannon has declared on the GOP establishment. 'It's an open revolt, and it should be,' Bannon said before introducing Ward at her campaign 's formal kickoff event." Politico An alysis: Some Bannon Candidates Also Backed By GOP Establishment. Politico (10/17, Karni, 3.6M) reports that Steve Bannon recently backed state Auditor Matt Rosendale 's (R) Montana Senate bid "as part of his war on the GOP establ ishment." However , Bannon's "interest in Rosendale - as well as many of the other candidates " he's backing - "has some Washington GOP power brokers confused by his defin ition of 'anti-estab lishment.' For mont hs, the National Republican Senatorial Committee has been media train ing Rosenda le," who's "also a client of the consult ing firm On Message, Inc., one of the most 'establishment' consulting firms in Washington ." Politico added, "The overlap between the 'establishment-backed' candidates and /\MERICAi\ pVERSIGHT EXT-18-248-D-000541 those Bannon is elevating in hopes of tak ing down the estab lishment has some accusing him of being more interested in a one-man show than his 'season of war against a GOP establishment. "' Nicholson Hails "Huge Endorsement " By Bannon In GOP Primary . In a report on Sen. Tammy Baldwin's (D-WI) 2018 reelection race, the AP (10/17, Bauer) focuses on the GOP primary, saying that businessman Kevin Nicholson (R) has "won the backing of former presidential strategist Steve Bannon in Wisconsin's US Senate race, a surprise move that sent shockwaves Tuesday through the" Republican contest. Nicholson is battling state Sen. Leah Vukmi r (R-WI) in the GOP primary. The AP says, "The endorsement by a political action comm ittee backed by Bannon," the Great America PAC, "comes after both Nicholson and Vukmir met separately in private with Bannon. " Nicholson "tweeted on Tuesday that he was 'humbled by this huge endorsement' by Bannon." HILL ANALYSIS: TRUMP 'S SUPPORT GIVES BARLETTA EDGE IN CROWDED PRIMARY . In a report on Sen. Bob Casey's (D-PA) 2018 reelection race , The Hill (10/17 , Kamisar , Hagen , 1.68M) said that Rep. Lou Barletta (R-PA) "is seen as the leading GOP candidate to take on" the incumbent Democrat , "with his chances boosted further after a de facto endorsement from President Trump last week . During a Harrisburg , Pa., rally last Wednesday , Trump lauded" Barletta "as a 'great guy' who w ill 'win big,"' and "then repeated the praise during an interv iew with Fox News host Sean Hannity . Trump 's praise will give Barletta , an early Trump endorser during the presidential race and a key campaign surrogate, a major bump in a crowded primary field that also includes wealthy real estate developer Jeff Bartos." EIGHT DEMOCRATS ON CNN'S LIST OF "10 SENATE SEATS MOST LIKELY TO SWITCH PARTIES" IN 2018 . On its webs ite, CNN (10/ 17, Bradner , 33.59M) offered its list of "the 10 Senate seats most likely to switch parties in the November 2018 midterms ." Topping the list is the seat of Sen. Dean Heller (R-NV), followed by those of Sens. Claire McCaskill (D-MO); Jeff Flake (R-AZ); Joe Donnelly (D- IN); Joe Manchin (D-WV); Heidi Heitkamp (D-ND) : Sherrod Brown (DOH); Jon Tester (D-MT) ; Tammy Baldwin (D-WI); and Bill Nelson (D-FL). HAWLEY SPOKESMAN SIDESTEPS QUESTION ON WHETHER CANDIDATE WOULD BACK MCCONNELL. McClatchy (10/17, Wise, 67K) reports that state Attorney Gen. Josh Hawley (RMO), "Republicans' top recruit to" take on Sen. Claire McCaskill (D-MO ) in next year's election , "won't commit to voting for Mitch McConnell as Senate Repub lican leader if elected in 2018." Asked if the GOP hopeful would back McConnel l, Hawley campaign spokesman Scott Paradise "deflected the question," saying in an email, "The Senate is broken and failing the people of Missouri. Josh is running because he is not willing to tolerate the fai lure of the D.C. estab lishment any longer . He won't tolerate Claire McCaskil l's failure . And he won't tolerate Republican failure , either ." McCaskill Acknowledges "Sloppy " Mistake In Claiming She Was Out When Controversial Bill Passed . The Springfield (MO) News-Leade r (10/17, Shesgreen , 61K) reports that McCaskill on Tuesday "said she was wrong when she asserted she'd been undergoing breast cancer treatment on March 17, 2016 - the day the Senate passed legislation undermin ing the Drug Enforcement Agency's ability to stop suspicious shipments of opioids to what they feared were pill-mills and illicit pharmacies. " The bill "dramatical ly undercut the DEA's efforts to staunch the /\MERICAi\ pVERSIGHT EXT-18-248-D-000542 flow of millions of opioid pills into commun ities across the country, according to an investigation by the Wash ington Post and '60 Minutes ,' published on Sunday ." Speaking on "Monday with CNN , McCaskill said she didn't go along with the bill and was out for breast cancer treatment when it passed." On Tuesday, however , McCaskill "said her statements on Monday were a 'sloppy embarrassing mistake."' SLF UNVEILS MICROSITE TARGETING DEMOCRAT DONNELLY ON OUTSOURCING. The Hill (10/17, Kamisar, 1.68M) reported that the Senate Leadership Fund (SLF), a super PAC aligned with Senate Majority Leader Mitch McConne ll, on Tuesday was to unveil "a new microsite " hitting Sen . Joe Donnelly (D-IN) "over revelations from this summer that he earned profit from a fam ily company that outsourced jobs to Mexico. The new website is called 'MexicoJoe.com ,' a nod to the pejorative nickname that Republicans have bestowed upon Donnelly since the news broke over the summer. It will be a central hub for the SLF's attacks on Donnelly , hosting content including video and news clippings. " Donnelly faces reelection next year. NELSON RAISES NEARLY $1.8M IN Q3, HAS $6.3M BANKED FOR REELECTION RACE. The Tampa Bay (FL) Times (10/ 17, Leary , 877K) reports that Sen . Bill Nelson (D-FL) , who faces reelection next year , "raised $1.75 million in the third quarter of 2017 and now has $6.3 million cash-on-hand . The haul comes as Nelson suspended his campaign for seve ral weeks due to the hurricanes , an aide said ." Florida Gov. Rick Scott (R), who is term-limited in 2018, is expected to challenge Nelson in next year's election . TESTIMON Y CONTINUE S IN MENENDEZ '$ FEDERAL CORRUPTION TRIAL. In continuing coverage of the federal corrupt ion trial of Sen . Bob Menendez (D) and his longtime friend and donor , eye doctor Salomon Melgen , Bloomberg News (10/17 , Weinberg , Voreacos , 4.52M) reports that Menendez's attorneys on Tuesday "sought to show jurors that the New Jersey Democrat was motivated by a desire to improve public policy and not by corrupt intent when he intervened in a Medicare billing dispute at the heart of' the prosecution 's case . Testifying for the defense , "Washington lobbyist Alan Reider" discussed "how he helped Melgen contest accusat ions that he overbilled for Lucentis, a macular degeneration drug that costs doctors $2 ,000. Reider, a health care lawyer, said he argued to Menendez that Medicare policy that prevented multiple doses of Lucentis from a single bottle was confusing and contradictory. " Reider "said his briefing with Menendez in 2012 focused on the multidos ing policy rather than Melgen's dispute with the government. " Politico (10/ 17, Friedman , 3.6M) reported that Rieder "said he learned of at least six othe r doctors who were concerned about 'multi-dosing ,' even though prosecutors have argued only Melgen had an interest in changing the government's policy on the issue ." Reider, "who testified that he had briefly registered as a lobbyist when representing Melgen" as an attorney , "met with Menendez , who later raised the multi-dosing issue with everyone from bureaucrats at the Centers for Medicare and Medicaid Services to then-Hea lth and Human Services Secretary Kathleen Sebelius . Prosecutors say those meet ings were favors Menendez did for Melgen ...in exchange for private jet flights, vacations and hundreds of thousands of dollars in campaign contributions. " /\MERICAi\ pVERSIGHT EXT-18-248-D-000543 The New York Times (10/17, Wang, Subscription Publication, 13.56M) reports that testifying on Tuesday , "Melgen's wife , Flor Melgen , was alternate ly subdued and defiant in answer ing questions about the relationship between her husband and Mr. Menendez ." The Times adds that at one point, "after Kirk Ogrosky, a lawyer for Dr. Melgen , asked whether Ms. Melgen had expected to receive anything in return for her donations to Mr. Menendez's campaigns , she replied no. But she then began to explain in Spanish, through an interpreter, that 'every citizen who lives in this country ' might expect a return from a candidate who could 'do good for the community. "' The AP (10/17, Porter) reports that Ms. Melgen "recalled how then-Republ ican Florida Gov. Charlie Crist showed up at her Palm Beach County home unannounced in October 2010 , when he was running for Senate as an independent. Crist apparently was hoping Menendez , at the time the chair of the Democratic Senatorial Campa ign Committee , was there that night , she testified . He wasn't, but Crist wound up dining and staying overn ight. He reimbursed the Melgens $100 for the dinner . 'So at least one politician knows how to pay your husband back ,' Justice Department attorney Monique Ab rishami said. Defense attorneys immediately objected , and US District Judge William Wal ls cautioned jurors to disregard attorneys ' 'throwaway questions. "' NJ News (10/ 17, Moriarty , Spoto , 1.21 M) reports , "Defense attorneys raised the subject of (Grist's reimbursement] to try to address the issue of one of the flights prosec utors allege Menendez took on Melgen's dime as part of a bribe. The defense has argued Menendez should not have been charged in that instance because , they say, that Oct. 9 to 11, 2010 , trip to Florida was campaign-related and should have been reimbursed by the DSCC ." Poll : 73% Of New Jersey Voters Say Menendez Should Resign Immediately , If Convicted . Meanwh ile, Fox News (10/ 17, Balara, 12.87M) reported on its website that in a Fox News poll of 679 New Jersey likely voters , taken Oct. 14-16, 63% of those surveyed said that Menendez "should resign immediate ly," if convicted of the corruption charges, while 19% said "he shou ld wait until the next governor is in office." Pence: If Convicted, It Would Be "Inappropr iate And Wrong " For Menendez To Remain In Senate . The Was hington Times ( 10/17, Persons, 541 K) reports that during a Tuesday interview with conservative radio host Hugh Hewitt, Vice President Pence said that having Menendez continue to serve in the Senate "would be 'inapp ropriate' if he's convicted in his federa l corruption case ." Said Pence, "I think that'll be a decision for members of the Senate. But having a conv icted felon in the United States Senate, I think, would be altogether inappropriate and wrong." NEW WILD FIRES EMERGE IN SANTA CRUZ MOUNTAINS . AB C World News Tonight (10/ 17, story 5, 1:55, Muir, 14.63M) reported that "as firefighters make progress on the devastati ng wildfires" in Californ ia, new fires emerged in the Santa Cruz Mountains on Tuesday night , leaving five firefighters injured. Sutter Santa Rosa Regional Hospital (SSRRH) evacuated all 77 patients. SSRRH Chief Nursing Executive Robin Allen said, "We believe over 30 physicians at this faci lity lost their homes , as we ll as over 40 staff members. " /\MERICAi\ pVERSIGHT EXT-18-248-D-000544 Sonom a Sheriff Deni es Report s Linking Wildfires To Arson-Related Arr est. The Redding (CA) Record-Searchlight (10/17, Sandhu, Longoria, 59K) reports that on Tuesday, Breitbart News and lnfoWars "attempted to link the Sunday arrest of' Latino man Jesus Fabian Gonzalez "on suspicion of arson in Sonoma to the massive, dead ly cluster of wildfires burning in California 's wine country ," but the outlets "offered no evidence to link the man's arrest to the fires and their accounts of the man's arrest were disputed the same day by Sonoma County Sheriff Rob Giordano." Giordano said in a news conference, 'There's a story out there he's the arsonist for these fires. That is not the case. There is no indication he is related to these fires at all." WEINSTEIN RESIGNS FROM HIS COMPANY ; AMAZON EXEC STEPS DOWN. NBC Nightly News (10/17, story 7, 2:10, Holt, 16.61M) reported Harvey Weinstein on Tuesday official ly resigned from the board of his company as more than 50 women accuse him of sexual harassment or assault. The head of Amazon Studios also resigned Tuesday amid sexual harassment allegations, and executive producer Amanda Segel now is accusing Weinstein 's brother, Bob Weinstein, of harassing her. The CBS Evening News (10/17, story 9, 0:25, Mason, 11.17M) reported that Spike TV has said it is investigat ing Segel's claims. A spokesman for Bob Weinstein has "denied the charges." ABC World News Tonight (10/17, story 4, 2:15, Muir, 14.63M) reported that "other Hollywood Alisters are coming forward with their own experiences" of harassment and assault, with actress Reese Witherspoon claiming she was abused by a "Hollywood director" and Jennifer Lawrence making her own claims. WOMEN DENOUNCE HARASSMENT IN CALIFORNIA 'S STATE LEGISLATURE . The New York Times (10/17, Nagourney, Medina, Subscription Publication, 13.56M) reports that more than 140 women - "including legislators, senior legislative aides and lobbyists " - have drafted a letter denouncing "what they describe as pervasive sexual misconduct by powerful men" in California's state legislature. Women "compla ined of groping , lewd comments and suggestions of trading sexual favors for legislation while doing business in Sacramento ." The letter "comes as the scanda l involving Mr. Wei nstein had set off a wave of investigations, recriminations and accusations across the nation, including in state capitals in Rhode Island and South Dakota ." NYTIMES A1: SECRETIVE "SELF-HELP " GROUP FOR WOMEN REQUIRES MEMBERS TO BE BRANDED. In a front-page story, the New York Times (10/17, A1, Meier, Subscription Publication, 13.56M) reports on the inner wo rkings of a secretive "self-he lp" organization, called Nxivm, where women, in order to gain admission, "were required to give their recruiter ...naked photographs or other compromising material" to ensure their silence about the group and then were "branded" with a cauterizing device . Since the late 1990s, "an estimated 16,000 people have enro lled in courses offered by Nxivm (pronounced Nex-e-um), which it says are designed to bring about greater self-fulfillment by eliminating psychological and emotional barriers ." With recent revelations of the "secret sisterhood and branding ," scores of members are leaving the organization, and interviews with a dozen of them "portray a group spinning more deeply into disturbing practices. " TRUMP ACCUSER DESCRIBES EARLIER HARASSMENT EXPERIENCE . In a USA Today (10/17, 8.62M) op-ed, journalist Natasha Stoynoff - who wrote last year in People about being /\MERICAi\ pVERSIGHT EXT-18-248-D-000545 harassed by Donald Trump during a 2005 interview - describes her experience being sexually harassed by an unnamed actor 30 years ago . Stoynoff writes that women are beginning to open up about their experiences of harassment and assault. Women "are not afraid anymore , and there is no room in th is world for men of this ilk." PENCE SAYS WALKING OUT OF COLTS GAME WAS "RIGHT THING TO DO." WXIN -TV Indianapolis (10/17, 178K) reports online that Vice President Pence said Tuesday that his decision to walk out from an Indianapolis Colts game after players knelt during the national anthem was the right choice. In a radio interview w ith WIBC -FM's Tony Katz, Pence said, "You know we had had plans for a long time to attend that game. Karen and I were looking very much forward to it, but frankly when we saw that so many players took a knee on the sideline we thought it was the right thing to do to leave ." Pence did say he and President Trump had discussed the situation before he came to Indianapo lis, and he added that while "everybody is entitled to their opinion ...the president and I believe it's not too much to ask for all players to respect our soldiers, respect our flag, respect our nationa l anthem, and that's why we left." In addition to providing video of Pence's interview with Tony Katz, WIBC-FM Indianapolis (10/ 17, 7K) reports online that Pence also discussed the Administration 's domestic and fore ign policy accomplishments and the importance of tax reform. Pence said, "And before the end of this year we 're going to cut taxes for wo rking-class fam ilies and small businesses all across America ." NFL OWNERS, PLAYERS MEET TO DISCUSS ANTHEM PROTESTS . NBC Nightly News (10/17, story 13, 0:20, Holt, 16.61M) reported that NFL team owners and players met on Tuesday in New York to discuss league protocol on kneeling during the national anthem. While the two sides "called the meet ing productive ," there was no agreement reached on the anthem protests. During the meeting , protests "erupted" outside . AB C World News Ton ight (10/17, lead story , 2:25, Muir, 14.63M) reported NFL Commiss ioner Roger Goodel l announced Tuesday evening that owners did not ask the players to stand for the national anthem. Players at the meeting said progress was made on bring ing attention to the reasons that some we re kneeling. Players and owners "are expected to get together to discuss" the kneeling issue again "within the next couple of weeks." GOOGLE SERVES "FAKE NEWS" ADS ON FACT-CHECKING SITES, NYTIMES FINDS. A New Yor k Ti mes (10/17, Wakabayash i, Qiu , Subscript ion Publication , 13.56M) investigation found that enticing fake "headlines served as bait to draw readers to fraudulent sites that masqueraded as mainstream news sites, such as People and Vogue ." The Ti mes found that "fake publishers used Google's AdWords system to place the advertisements on websites that fit thei r broad parameters ," including , ironically, "PolitiFact and Snopes , fact-check ing sites created precisely to dispel such falsehoods ." The article highlights opinion that this investigat ion's finding underscores the challenges of avoiding so-called "fake news." NATIONAL ARCHIVES WARNED ADMINISTRATION TO PRESERVE DOCUMENTS . Politico (10/17, Dawsey, Bender, 3.6M) cites sources and documents as indicat ing "National Archives /\MERICAi\ pVERSIGHT EXT-18-248-D-000546 officials have periodically warned White House lawyers that the Trump administration needs to follow document preservation laws ." Nationa l Archives officials reported ly "told the White House counsel's office they were concerned that wasn't happening , particularly early in the admin istration." In addition , the nonpartisan watchdog group Citizens for Responsib ility and Ethics "is suing the Trump administration over its adherence to the record law, citing the use by White House officials of encrypted smartphone apps to communicate , such as Confide and Signal, which are designed to delete data ." BIPARTISAN GROUP TO URGE TRUMP TO ALTER POLICING POLICIES. The New Yor k Times (10/17, Haberman, Subscript ion Publication , 13.56M) reports that a "broad coalition" of law enforcement officials and activists "is expected to urge President Trump on Wednesday to adjust policies on policing and criminality, the first time such a group has spoken out aga inst the Trump admin istration." According to the Times , "some of the nation's most prominent prosecutors , police chiefs and crimi nal just ice overhaul advocates," includ ing Sen . Thom Tillis (R-NC) and "representatives from the conservat ive Koch brothers network, " will meet in Washington, DC for the National Law Enforcement Summit. Former Attorney General Eric Holder and Sally Q. Yates, "the acting attorney general whom Mr. Trump abrupt ly fired in the first few days of his preside ncy, will speak ." The presenters "are expected to pose the challenge to Mr. Trump, who ran in 2016 as a 'law and order' cand idate but whose attorney general's policies - as well as Mr. Trump 's own messaging - have come under increas ing criticism from local law enforcement officials ." OPEN SOCIETY DISCLOSES $18 BILLION IN DONATIONS FROM GEORGES SOROS . On its front page, the Wall Street Journal (10/17 , A 1, Chung , Das, Subscription Publication , 6.45M) reports that Open Society Foundations said Tuesday that in recent years , George Soros has moved about $18 billion of his money into Open Society. Soros reportedly has no plans to trade the billions now belong ing to Open Society, as his fami ly office manages the endowment. The article outlines causes supported by Open Society , including immigration reform , US crimina l justice reform, mentoring programs for black and Latino young men, and indirectly, the Black Lives Matter movement. The New York Times (10/17, Gelles, Subscr iption Publication , 13.56M) reports that this makes Open Soc iety "the second largest foundation in the United States by assets, accord ing to the Nationa l Philanthropic Trust." The Times mentions that Soros had wrongly bet against the stock market after Trump was elected . DUCKWORTH: CONGRESS SEEKING TO REMOVE PROTECTIONS FOR DISABLED . In a Wash ington Post (10/ 17, 10.38M) op-ed , Sen. Tammy Duckworth (D-IL) writes that Congress led by "special interests" in the hospitality and retail industries - are working to underm ine the Americans with Disabilities Act by offer ing legislation that seeks "to shift the burden of ADA compliance away from business owners and onto individuals with disabil ities." The argues that if Congress passes the "misguided " ADA Education and Reform Act, "it would send a disgraceful message to Americans with disabilities that their civil rights are not worthy of strong enforcement. " WSJOURNAL DECRIES COURT RULING ABSOLVING PROSECUTORS FOR USING FALSE INFORMATION . The Wall Street Journal (10/17 , Subscription Publication , 6.45M) editorializes abo ut Tuesday 's ruling by the 2nd Circuit Court of Appeals that absolved prosecutors for the use /\MERICAi\ pVERSIGHT EXT-18-248-D-000547 of false information in the prosecution of hedge fund founder David Ganek . Ganek had sued the prosecutors, seeking damages after the prosecution had put his hedge fund out of business . The appeals court ruled that the prosecutors were immune from liability . The Journal cal ls this another example of abus ive behavior by prosecutors , and it urges the Justice Departme nt to investigate the incident and to discipline the prosecutors . WSJOURNAL APPLAUDS GOV . BROWN 'S VETO OF CAMPUS SEXUAL ASSAULT BILL. The Wall Street Jo urnal (10/17 , Subscription Publication, 6.45M) editorial board praises California Governor Jerry Brown's (D) Sunday veto of a bill that would have codified the Obama Adm inistration 's "Dear Colleague" guidance, which said universities wou ld lose federa l funds if they did not create courts to litigate Title IX campus sexua l assau lt claims . The Journal urges politicians to stay focused on their princip les in spite of desire to buck the Trump Administration. WPOST OFFERS FAREWELL TO FORMER COMMUNICATIONS VICE PRESIDENT. In an editorial , the Washington Post (10/ 17, 10.38M) writes offers a farewell message for The Post's former vice president of communicat ions, Vincent E. Reed, who died Tuesday at the age of 89. The Post says Reed "leaves a rich legacy" in the lives of the students who benefited from the school he created - Benjami n Banneker Academ ic High School - and the educators "helped by the support and guidance he provided from his position at The Post." Editorial Wrap-Up: NEW YORK TIMES . "Mr Trump Outdoes Himself In Picking A Conflicted Regulator." A New York Times (10/17, Subscription Publication , 13.56M) editorial says President Trump has "made a habit of filling important jobs with people dedicated to undermin ing the laws they're supposed to admin ister while pamper ing the industr ies they're supposed to regulate ," and "yet no nomination has been as brazen , as dangerous to public health and as deserving of Senate rejection as that of Michael Dourson to run the EPA office in charge of reviewing chemicals used in agricu lture , industry and household products ." Dourson's nomination is "enthusiast ically endorsed by the chemical industry ," but "horrifies environmental groups , public health advocates, firefighters and scientists." The Times says it "would take just a few Repub licans to block the nomination ," and urges senators to "think hard about the impact their votes could have on the health of Americans for years to come ." WASHINGTON POST. "Janet Yellen Deserves A Second Term As Fed Chair. " In an editoria l, the Washington Post (10/17, 10.38M) writes that President Trump should select Janet Yellen for a second term as Federal Reserve Chairman because of her experience w ith steadily raising interest rates and with the unwinding of the Fed's asset purchasing program, her encouragement and defense of safeguards on financia l institutions, and her relative flexibility compared with the other candidates . The Post concludes that her selection would signa l the preservat ion of the Federal Reserve's independence from politicization and "would send a reassuring message of continu ity." /\MERICAi\ pVERSIGHT EXT-18-248-D-000548 "The Hope For Change In Venezuela Suffers A Crushing Blow." A Washington Post (10/17, 10.38M) editorial says "hopes that Venez uela could emerge from its catastrophic politica l and economic collapse by democrat ic means suffered a crushing and perhaps terminal blow on Sunday" when the government of Nicolas Maduro staged elections for provincial governors . Polls showed the opposition , "which reluctant ly agreed to participate, would win up to two-thirds of the races ," and yet the results "announced by pro-regime election authorit ies were nearly the oppos ite." The Post argues that Sunday 's result suggests that a free and fair democratic election in Venezuela "is no longer possible." "Saying Farewell To A Local Icon Of National Renown ." In an editorial , the Washington Post (10/17, 10.38M) writes offe rs a farewe ll message for The Post's former vice president of comm unications, Vincent E. Reed, who died Tuesday at the age of 89. The Post says Reed "leaves a rich legacy" in the lives of the students who benefited from the school he created Benjamin Banneke r Academic High School - and the educators "helped by the support and guidance he provided from his position at The Post." WALL STREET JOURNAL. "The Realtors Take A Tax Hostage." In an editorial, the Wall Street Journal (10/ 17, Subscription Publication, 6.45M) writes that The National Association of Realtors' attack on GOP tax legislation is based upon their desire to keep middle-c lass tax rates high to preserve thei r mortgage interest deduction subsidy . The Journal concludes that Republicans should stand firm against the hous ing lobby's efforts against the GOP plan. "Jerry Bro wn 's Title IX Veto." The Wall Street Journa l (10/17, Subscript ion Publication , 6.45M) editor ial board praises California Governor Jerry Brown's (D) Sunday veto of a bill that would have codified the Obama Admin istration's "Dear Colleague " guidance , wh ich said universities would lose federal funds if they did not create courts to litigate Title IX campus sexual assault claims. The Journal urges politicians to stay focused on their princ iples in spite of desire to buck the Trump Admin istration. "Prosecutorial Impunity ." The Wall Street Journal ( 10/17, Subscr iption Publication , 6.45M) editoria lizes about Tuesday's ruling by the 2nd Circuit Court of Appea ls that abso lved prosecutors for the use of false information in the prosecutio n of hedge fund founder David Ganek . Ganek had sued the prosecutors, seeking damages after the prosecution had put his hedge fund out of business . The appeals court ruled that the prosecutors were immune from liability . The Journal calls this another examp le of abusive behavior by prosecutors, and it urges the Justice Department to investigate the incident and to discipline the prosecutors . The Big Picture: HEADLINES FROM TODAY 'S FRONT PAGES. /\MERICAi\ pVERSIGHT EXT-18-248-D-000549 Wall Stre et Journal: Senators Reach Deal To Shore Up Health Markets Soros Transfers $18 Billion To Foundation , Creating Instant Giant US-Backed Forces Say They Have Taken Last Islamic State Urban Stronghold The Other Brother: Bob Weinstein Was An Abus ive Boss New York Times: 2 Senators Strike Deal On Health Subsidies That Trump Cut Off Raqqa, ISIS 'Capital,' Is Captured, US-Backed Forces Say As Party Gathers, Xi Jinping Displays A Firm Grip On Power Inside A Secretive Group Where Women Are Branded Navy SEALs Were Ready If Pakistan Failed To Free Family Held As Hostages Women Denounce Harassment In California 's Capital Washington Post: Latest Healthcare Effort Quickly Stalls US-Backed Force Says Raqqa Free Of ISIS Despite Decision Against Uber, London's Rivalry Between Traditional , Modern Transit Continues Drug Czar Pick Bows Out Amid Criticism Of Law Judge Largely Halts Latest Version Of Travel Ban Financial Times: US-Backed Forces Claim Victory Over ISIS In Raqqa As Jihadis Flee Airbus Challenges Boeing With Vow To Create US Jobs Wall St Banks Boosted By Lending To Rich Clients Washington Time s: Trump Supports Bipartisan Short-Term Fix To Stabilize Obamacare Judge Blocks Trump's Travel Ban For Third Time /\MERICAi\ pVERSIGHT EXT-18-248-D-000550 Islamic State's 'Caliphate' Dissolves. But Ideology, Operations Spread Around World New Yor k Times' Social Media Policy Only Hides Political Bias, Doesn't Eliminate It Biden And Kasic h Claim Political Center , Turn Bipartisan Talk Aga inst Trump After Year In Coffin, Thai King's Body Prepared For Royal Cremation Story Lineup From Last Night's Network News: ABC: NFL Owners Meeting; Bipartisan Healthcare Plan; Wh ite House-Fallen Soldiers Call ; Weinstein Sexual Harassment Scandal ; California Wildfires ; Travel Restriction Blocked ; SyriaRaqqa Assault; Ohio-Police Violence; Cold Medicine Murder; Texas Air Balloon Crash Investigation ; Ford Explorers-Call For Recall; Aspiring Kid. CBS: Opioid Epidemic-Marino Nomination Withdrawn ; Opioid Epidemic-Hard Hit Area; Texas Air Balloon Crash Investigat ion; McCain, Biden-Trump Criticisms; Wh ite House-Fallen Soldiers Call; Syria-Raqqa Assault; Ford Explorers -Call For Recall; Travel Restriction Blocked ; Weinstein Sexual Harassment Scandal; Young Political Candidates. NBC: White House-Fallen Soldiers Call ; Bipartisan Healthcare Plan; Wall Street Records; Opioid Epidemic-Marino Nominat ion Withdrawn; Opioid Epidemic-Ch inese Imports; Travel Restriction Blocked ; Weinstein Sexual Harassment Scandal; United Overbook ing Investigation ; Texas Air Balloon Crash Investigat ion ; Syria-Raqqa Assault; Ford Explorers-Call For Recall; NFL Owners Meeting ; GMO Apple; Brooklyn-Loose Cow ; Creative Chem istry Class. Network TV At A Glance: White House-Fallen Soldiers Call - 8 minutes , 15 seconds Opioid Epidemic - 6 minutes , 25 seconds Syria-Raqqa Assault - 6 minutes , 15 seconds Weinstein Sexual Harassment Scandal - 4 minutes, 50 seconds Ford Explorers-Call For Recall - 4 minutes, 20 seconds Travel Restriction Blocked - 1 minute, 20 seconds Story Lineup From This Morning's Radio News Broadcasts: ABC: Travel Restriction Blocked; Bipartisan Healthcare Plan; NFL Owners Meeting ; MarylandHate Crime Trial; Wall Street News . CBS: Bipartisan Healthcare Plan; Travel Restriction Blocked ; Opioid Epidemic ; White HouseFallen Soldiers Call ; California Wildfires. FOX: Bipartisan Healthcare Plan ; California Wildfires ; Weinst ein Sexual Harassme nt Scandal. /\MERICAi\ pVERSIGHT EXT-18-248-D-000551 NPR: Travel Restriction Blocked; California Wildfires; NFL Owners Meeting ; Amazon Sexual Harassment Scandal. Last Laughs: LATE NIGHT POLITICAL HUMOR. Jimmy Kimmel: "They have a policy where if an anima l escapes a slaughterhouse , it gets to go free . Isn't that great? The bull is being sent to a rehabilitation facility for misbehaving cows. That's the good news. The bad news is it is also where they sent Harvey Weinstein." Trevor Noah: "Speaking of hairy creatures , yesterday President Trump held a surprise press conference with Senate Majority Leader Mitch McConnell, which is kind of the worst surprise ever . 'Surpr ise, I brought Mitch McConnell!' Boo! What kind of surprise party is [with] Mitch McConnell? " Trevor Noah: "I don 't know, something 's fishy here. They sound less like real friends and more like Trump trying to get Mitch a green card . 'Th is gentleman , I'm going to say Mitch, right, Mr. Immigration Officer , this relationship is special, it's so special .' 'That's what you said about Melania.'" Trevor Noah : "See what (President Trump] said? 'President Obama never called . I call and I write . I also haven't cal led and I didn't write . But I do , except when I don't, which is now."' This copy of the HHS News Briefing was sent to you because you are registered for email notificat ion on our we bsite. If you wo uld like to cancel emai l delivery click here. Copyright 2017 by Bulletin Intelligence LLC Reproduction or redistribution without permiss ion prohibited . Content is drawn from thousands of newspapers , national magazines , national and local televis ion programs , radio broadcasts, social-media platforms and additional forms of open source data. Sources for Bulletin Intelligence aud ience-size estimates include Scarboroug h, GfK MRI , comScore, Nielsen, and the Audit Bureau of Circulation . Data from and access to third party socia l media platforms , including but not limited to Facebook , Twitter , lnstagram and others, is subject to the respective platform's terms of use . Services that include Factiva content are governed by Factiva's te rms of use. Services including embedded Tweets are also subject to Twitter for Website's information and privacy policies. The HHS News Briefing is published five days a week by Bulletin Intelligence, which creates custom briefings for government and corporate leaders. We can be found on the Web at Bulletinlntell igence .com, or called at (703) /\MERICAi\ pVERSIGHT EXT-18-248-D-000552 483-6 100. Sender: Bulletin Intel ligence Recipient: "HHS@bullet inintell igence.com" Sent Date: 20 17/10/ 18 07:29: 16 Delivered Date: 20 17/10/18 07:32:33 /\MERICAi\ pVERSIGHT EXT-18-248-D-000553 HHS NEWS BRIEFING P RODUCED B Y BU LLETIN INTELLIGENCE WWW.BULLETININTELLIGENCE.COM/HHS TO: THE SECRETARY AND SENIOR STAFF DATE: WEDNESDAY, OCTOBER 18, 2017 7:30 AM EDT TODAY'S Leading the News Senators Reach Bipartisan Agreement To Fund ACA Subsidy Payments . ............. .................... ....3 The Secretary in the News Trump May Be Considering Alex Azar To Replace Price As HHS Secretary , Sources Say ... ............5 Trump Says He Will Nominate A New HHS Secretary Soon ...... ............ ....... ......................... .5 Democratic Lawmakers Want Trump Administration To Justify Decision To End ACA Subsidy Payments .. ............ .............................................. 5 HHS in the News Trump Administration Reportedly Preventing Undocumented Minors Who Were Raped From Obtaining Abortions ...................... ................... ....5 HHS To Hold Nat ional Conference On Small Business Grants In Milwaukee ............................6 Benefits Of Implementing Value-Based Care In Question .... ............ ..............................................6 Opinion: HHS Should Use Emergency Prescript ion Ass istance Program To Help Those Affected By Recent Hurricanes . ........................................6 Indian Health Service Defends Contract Awarded To Former NextCare CEO . ........ ....... ...... ............6 Health Experts Call For Changes To Food Environment As CDC Research Shows Rising Obesity Rates ..... ............ .............. ........ .......... .....6 Brennan : NLM Is A "Safe Harbor" For Information ... .7 Opinion: US Shou ld Fund More Research On How To Care For People With Alzheimer 's D isease . .7 More Researchers Keeping Primates In Sha red Cages Rather Than Alone . .......... ........ ........... ....7 Health Reform Trump Calls On Congress To Fix "ObamaCare Mess " At Heritage Foundation Event. .................7 President Trump May Have To Lobby For Bipartisan Healthcare Deal. ................ ....... ............ ....... .......7 EDITION Trump Says Senate GOP W ill Resume Work On ACA Repeal Bill After Tax Reform . .......... ....... ....7 Trump Blames Dems For Premium Hikes For ACA Plans .. .......... .............. ................ .......... .......... .....7 Sens. Bennet, Kaine Unveil Proposal To Add Public Option To ACA. ...................................................7 Some States , Insurers Scrambling To Raise Rates Following Trump 's Decision To End ACA Subsidy Payments . .............................................8 Senate GOP's Slim Majority Threatened By The Age And Illnesses Of Certain Lawmakers . .........8 Sens. Toomey , Cotton Unveil New Bill To Exempt Certain People From ACA 's Individual Mandate . .............................................................8 Insurers May Lose About $1 Billion During The Remainder Of 2017 If ACA Subsidy Payments End , Analysis Indicates ...... .................................8 Federal Funding For Indiana's ACA Navigators Cut By 82% ......... ............. ............ ....... ............ ...... .....8 Pittsburgh, Erie Roman Catholic Dioceses Settle Lawsuits Over ACA's Contraception Mandate . ..8 De mocratic Cand idates In Minnesota's Gubernatorial Race Unanimously Support Single-Payer Healthcare System ........................ 8 North Dakota Insurance Commissioner Says He Will Not Allow More Rate Hikes For ACA Plans . 9 Centene Raises Premiums In Arkansas By 21.4 Percent. ..... ..........................................................9 Ce ltic lnsurance / MHS To Raise Average ACA Plan Premiums In Indiana By 35.7 Percen t. ............... 9 New Jersey Regulators Approve Premium Increases For Individual ACA Plans .... ............ ...9 Massa chusetts State Senators Propose WideRanging Hea lthcare Reform Bill. .........................9 Vermont Joins Lawsu it Against Trump To Maintain ACA Subsidies ... ............ ....... ................... ...........9 Senate Hea lthcare Bill Could Rescue MinnesotaCare Funding Cuts ............. ...... ..........9 McCa in, Murkowski Say They Support Bipartisan Healthcare Deal. ........... ....... ............ ................. 10 EXT-18-248-D-000554 Opinion: CMS Proposal To Exempt Rural Physicians From MIPS Will Do More Harm Than Good ... .................................... ................. 15 Bipartisan Healthcare Deal Includes Provisions For Democrats And Republicans . .......................... . 10 Sen . Johnson To Question OPM Nominees On Congressional Healthcare Contributions . ......... 10 Key Questions Surround The Senate 's Bipartisan Healthcare Proposal. ......................................... 10 Commentary Considers Health Reform ...... ............. 10 Medicaid & CHIP "Bickering " Over CHIP , Community Health Centers Reportedly Harming Nation 's Healthcare ..... .... 15 Arkansas Governor Says Insurance Rate Hikes Will Not Threaten State Medicaid Expans ion . ......... 16 Michigan Democrats Say Proposed Medicaid Cuts "Devastating " For Vulnerable People ................ 16 Opioid News Rep. Marino Withdraws From Consideration For Drug Czar Position After Criticism ....... ............ . 12 Trump Says He'll Formally Declare National Emergency To Combat Opioid Epidem ic Next Week ... .............................................................. 13 DOJ To Consider Repeal Of Law Blocking DEA From Halting Opioid Shipments ........................ 13 Investigat ion Of Alleged Fentanyl Shipping Operation Leads To Multiple Indictments ......... 13 Opioid Cris is Caus ing Increase In Hepatitis C Cases ................... ............................................ . 13 Hospitals Move Forward On Opioid Response Strateg ies Despite Lack Of Federal Funding .... 13 PhRMA Calls For Repeal Of Law Limiting DEA's Opioid-Response Capab ilities .......... ................. 13 Healthcare Providers Seek Alternative Pain Treatments In Response To Opioid Epidemic .. 14 Beaver County Becomes Third In Pennsylvania To Sue Pharmaceutical Companies Over Opioid Crisis .... ............................................ ................. 14 Health & Medical News Pharmaceutical Companies Deny Responsibility For Drug Pricing At Senate Hearing ............. ........... 16 Senator Quest ions Pharmaceut ical Industry About Doing Away With Rebates .. ............. ................. 16 Families Of Deceased Troops Allege Pharmaceutical Companies "Knowingly Financed " Anti-American Militia In lraq ............. 16 Massachusetts Senate Considers Bill To Require Data Submissions From Drug Companies ... .... 16 Appeals Court Vacates Verdict In Talcum Powder Cancer Case ........ ................... ............ .............. 17 Gene Tumor Boards Increasing ly Providing Guidance On Cancer Care ... ............. ............... 17 Mouse Study Finds Link Between Stress And Digestion In Female Mice ... ............. ................. 17 New Hampshire Gov . Removes Member From Cancer Cluster Panel. ............. .......................... 17 Scientific American Editors Voice Support For Cosmetics Safety Bill ..... ................................... 17 Transenterix CEO Says Senhance Won' t Compete Direct ly With Intuitive Surgical's Da Vinci. ........ 17 Johnson & Johnson 's Animas Closure , Cessation Of Insulin Production Are Reflect ive Of Broader Healthcare Issues . ........................... ................. 17 DC Counc il Disapproves Of Extending Contract To Manage City's Only Public Hospital. ................. 18 People With Adverse Ch ildhood Events Found More Likely To Suffer Health Problems As Adults .... . 18 Second TB Case Reported In Durham County, North Carolina . ................................. ................. 18 VA Facility In Omaha Maintained Secret Waiting List Of Veterans Seek ing Mental Health Appoin tments ....... ................. ............................ 18 Hepatitis A Deaths Now Up To 19 In San Diego County .. ................................ ............ ................. 18 Researche rs Trying To Identify Early Signs Of Brain Damage In Professional Fighters ............. ........ 18 US District Judge Orders Flint To Pick A Long-Term Water Source .............. ............ .......................... 18 Researchers Identify Four Genes In Humans , Dogs , And Mice That May Be Linked To OCD . .......... 19 Excessive Exercise May Be Linked To Higher Risk Of Buildup Of Plaque In Heart Arteries By Healthcare News UnitedHealth Posts Higher Q3 Earnings, Beats Analysts ' Expecta tions ...... ................. .............. . 14 Columnist Warns Federal Retiree Health Premiums Could Increase Markedly If House Budget Proposal Becomes Law . .................. ................. 14 Wisconsin Bill Would Prohibit University Of Wisconsin Employees From Working At Planned Parenthood ...... .................. ................. 14 Arkansas Health Care Associat ion Joins Coalition To Support Limits On Payouts For Lawsuits ... . 15 Pennsylvania Regu lators Issue More Nursing Home Citations But Understate Incidents' Severity, Experts Say ....................................................... 15 Emergency Response and Pandemic Preparedness Vulnerable Elderly Increasingly Becoming Victims Of Emergencies, Disasters .... ............ .............. . 15 Nutrition & Obesity Google Maps Pulls Experimental "Calorie Counting " Feature From App After Criticism .... ................. 15 Medicare Expanded Medicare Enrollment Options Give Seniors More To Sort Out. ............... ................. 15 2 EXT-18-248-D-000555 Obama UN Ambassador Says Unmasking Requests Were Made In Her Name ................ .25 Trump Says Fed Cha irman Pick Coming Soon, Source Says Early November ........................... 25 Dow Tops 23,000 For First Time .. ............................25 Trump Calls On Americans To Say "Merry Christmas" During Holidays .. ............................25 Trump Drops In Forbes 400 Rank ing ...... .................26 Trump DC Judicia l Nominee Addresses Judiciary Committee ............ ............................................. 26 Pruitt Seeks To Assure Senators Over Biofuels Mandate . ...........................................................26 Sessions Creates Watchdog For Asset Forfeiture Program .............................................................26 Zinke Booster Now Expresses Concerns About His Public Land Policies ......................................... .26 Chao Silent On Federal Money For Miam i's Metrora il. ............................... ............................26 Fox News Poll: Jones , Moore Tied At 42% In Dec. 12 Special Election ............................................26 Three Polls Show Virginia Governor 's Race "Within The Margin Of Error." ........................................27 Two Polls Show Democrat Murphy Up Double Digits In New Jersey Governor 's Race ........ ...............27 Pence's Fundraiser Benefiting Collins Draws "About 80" Protesters ....................................................27 Ca lifornia House Republicans Get Large Financial Boost From PAC's Fundraiser With Pence .. ....27 Endorsing Flake Primary Foe Ward , Bannon Rips McConnell, Senate Republicans ....................... 28 Hill Analysis: Trump 's Support Gives Barletta Edge In Crowded Primary ... .......................................28 Eight Democrats On CNN's List Of "10 Senate Seats Most Likely To Switch Parties" In 2018 .. 28 Hawley Spokesman Sidesteps Question On Whether Candidate Would Back McConnell. ...28 SLF Unveils Microsite Targeting Democrat Donnelly On Outsourcing ........... ......................................29 Nelson Raises Nearly $1 .8M In 03 , Has $6.3M Banked For Reelection Race ..... .......................29 Testimony Continues In Menendez 's Federal Corruption Trial. ................................................29 New Wildfires Emerge In Santa Cruz Mountains .....30 Weinstein Resigns From His Company ; Amazon Exec Steps Down ..............................................30 Women Denounce Harassment In California 's State Legislature .... .....................................................30 NYTimes A 1: Secretive "Self-Help " Group For Women Requires Members To Be Branded ... .30 Trump Accuser Describes Earlier Harassment Experience . .......................................................30 Pence Says Walking Out Of Colts Game Was "Right Thing To Do."......................................... .30 NFL Owners, Players Meet To Discuss Anthem Protests ..... ............ ....................................... ..... 31 Middle Age In Caucasian Men , Study Suggests ........................................................... 19 NAFLD, Nonalcoho lic Steatohepatitis The FastestGrowing Reasons For Liver Transplants In Young Americans , Research Indicates . ........... 19 lmpax Laboratories Inks Deal To Merge With Amnea l Pharmaceuti cals ............ ...................... 19 Column: Allergan Restasis Case Exemplifies How Companies Manipulate Patent System ... ......... 19 Troy University Researchers Developing Ant iDepressants Through Zebrafish Studies ...... .... 19 District Judge Invalidates Allergan 's Restasis Patents ..... .................. ....................................... 19 District Judge Refuses Pharmaceutical Companies ' Request To Block Nevada Drug Pricing Law ... 20 Experts Consider Whether lgnyta Pharmaceuticals' Cancer Treatment Can Be Compared To Pfizer's .............................. .................... ............. 20 Study Reveals Association Between Depression , Sagging Testosterone Levels In New Fathers ..20 Men Who Receive Blood Donated By Previously Pregnant Women May Face Increased Risk Of Death Following The Transfusion , Study Indicates ... .........................................................20 Physician Warns Of Dangers Of Online Companies Selling Designer Substances ..... .......................20 Oversized Eyedrops Waste Patient's Money And Medicine By Design . .........................................20 More Hospitals Investing In Housing And Support For Homeless To Reduce ER Visits .. ...............21 Global Health Ch ina Confirms H5N6 Bird Flu Outbreak In Central Province . ...........................................................21 Op-Ed : Canada Must Push For National Registry Of Payments From Compan ies To Physicians ......21 National News House Panel Sets Puerto Rico Recovery Hearing For Next Week . .................................................21 Puerto Rican Delegate : Trump Has Given Everything We 've Asked For .............................21 Desperate Puerto Ricans Turning To Wells At Superfund Site For Water . ................................21 Discussing Obama And Slain Soldiers, Trump Cites Death Of Kelly's Son . ........................................21 Trump Says He Was "Surprised " By The "Dishonesty In The Media." ...............................23 Trump Warns McCain , "I Fight Back And It Won't Be Pretty ." ...............................................................23 White House Urges Corker To "Get Out Of The Name-Calling ." ..................................................24 White House Denies Trum p Joked Pence Wanted To "Hang" Gays .................................................24 Senate Committee Subpoenas Page , Seeks Information From Flynn's Son ...........................24 3 EXT-18-248-D-000556 Google Serves "Fake News" Ads On Fact-Checking Sites, NYTimes Finds.......................................31 National Archives Warned Administration To Preserve Documents. .......................................31 Bipartisan Group To Urge Trump To Alter Policing Policies. .............................................................31 Open Society Discloses $18 Billion In Donations From Georges Soros.... ....................................31 Duckworth: Congress Seeking To Remove Protections For Disabled...................................32 WSJournal Decries Court Ruling Absolving Prosecutors For Using False Information.........32 WSJournal Applauds Gov. Brown's Veto Of Campus Sexual Assault Bill. .............................32 WPost Offers Farewell To Former Communications Vice President. ..................................................32 Editorial Wrap-Up New York Times .. .....................................................32 Washington Post.......................................................32 Wall Street Journal. ..................................................33 The Big Picture Headlines From Today's Front Pages......................33 Last Laughs Late Night Political Humor. .......................................34 The article says that although the deal "is a breakthrough, they still need to secure the support of fellow Republicans and Democrats." The piece adds that Senate Majority Leader Mitch McConnell (R-KY) "was noncommittal , while Minority Leader Chuck Schumer , D-N.Y., welcomed the agreement as a step forward that will provide stability for insurance markets in the short-term ." On its front page, the Washington Post (10/ 17, A1, Sullivan , Eilperin, 10.38M) reports "Republican leaders did not immediate[ly] endorse the Alexander-Murray framework , raising new questions about whether it would find any traction." The article adds that for now, "many Republican senators are distancing themselves from the emerging Alexander-Murray plan." Bloomberg News (10/ 17, Edney, Wasson , Utvan, 4.52M) reports that if the proposal "becomes law, it could end a chaotic week that saw the White House move to dismantle parts of the Affordable Care Act even as Trump took credit for pushing lawmakers to work out the fixes." Reuters (10/17, Abutaleb , Cowan) reports that Murray said about the deal, "We are ironing out a few of the last details right now but I am very optimistic that we will be able to make an announcement with all the details very soon." For his part, Alexander stated, "This takes care of the next two years." He added , 'This is a small step. I'd like to undersell it, not oversell it." Also covering the story are ABC World News Tonight (10/17, story 2, 2:35, Muir, 14.63M) , NBC Nightly News (10/17, story 2, 0:30, Holt, 16.61M), USA Today (10/ 17, Berry, 8.62M) in a second story, the Los Angeles Times (10/17 , Levey , Mascaro, 4.49M) , the Wash ington Times (10/17, Boyer, 541K), the New York Post (10/17, LEADING THE NEWS Senators Reach Bipartisan Agreement To Fund ACA Subsidy Payments. The New York Times (10/ 17, Kaplan, Subscription Publication, 13.56M) reports on its front page that Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA) "have reached a bipartisan de~I to provide funding for critical subsidies to health insurers that President Trump said last week that he would cut off," Alexander said on Tuesday . This agreement aims "to stabilize health insurance markets under the Affordable Care Act." Under the agreement, "the subsidies would be funded for two years, a step that would provide at least short-term certainty to insurers." The article says Trump called the deal a "short term" solution. USA Today (10/17, Jackson, 8.62M) reports that Trump again criticized the ACA on Tuesday, saying, "Obamacare is a disgrace to our natio.~.... We are solving the problem of Obamacare. He also said the ACA was "dead" in his opinion . But after being told about the bipartisan deal, Trump said lawmakers "are working together and I know very much what they're doing, OK?" In a front-page article, the Wall Street Journal (10/17, A 1, Armour , Peterson , Subscrip!ion Publication, 6.45M) quotes Alexander as saying, "Sen. Murray and I have an agreement. ... Democrats feel like there are protections there ...at the same time we give significant flexibility to states." The AP (10/17, Fram) reports that Trump "spoke favorably about the bipart~~an compromise, which is still likely to face oppos1t1on in Congress." Alexander added that Trump had been encouraging, and that he "likes this idea." 4 EXT-18-248-D-000557 Fredericks, 4.31 M), Politico (10/17, Haberkorn, 3.6M), CNBC (10/17, Mangan, Pramuk, Coombs, 3.48M) , The Hill (10/17, Sullivan, 1.68M), the Huffington Post (10/17, Fuller, Bobic, Cohn, 5.74M), NPR (10/17, Kodjak, 2.4M), the Washington Examiner (10/17, Leonard, 465K), Roll Call (10/17, McIntire, 134K), and Modern Healthcare ( 10/17, Meyer, Subscription Publication, 238K). Mark Walker Calls Bipartisan Deal "An Affront To GOP Promises To Repeal" ACA. The Hill (10/17, Sullivan, 1.68M) reports that in response to the announcement about the bipartisan deal, Rep. Mark Walker (R-NC), chairman of the conservative Republican Study Committee in the House, dismissed it "as an affront to GOP promises to repeal President Obama's signature legislation." Walker said, "Anything propping [ObamaCare] up is only saving what Republicans promised to dismantle." The Washington Examiner (10/17, King, 465K) reports that Walker tweeted, ''The GOP should focus on repealing & replacing Obamacare, not trying to save it. ... This bailout is unacceptable." In a separate article, the Washington Examiner (10/17, King, 465K) reports that Sen. Lamar Alexander (R-TN) "shrugged off criticism from House conservatives Tuesday that it was a 'bailout."' He said, "I appreciated President Trump's encouragement and his recommendation that it was important to continue the cost-sharing payments for two years in order to avoid harming millions of Americans .... That is kind of comment that I welcome, and I think his support is important." Another article in The Hill (10/17, Roubein, 1.68M) also covers the story. Heritage Foundation Fellow Slams Bipartisan Deal To Fund ACA Subsidy Payments. The Hill (10/17, Greenwood, 1.68M) reports that on Tuesday, Ed Haislmaier, a senior research fellow in healthcare policy for the Heritage Foundation, "ripped a bipartisan deal ...that would provide funding for" ACA subsidy payments to insurers. He stated, "For Congress, the most important thing is to recognize that funding the cost sharing reduction subsidies - as many are now calling for - would prop up the subsidized ObamaCare exchange market, but would do absolutely nothing to stabilize the broader, unsubsidized individual market." Mark Meadows Calls Bipartisan Deal A" Good Start." The Hill (10/17, Weixel, 1.68M) reports that on Tuesday, Rep. Mark Meadows (RNC), chairman of the House Freedom Caucus, "said more work needs to be done to get conservatives to support a bipartisan Senate deal to extend critical ObamaCare payments to insurers, but he called it a starting point." Meadows is quoted as saying, "There are elements in the Alexander-Murray plan that we can build on, but much more work needs to be done." He characterized the agreement as a "good start." The Washington Examiner (10/17, Weaver, 465K) also covers the story. Connecticut Lawmakers Praise Bipartisan Deal. The Connecticut Mirror (10/17, Radelat) reports that the bipartisan deal "would also restore $106 million in funding for advertising and marketing of the Affordable Care Act that helps people enroll in insurance plans." Commenting on the agreement, Sen. Richard Blumenthal (D-CT) said, "This bipartisan agreement is a victory for American patients and consumers, showing how we can work together across party lines. ... Extending payments for critical healthcare subsidies ensures that countless Americans will retain access to their healthcare, in spite of the president's repeated attempts to sabotage insurance markets." Meanwhile, Sen. Chris Murphy (D-CT) "called the agreement 'good news."' THE SECRETARY IN THE NEWS Trump May Be Considering Alex Azar To Replace Price As HHS Secretary, Sources Say. Politico (10/17, Restuccia, Johnson, Karlin-Smith, Dawsey, 3.6M) reports President Trump "is leaning toward nominating Alex Azar, a former pharmaceutical industry executive and George W. Bush administration official, to serve as Health and Human Services secretary, according to two White House officials." If confirmed, Azar would replace former HHS Secretary Tom Price who resigned last month following criticism about his use of private jets and military planes. The article adds that according to several unnamed sources, other possible candidates for the post, including CMS Administrator Seema Verma and FDA Commissioner Scott Gottlieb, "are no longer under consideration." 5 EXT-18-248-D-000558 Reuters (10/17, Walsh) reports that Azar served as "deputy secretary at HHS during the administration of President George W. Bush before joining drugmaker Eli Lilly and Co, first as senior vice president of corporate affairs and communications, and later as president of Lilly USA, its U.S. affiliate." The Washington Post (10/17, Eilperin, Goldstein, 10.38M) reports that "both of the HHS secretaries for whom Azar worked are supporting him for the position." Mike Leavitt on Tuesday said Azar was "an experienced, competent conservative who is confirmable." Tommy Thompson praised Azar's "record of proven competence" and combination of private- and public-sector management and "deep substantive health-care knowledge." The New York Daily News (10/17, Silverstein, 3.61M) reports that while Azar has experience working at HHS, he spent most of the last decade "working for the same drug industry he would be expected to oversee while leading the department." The Hill (10/17, Savransky, 1.68M) the Washington Times (10/17, Persons, 541K), the Indianapolis Star (10/17, Grappe, 479K), and the Indianapolis Business Journal (10/17, 37K) also cover the story. would have on health insurance costs, access to coverage, and federal spending." HHS IN THE NEWS Trump Administration Reportedly Preventing Undocumented Minors Who Were Raped From Obtaining Abortions. The Huffington Post (10/17, Foley, 5.74M) reports, "Many undocumented immigrant girls seeking safety in the United States are raped during their jou rneys," but when "they arrive, they are put in custody of a government that is now obstructing access to abortion." The article says earlier this year, the Trump Administration implemented new rules "to prevent undocumented minors in government custody from getting abortions. Since March, the government has required shelters to get its approval before releasing girls for abortion-related services approval that officials have refused to grant." The piece adds that officials are demanding that "minors be sent to crisis pregnancy centers that discourage them from seeking abortions, and at times have intervened directly to discourage girls from terminating their pregnancies." The Office of Refugee Resettlement said in a statement, "There is no constitutional right for a pregnant minor to illegally cross the U.S. border and get an elective abortion while in federal custody." Undocumented Immigrant Minor Files Another Lawsuit Seeking Permission For An Abortion. The Washington Post (10/17, Sacchetti, Somashekha r, 10.38M) reports, "The American Civil Liberties Union is accusing the Trump administration of illegally blocking a 17year-old Central American immigrant from having an abortion and will urge a federal judge in Washington on Wednesday to clear the way for her and other young immigrants to terminate their pregnancies." The Dallas Morning News (10/17, Wang, 984K) reports that "Jane Doe," a 17-year-old undocumented and unaccompanied immigrant in Texas, has filed another lawsuit seeking permission for an abortion. The article explains that Doe's previous lawsuit was dismissed, but that she has filed another federal lawsuit in a different court against the heads of the Department of Health and Human Services, the Administration for Children and Families, and the Office of Refugee Resettlement. The American Civil Liberties Union is representing Doe in the Trump Says He Will Nominate A New HHS Secretary Soon. The AP (10/17) reports that on Tuesday, President Trump said he is '"more than close' to naming a new health and human services secretary." He added that if his choice for HHS Secretary is confirmed, "it will be...fantastic ." Democratic Lawmakers Want Trump Administration To Justify Decision To End ACA Subsidy Payments. The Washington Examiner (10/17, Leonard, 465K) reports that on Tuesday , congressional Democrats "demanded that the Trump administration justify its decision to end insurer payments, accusing him of doing so not for legal reasons, but to 'sabotage' Obamacare." They wrote to President Trump and Acting HHS Secretary Eric Hargan, seeking "documentation to show which factors were considered in Trump's decision to end the payments, known as costsharing reduction, or CSR, subsidies." The lawmakers "asked for any analyses that were conducted, including what impact his decision 6 EXT-18-248-D-000559 lawsuit, and "has requested a temporary restraining order to allow Doe to have an abortion." The New York Daily News (10/17, Cullen, 3.61 M) reports that the Administration for Children and Families said in a statement that under federal law, the Office of Refugee Resettlement can "decide what is in the best interests of a minor in the unaccompanied alien children program and, in this case, her unborn baby." The Daily Caller (10/17, Carr, 521K) reports that Texas Attorney General Ken Paxton said that ruling in favor of Doe would "create a right to abortion for anyone on earth who enters the US illegally. And with that right, countless others undoubtedly would follow . Texas must not become a sanctuary state for abortions." CNN (10/17, Levenson, Burnside, 33.59M) also covers the story. innovation center, saying it wants to cut red tape, empower consumers , and 'allow physicians and other providers to focus on providing high-quality healthcare to their patients."' Opinion: HHS Should Use Emergency Prescription Assistance Program To Help Those Affected By Recent Hurricanes. Brian Nyquist, the executive director of the National Infusion Center Association , writes in an opinion piece in The Hill (10/ 17, 1.68M) that the Department of Health and Human Services should enact the Emergency Prescription Assistance Program to help those who are struggling to obtain their prescriptions because of recent hurricanes. Nyquist explains that "the program provides a mechanism for more than 70,000 enrolled retail pharmacies nationwide to process claims for certain kinds of prescription drugs, specific medical supplies, vaccines and some forms of medical equipment for uninsured individuals in a federally-identified disaster area." HHS To Hold National Conference On Small Business Grants In Milwaukee. The Milwaukee Journal Sentinel (10/17, Hauer, 628K) reports the Department of Health and Human Services will hold a national conference on the Small Business Innovation and Research and Small Business Technology Transfer grants in Milwaukee from November 7 to November 9. During the conference , "around 100 program managers from" the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health will be in Milwaukee, and "attendees will be able to meet one-on-one with the program managers to learn how to submit successful applications." Walter Koroshetz, the director of the National Institute of Neurological Disorders and Stroke, will give one of the keynote addresses at the conference . Indian Health Service Defends Contract Awarded To Former NextCare CEO. "The federal Indian Health Service agency is defending a contract it awarded" in September to Arizona-based Tribal Emergency Medicine, "whose CEO formerly led a firm that paid $10 million to settle allegations of submitting false claims to government health programs," the A P (10/ 17) reports. "Tribal Emergency Medicine CEO John Shufeldt previously led NextCare Inc., a multistate chain of urgent-care clinics," the article explains. In 2009, a former employee filed a lawsuit against NextCare "on behalf of the U.S. government alleging the company conducted hundreds of unnecessary allergy and respiratory tests on patients and then submitted bills for the tests to government programs. ... The lawsuit also alleged the company inflated billings as part of a practice known as upcoding." Benefits Of Implementing ValueBased Care In Question. STAT (10/17, 43K) reports that "the implementation of valuebased care is a flop so far," as "costs have continued to skyrocket," Medicare "has lost money on accountable care organizations," and "forecasted quality gains have not materialized." The article explains that Centers for Medicare and Medicaid Services Director Seema Verma has begun "began soliciting new ideas last month for changing how care is delivered and paid for by the government." According to STAT, Verma's request "charted a new course for the agency's Health Experts Call For Changes To Food Environment As CDC Research Shows Rising Obesity Rates. With obesity rates in the US at "a new high," public health experts are calling for "an aggressive shift in strategy - one that would change the food environment through initiatives such as soda taxes," USA Today (10/17, Toy, 8.62M) reports. Traditional "public health efforts have centered on 7 EXT-18-248-D-000560 communicating messages about what is healthy in the hopes of changing people's behavior," but new research by the Centers for Disease Control and Prevention's National Center for Health Statistics shows a steady increase in obesity rates among US adults, up from 30.5 percent in 19992000 to 39.8 percent in 2015-2016 . The article cites "Craig Hales, the study's lead researcher and a medical epidemiologist at the CDC," and notes that "physician Jerome Adams, who was sworn in as surgeon general in August, on Monday cited obesity as among the Department of Health and Human Services' three top priorities," with the other two being mental health and addiction. More Researchers Keeping Primates In Shared Cages Rather Than Alone. The NPR (10/17, Greenfieldboyce, 2.4M) "Shots" blog reports that more researchers are keeping primates in shared cages rather than alone. According to a survey, the percentage of research labs that kept primates in cages alone decreased from 59% in 2003 to 35% in 2014. The article reports that the National Institutes of Health's Office of Laboratory Animal Welfare's Guide for the Care and Use Of Laboratory Animals says shared cages should be the "default" for primates. HEALTH REFORM Trump Calls On Congress To Fix "ObamaCare Mess" At Heritage Foundation Event. The Hill (10/17, Bowden, Brennan: NLM Is A "Safe Harbor" For Information. STAT (10/17, Blau, 43K) interviews National Library of Medicine Director Patricia Brennan, who discusses efforts to improve the accessibility of data. "The library is a safe harbor for information," Brennan told STAT. "We are counted on to openly curate the important health knowledge of an era - and preserve it across eras." Brennan insists that the NLM, part of the National Institutes of Health, "has not received any directive to restrict our information or change the information we have available," unlike other agencies which have restricted public access to certain information under the Trump Administration. "I have a buffer between me and the political," she said during a recent talk to journalists at the NLM, referring to Dr. Francis Collins, head of the NIH, an Obama appointee who has kept his job under the new Administration. 1.68M) reports President Donald Trump told a conservative gathering at the Heritage Foundation that he "commends" the bipartisan legislation negotiated by Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA) to stabilize the healthcare system and said Congress should fix the "ObamaCare mess." Trump also said, "I'm pleased that Democrats have finally responded to my call for them to take responsibility for their ObamaCare disaster and work with Republicans to provide much needed relief to the American people." The Hill adds that "the bipartisan deal got a cold shoulder from Republicans on Tuesday, suggesting it faces a rocky path to become law." President Trump May Have To Lobby For Bipartisan Healthcare Deal. Politico (10/17, Haberkorn, Cancryn, 3.6M) reports that a bipartisan deal negotiated between Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA) to stabilize health insurance markets may rely on President Trump's support. The President praised the legislation as "a very good solution" Tuesday, but also said later to the Heritage Foundation, "While I commend the bipartisan work done by Sens. Alexander and Murray - and I do commend it - I continue to believe Congress must find a solution to the Obamacare mess instead of providing bailouts to insurance companies." Sen. Mike Rounds (R-SD) said, "The fact that the president has indicated a real interest in seeing a bipartisan fix like this move forward for a shortterm fix is critical." Senate Majority Leader Mitch McConnell added that a vote has not been Opinion: US Should Fund More Research On How To Care For People With Alzheimer's Disease. Rob Egge, the chief public policy officer of the Alzheimer's Association, writes in an opinion piece in The Hill (10/17, 1.68M) that "this week, leading experts in dementia care and services are gathered at the National Institutes of Health (NIH) for the National Research Summit on Care, Services and Supports for Persons with Dementia and Their Caregivers." Egge argues that while funding for research to prevent or cure Alzheimer's disease is crucial, the federal government should also fund research on how to better care for those already living with the disease. 8 EXT-18-248-D-000561 scheduled on the legislation, saying, "We haven't had a chance to think about the way forward yet." Payments. Carolyn Y. Johnson writes in the Washington Post (10/17, 10.38M) "Wonkblog" that state insurance regulators and insurers "scrambled to raise premiums for insurance plans sold on the Affordable Care Act exchanges Monday, after the White House announced it was ending key federal subsidy payments." The piece says some insurers are only now raising prices following President Trump's decision to end ACA subsidy payments. However, in several states, "insurance companies had already priced in a possible end of CSRs to their rate requests, anticipating President Trump's move." Trump Says Senate GOP Will Resume Work On ACA Repeal Bill After Tax Reform. The Washington Examiner (10/17, Morrongiello, 465K) reports that on Tuesday, President Trump predicted that "Senate Republicans will return to healthcare reform as soon as Congress passes tax cuts, claiming GOP leaders still have the votes to pass a bill that would redirect federal funding for Obamacare to the states." He is quoted as saying, "We are very close." The article says Trump also endorsed the bipartisan deal that seeks to shore up ACA marketplaces. U.S. News & World Report (10/17, 1.73M) also covers the story. Senate GOP's Slim Majority Threatened By The Age And Illnesses Of Certain Lawmakers. The AP (10/17, Fram) reports, 'Top Republicans coping with a razor-thin majority in the Senate as they try pushing a partisan agenda are running smack into another complication - the sheer age and health issues of some senators." The article adds that Sen. Thad Cochran (R-MS), aged 79, returned to Washington, DC on Tuesday "after a month of treatment at home. A statement said he still had urological issues and his treatment 'could affect his work schedule."' The piece also mentions Sen. John McCain (R-AZ) , 81, who is receiving treatment for brain cancer, and says that in July, the Senate delayed a vote to repeal the ACA for a week so that McCain could participate. Trump Blames Dems For Premium Hikes For ACA Plans. The Hill (10/17, Weixel, 1.68M) reports that on Tuesday, President Trump "blamed Democrats for any premium spikes for ObamaCare plans, even as key senators announced a bipartisan deal aimed at saving the insurance markets from actions taken by the administration." Trump tweeted, "Any increase in ObamaCare premiums is the fault of the Democrats for giving us a 'product' that never had a chance of working ." Sens. Bennet, Kaine Unveil Proposal To Add Public Option To ACA. The Hill Sens. Toomey, Cotton Unveil New Bill To Exempt Certain People From ACA's Individual Mandate. The Hill (10/17, Sullivan, 1.68M) reports that on Tuesday, Sens. Michael Bennet (D-CO) and Tim Kaine (OVA) unveiled a bill which seeks "to add a government-run 'public option' plan to ObamaCare, modeled on Medicare." The article says the proposal, "part of a long-running debate in the Democratic Party about how far to go in expanding government-run health insurance, would move ObamaCare to the left, but does not go as far as Sen. Bernie Sanders's (I-Vt.) 'Medicare for all' plan." The piece adds that rather than eliminate the ACA and replace with Medicare for everyone, this bill "would provide an option modeled on Medicare as a choice alongside private plans offered through the existing ObamaCare system." (10/17, Weixel, 1.68M) reports Sens. Pat Toomey (R-PA) and Tom Cotton (R-AR) have unveiled legislation that "would exempt certain people from ObamaCare's requirement that everyone must purchase health insurance or pay a fine." The lawmakers said the ACA's individual mandate is "cruel," and "they want to exempt working class Americans from the requirement." The measure "would exempt anyone who earns less than the national median household income; lives in a state where the average premium increased by more than 1O percent year over year; or anyone who lives in a county with only one insurer." Insurers May Lose About $1 Billion During The Remainder Of 2017 If ACA Subsidy Payments End, Analysis Some States, Insurers Scrambling To Raise Rates Following Trump's Decision To End ACA Subsidy 9 EXT-18-248-D-000562 Indicates. The Washington Examiner (10/17, Democratic Candidates In Minnesota's Gubernatorial Race Unanimously Support Single-Payer Healthcare System. The St. Paul (MN) Pioneer Press King, 465K) reports a new analysis conducted by Avalere Health indicates ACA plans "will post losses of up to $1 billion for the rest of 2017 due to President Trump's decision to cut off insurer payments." These losses differ "from state to state, with North Dakota plans losing the least with $1.2 million for the rest of 2017 and Florida losing the most with $200 million." The article says the analysis highlights the impact of Trump's decision, and the possible effect on ACA insurers if Congress fails to take action. (10/17, Stassen, 527K) reports that as debate over the fate of the ACA continues, "Minnesota Democrats who would be governor are near united in their prescriptions: Universal and singlepayer is the way forward." The article says during a recent debate, "the half-dozen DemocraticFarmer-Labor candidates gave nods to supporting universal health care." Four of them "proudly said they supported a single-payer health care model, meaning a publicly financed system." Federal Funding For Indiana's ACA Navigators Cut By 82%. The Indianapolis Star (10/17, Rudavsky, 479K) reports the Trump Administration recently cut "funds to support its Navigator program, which helps consumers find coverage through the marketplace and enroll for Medicaid." The move deeply impacted Indiana, which "saw an 82 percent cut in its funding, going from $1.6 million in 2016 to $296,704 for 2017." The article says these decreases have caused concern that people will be unable to find assistance to enroll in ACA plans. The piece adds, however, that in many cases, "federally qualified health centers have their own navigators and other entities also support individuals who can assist with enrollment." North Dakota Insurance Commissioner Says He Will Not Allow More Rate Hikes For ACA Plans. The AP (10/17, Nicholson) reports that on Tuesday, North Dakota Insurance Commissioner Jon Godfread said "he will deny any additional rate increases" for ACA plans being offered for 2018. Godfread warned last week that President Trump's decision to end ACA subsidy payments to insurers could raise rates by up to 1O percent. On Tuesday, Godfread wrote to Blue Cross Blue Shield of North Dakota, Medica and Sanford Health Plan, saying he would not allow any more increases. He stated that "this is an issue that is between insurance carriers and the federal government," and that it was his "duty to look out for those consumers who have had to absorb multiple rounds of increases to their health insurance premiums without rece1v1ng any assistance from the federal government." Pittsburgh, Erie Roman Catholic Dioceses Settle Lawsuits Over ACA's Contraception Mandate. The AP (10/17, Mandak) reports, "The Pittsburgh and Erie Roman Catholic dioceses have settled lawsuits seeking to overturn an Affordable Care Act mandate that would have forced them to provide contraceptive and abortion-inducing drugs or services as part of their employee health care plans." Earlier this month, the Trump Administration announced it was rescinding the ACA's contraception mandate, and issued new rules which "broadened 'conscience protections' to include nonprofits and certain other businesses that claim a moral objection to contraception or abortion, even if it's not religious-based." The article says the US Supreme Court had ordered the plaintiffs and the US government to settle the suits, and on Tuesday, Pittsburgh Bishop David Zubik, the lead plaintiff in the case, announced the settlement saying that it "restores religious freedom granted by the First Amendment." Centene Raises Premiums In Arkansas By 21.4 Percent. The Arkansas Democrat Gazette (10/17, Davis, 319K) reports that Arkansas Gov. Asa Hutchinson (R) said additional premium increases for plans on the state's exchange will have a "minimal impact" on the cost of the state's expanded Medicaid program. Due to the increases, "the state will pay higher premiums next year to provide coverage under Arkansas Works," but the costs are likely to be offset by the elimination of cost-sharing reduction payments. The article explains that Centene has raised its average premium in the state by 21.4 percent. 10 EXT-18-248-D-000563 Attorney General T J Donovan announced Tuesday that his state will jo in a lawsuit along with 17 other states and DC against President Trump over his "decision to cut off federal health insurance subsidies designed to help low-income sick people." Donovan explained, "There's got to be some sort of process here.... You just can't say one day, 'We're going to stop making these payments from the federal government.' That would be too arbitrary. It comes down to process." The article reports that 13,000 Vermont residents receive federal cost-sharing reduction subsidies. Celtic lnsurance/MHS To Raise Average ACA Plan Premiums In Indiana By 35.7 Percent. The Indianapolis Business Journal (10/17, 37K) reports that Celtic Insurance Co./MHS is increasing its average premiums for ACA exchange by 35.7 percent to $496 per month. The article points out that the company "is one of two insurers that have committed to the Obamacare exchanges for Indiana next year." New Jersey Regulators Approve Premium Increases For Individual ACA Plans. The Philadelphia Inquirer (10/17, Senate Healthcare Bill Could Rescue MinnesotaCare Funding Cuts. The Brubaker, 1.71M) reports that the New Jersey Department of Banking and Insurance approved average rate increases for individual ACA plans for next year. Horizon Blue Cross Blue Shield of New Jersey will increase rates 24.3 percent and AmeriHealth New Jersey rates will rise by 17.1 percent. The Inquirer adds, "Were it not for uncertainty over federal policy, such as the elimination of payments to insurers to cover outof-pocket costs for consumers and weakened enforcement of the requirement that individuals buy health insurance, the increases would have been significantly lower, Horizon said." The AP (10/17) reports that AmeriHealth has expanded its service and will offer plans in 13 of the state's 21 counties under the new rates next year. Minneapolis Star Tribune (10/17, Brooks, 1.27M) reports that the bipartisan legislation proposed by Sens. Patty Murray (D-WA) and Lamar Alexander (R-TN) clarifies that lowering premiums in the state insurance marketplace, as Minnesota has done, will not cause a reduction in federal healthcare subsidies. The measure is in response to the Centers for Medicare and Medicaid Service's decision on the state's ACA waiver application, which determined that the state would lose $742 million in funding for its MinnesotaCare program. Sen. Amy Klobuchar (D-MN) said, 'They want to encourage things like what Minnesota did," adding, "What we did was set a path for other states to do the same thing, and if you cut us off, you cut off other states." McCain, Murkowski Say They Support Bipartisan Healthcare Deal. The Hill Massachusetts State Senators Propose Wide-Ranging Healthcare Reform Bill. The AP (10/17, Salsberg) reports (10/17, Carney, 1.68M) reports Sens. John McCain (R-AZ) and Lisa Murkowski (R-AK) both gave their support behind a bipartisan healthcare bill Tuesday. McCain said, "While this deal certainly doesn't solve all the problems caused by Obamacare, it shows that good faith, bipartisan negotiations can achieve consensus on lasting reform.. .. I look forward to voting in support of this bill." Murkowski called it a "short-term deal" and added that it was "an important step as we work towards long-term solutions." The Hill added, however, that it is "not clear if the AlexanderMurray deal can get the 60 votes needed in the Senate, much less win over the more conservative House GOP caucus." Massachusetts Senate leaders filed a bill Tuesday to which "aims to squeeze out between $475 million and $525 million in overall health care savings by 2020." The "wide-ranging proposal" includes provisions to "curb price increases for prescription drugs, reduce the number of unnecessary visits to hospital emergency rooms and smooth out vast disparities between payments made to smaller community hospitals and their large Boston counterparts." The AP reports that the measure is "likely to undergo changes as it makes its way through the legislative process." Bipartisan Healthcare Deal Includes Provisions For Democrats And Republicans. The Wall Street Journal (10/17, Vermont Joins Lawsuit Against Trump To Maintain ACA Subsidies. VTDigger (VT) (10/17, Mansfield, 3K) reports Vermont 11 EXT-18-248-D-000564 Hackman, Mathews, Subscription Publication, 6.45M) examines the compromise between Democrats and Republicans in the healthcare proposal announced Tuesday by Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA). The Journal observes that Democrats secured restored funding for cost-sharing payments for two years and funding for ACA outreach, while Republicans added increased flexibility for waivers and catastrophic plans. Matt O'Brien writes for the Washington Post (10/17, 10.38M) "Wonkblog" that President Trump is taking a "three-pronged approach to undermining Obamacare" which includes cutting back on outreach, letting people buy "bare-bones coverage" again, and "pulling the plug on Obamacare's cost-sharing reduction payments." O'Brien discusses Trump's statements in support of a bipartisan bill that would continue the CSRs, but concludes, "The only thing that is clear is that right now Trump is threatening to take steps to make insurance more expensive and markets less stable than they were before." Brian Balogh writes in a Washington Post (10/17, 10.38M) piece that last week, President Trump again sought to erase "his biggest humiliation since taking office: the failure to repeal and replace Obamacare." The executive order he signed includes a provision to expand access to "Association Health Plans." Balogh wonders if Trump understands what comprises an association, and adds, "We really can't blame the president for not knowing the scope of associations, though . Few Americans understand how associations affect every facet of their daily lives." Aaron Blake writes for the Washington Post (10/17, 10.38M) "The Fix" blog that President Trump first justified his decision to stop paying ACA subsidies to insurers because the insurance companies were "getting rich" off of them, pointing to their stock prices. Blake adds that Trump was "cherry-picking his data" from the date the ACA passed, not when it was "actually implemented," and leaves out the fact that insurers are "generally taking losses from their Affordable Care Act plans." The piece concludes, "Very little of it makes sense, and coming from a president who seemed to vacillate daily on what he wanted from an Obamacare replacement, it suggests Trump doesn't really have a game plan or understanding of how all of this works." Joshua Jamerson writes in a Wall Street Journal (10/17, 6.45M) "WashWire" piece that President Trump has indicated he would sign a bipartisan effort to shore up ACA marketplaces. Jamerson adds that Sens. Lamar Alexander (RTN) and Patty Murray (D-WA) are working on such a measure. It would authorize funding for ACA subsidy payments to insurers, and provide states with more flexibility to reshape the healthcare law. Sen. Johnson To Question OPM Nominees On Congressional Healthcare Contributions. Roll Call (10/17, Lesniewski, 134K) reports Sen. Ron Johnson (R-WI), Senate Homeland Security and Governmental Affairs Chairman, plans to question nominees for the Office of Personnel Management Wednesday on the agency's policy of paying "employer contributions for members of Congress and staffers who were moved from the Federal Employee Health Benefits system to the District of Columbia exchange set up under" the ACA. The nominees, Jeff T.H. Pon for director and Michael Rigas for deputy director, were informed that the committee sought documents regarding that topic as part of the confirmation process. Johnson added, "I've already spoken to both the nominee for director and for the deputy director .... They're fully aware of it, and you can expect that question coming up in the hearing tomorrow as well." Key Questions Surround The Senate's Bipartisan Healthcare Proposal. The Washington Examiner (10/18, King, Leonard, 465K) examines some key questions about the bipartisan plan circulated by Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA). The piece discusses whether the plan could pass in the House given the Republican Study Committee's tweet that the deal was a "bailout " ' and whether the President will support it. The Examiner also assesses how states will benefit from the measure, including whether 2018 rates will be affected, and the piece asks whether the Administration might delay open enrollment which is set to start November 1. Commentary Considers Health Reform. Several outlets offer opinions on health reform. 12 EXT-18-248-D-000565 Patty Murray (D-WA) is a "modest bill" that is a "no-brainer fix." The piece observes that the bill is a "bipartisan remedy" to a "health-insurance crisis of the President's own making - restoring subsidies that enable insurance companies to offer plans with affordable copays, and taking other steps to stabilize, not sabotage, Obamacare markets." Despite being a "no-brainer," the piece says that it has no "guarantee that it has any chance of passage in the Republican-controlled House." John Stoehr, in a U.S. News & World Report (10/ 17, 1.73M) column , calls for "constitutional conservatives" to recognize that President Trump's announcement to end payments to health insurers that help cover out-of-pocket costs for low-income Americans "is actual tyranny." The piece discusses the Anti-Federalist papers during the founding era which "understood a nation is a social contract." The column concludes that "selfdescribed constitutional conservatives are not considering the fullness of the Constitution" and "are focusing on one vital aspect - which is that Congress has the power of the purse - while overlooking another vital aspect - which is the goal of protecting and defending against the state of nature." Abbe Gluck, professor at Yale Law School's Solomon Center for Health Law and Policy, writes for Vox (10/17, 1.54M) that "Modern American history has never seen as full-scale an effort to sabotage a valid law as we have with President Trump and the Affordable Care Act." The "intentional, multi-pronged sabotage of the ACA ... violates both Trump's constitutional obligations and quite possibly the obligations of his Department of Health and Human Services." Gluck adds that the Constitution requires the President to "take Care that the laws be faithfully executed," and concludes, 'The president has a right not to like the ACA. But so long as it is the law of the land, he does not have the right to undermine it through the use of executive power." Jay Bookman writes in the Atlanta JournalConstitution (10/17, 1.16M) that when President Trump claims that "Obamacare is finished," what he means is that he "is ensuring that the program helps as few Americans as possible, at as high a cost as possible to taxpayers , in hopes that by inflicting a lot of pain he can destroy the program's growing popularity." Bookman continues, "Trump has taken a hostage with no real idea of what ransom he wants in return" because after more Bloomberg View (10/17, 4.52M) editorializes that the bipartisan agreement reached by Sens. Lamar Alexander (R-TN) and Patty Murray (DWA) to shore up the health insurance system is "exactly the kind of rational compromise that Washington needs more of." The editorial urges President Trump to "get his own party, especially in the House of Representatives, to help pass it." The piece concludes that "by demonstrating how readily the law can be tweaked in productive ways that appeal to both Democrats and Republicans, it could begin to lay a bipartisan foundation for the U.S. health-care system." Michael Katz, a pediatric anesthesiologist, writes in The Hill (10/17, 1.68M) that the healthcare debate in Washington is "missing a fundamental point: the real problem with American health care is the fundamentally flawed business structure underlying its delivery." Katz explains that the "system is exceptionally good at caring for the very sick, injured and dying but poorly equipped to promote a healthy society and the healthy lifestyles that consume less care." The piece recommends that the President and Congress enact policies to "develop a consolidated and integrated health system" and concludes that we need leaders who recognize "our society's moral obligation to achieve health equality." David 0. Barbe, President of the American Medical Association, writes in the U.S. News & World Report (10/17, 1.73M) that the Trump Administration's "decision to end cost-sharing reduction payments not only disrupts the health insurance market, but contradicts many of the health reform priorities expressed this year by both the president and members of Congress." The decision will "not increase competition or consumer choice" of health insurance plans, will "cause average premiums to rise by 20 percent in 2018," and will "increase the federal deficit by $194 billion from 2017 through 2026," according to Congressional Budget Office analyses. Barbe concludes, "Clearly, the recent action taken by the administration has created a crisis point where partisan differences must be set aside in favor of a bipartisan agreement to maintain the stability of the non-group insurance market place" and that "our patients are counting on Congress to do the right thing ." The New York Daily News (10/18, 3.61M) editorializes that the bipartisan legislation authored by Sens. Lamar Alexander (R-TN) and 13 EXT-18-248-D-000566 week when the president abruptly announced that he was canceling the payment" of the CSR reimbursements. Kilgore adds that the "main problem with this I-broke-it-so-Congress-can-fix-it approach is timing" because rates for 2018 have already been set and the "damage may already be done." The Tulsa (OK) World (10/ 17, 320K) editorializes that President Trump's "most controversial move" to "halt federal payments for cost-sharing reductions that help millions of lowerincome Americans afford coverage" has caused "concern for the viability of the 'Obamacare' marketplaces." The editorial adds that President Trump "owns the political consequences" of the decision. The World concludes that "if the cost of that insurance skyrockets and the availability disappears because of Trump's actions, the president will have a hard time blaming the implosion of Obamacare on Obama." than two years, Trump has "offered up nothing in the form of a plan or a bill" - aside from what congressional Republicans "vomited forth." Bookman concludes that Trump's '"plan' is to cause as much chaos and pain to as many people as possible," and that he is "doing it because he can destroy, but he cannot build." Eric Leenson and Dan Geiger, Co-Directors of the Business Alliance for a Healthy California, write in the San Diego Union-Tribune (10/17, 668K) that "small businesses are among the most negatively impacted by our nation's health care system's runaway costs and corporate insurance system." The column says that the Healthy California Act, SB 562, provides for Medicare-forall and would especially benefit small businesses by "lowering overall health expenditures," "freeing businesses from the burden and expense of managing and paying for employees' health care," and "the stress of administering" health insurance plans. The piece concludes by quoting a former Cigna vice president, Wendell Potter, who said, "When businesses understand the benefits of single payer and speak out, there will be no stopping the movement for universal health care." Daniel Hemel, assistant professor at the University of Chicago Law School, in an op-ed in the Washington Post, reprinted in the Harrisburg (PA) Patriot-News (10/17, 553K), calls for states to seize the "opportunity to restore order to their insurance markets" following President Trump's announcement his Administration will not pay ACA subsidies. The states can make those subsidy payments themselves, encouraging "insurers to stay on the exchanges rather than rushing to the exits," then sue the Department of Health and Human Services for reimbursement. The states are likely to win such a suit, as "the Supreme Court has interpreted similar statutory language to require the federal government to make payments even in the absence of a congressional appropriation." Ed Kilgore writes in the Daily Intelligencer (NY) ( 10/17, 519K) that "only legislation can bring back the payments that offset insurers' obligation under the Affordable Care Act to ensure that lowincome consumers can buy an individual healthinsurance policy without ruinous out-of-pocket expenses." While Sens. Lamar Alexander (R-TN) and Patty Murray's (D-WA) proposals had long included continuing cost-sharing reduction payments, their "negotiations were made both more urgent and more politically complicated last OPIOID NEWS Rep. Marino Withdraws From Consideration For Drug Czar Position After Criticism. NBC Nightly News (10/17, story 4, 0:20, Holt, 16.61M) reported, "President Trump says his nominee to be the next US drug czar is withdrawing from consideration for the job ." The CBS Evening News (10/17, lead story, 1:40, Mason, 11.17M) reported that "Congressman Tom Marino [R-PA] withdrew under pressure today as President Trump's nominee to be drug czar" following a television report revealing his "role in legislation that makes it easier for drug companies to distribute opioids in the midst of an epidemic that's claiming thousands of lives." The New York Times (10/18, A19, Baker, Subscription Publication, 13.56M) reports, "The collapse of Mr. Marino's nomination highlighted the Trump administration's troubles formulating a response to a crisis that the president has called unlike any" other in the history of the US. The Was hington Post (10/17, Gearan, Bernstein, Higham, O'Keefe, 10.38M) reports Trump announced the withdrawal of Rep. Tom Marino's nomination as the head of the Office of National Drug Control Policy. The article points out that the announcement follows a Washington Post/"60 Minutes" investigation that found Marino had "helped steer legislation in Congress making it harder for the Drug Enforcement Administration 14 EXT-18-248-D-000567 is one of those obstacles for the Trump Ad ministration. Commentaries Address Opioid Crisis, Marino's Withdrawal. A USA Today (10/17, 8.62M) editorial is critical of the President's delay in addressing the opioid epidemic, saying he said "he would declare the emergency" over the summer, "but didn't follow through." USA Today says both Congress and the President need to do more, and in the wake of Rep. Tom Marino's withdrawal Tuesday as Trump's nominee to lead the ONDCP, the editorial urges Trump to nominate "a public health expert, not a politician." John M. Gray, president and CEO of the Healthcare Distribution Alliance, argues in USA Today (10/17, 8.62M) that the 2016 law which prompted Marino's withdrawal, known as the Ensuring Patient Access and Effective Drug Enforcement Act, was "a bipartisan, commonsense step forward to improve enforcement efforts and combat the opioid epidemic." He notes that it went into effect in April 2016, "well after the opioid epidemic took hold. Based on this timeline, the law had no bearing on any enforcement slowdown that occurred in prior years, as alleged by the reporting." to act against giant drug companies." The Los Angeles Times ( 10/ 17, Lauter, 4.49M) reports Trump said that "we're going to be looking into" Marino's actions. Reuters (10/17, Lynch, Brice) reports that "the legislation championed by Marino...was the product of a drug industry quest to weaken the US Drug Enforcement Administration's authority to stem the flow of painkillers to the black market." The article reports that "the law made it almost impossible for the DEA to freeze suspicious shipments of narcotics to prevent them from reaching the street." The Wall Street Journal (10/ 17, Nicholas, Subscription Publication, 6.45M) reports after the investigation's findings were released, many members of Congress called for his nomination to be withdrawn and praised the President after he made the announcement. The AP (10/17, Superville, Daly) reports Sen. Claire McCaskill (OMO) said that she will introduce legislation to repeal the law. The Philadelphia Inquirer (10/17, Whelan, 1.71 M) reports Reps. Brian Fitzpatrick (R-PA) and Kyrsten Sinema (D-AZ) are leading an effort to repeal the bill in the House. Fitzpatrick said in a press release, "This legislation is about righting a wrong and upholding our comm itment to keep our constituents safe." The Hill (10/17, Savransky, Roubein, 1.68M) points out that several agencies that "play a role in the federal response to the opioid epidemic" lack Senate-confirmed leaders, including the Department of Health and Human Services, the White House Office of National Drug Control Policy, and the DEA. Also covering the story are Politico (10/17, Ehley, 3.6M), the Washington Examiner (10/ 17, Giaritelli, 465K), the ABC News (10/17, Stracqualursi, 2.83M) website, CNN (10/ 17, Vazquez, 33.59M), Bloomberg News (10/17, Olorunnipa, 4.52M), NPR (10/ 17, Chappell, 2.4M), The Atlantic (10/16, Berman, 1.64M), the New York Daily News (10/17, Silverstein, 3.61 M), and the Allentown (PA) Morning Call (10/17, Olson, 312K). Columnist: Withdrawal Of Marino Nomination Is Another Obstacle To Addressing The Opioid Crisis. Dan Janison writes in his column in Newsday (NY) (10/17, Janison, 1.64M) that the White House is facing "hurdles on the path to solutions" for the opioid crisis. Janison argues that the controversy surrounding Marino's nomination to head the DEA Trump Says He'll Formally Declare National Emergency To Combat Opioid Epidemic Next Week. USA Today (10/17, Korte, 8.62M) reports that after first promising "to declare a national emergency to confront the epidemic 68 days ago," President Trump "now says he'll formally declare that emergency next week, a two-month delay that he said underscores the 'time-consuming work' behind his admin istration's response to the crisis." Neither the White House nor the President "would explain what's holding up the proclamation, though Trump suggested that he's wading through uncharted waters." DOJ To Consider Repeal Of Law Blocking DEA From Halting Opioid Shipments. USA Today (10/17, Johnson, 8.62M) reports the Justice Department is weighing whether to seek a repeal of the Ensuring Patient Access and Effective Drug Enforcement Act, legislation passed in 2016 "that ultimately undermined law enforcement's ability to stop suspicious shipments of opioids that have been driving surges in overdose deaths across the country." That review follows "a joint investigation 15 EXT-18-248-D-000568 by The Washington Post and 60 Minutes" which found "that the federal Drug Enforcement Administration was essentially handcuffed by the law pushed by Rep. Tom Marino," President Trump's nominee to oversee national drug policy who has withdrawn his name from consideration in the wake of the investigation. Also reporting on the calls for review and repeal of the law are the Los Angeles Times (10/17, Bennett, Bierman, 4.49M) , the Washington Times (10/17, Noble, 541K), and The Hill (10/17, Roubein, 1.68M). Hospitals Move Forward On Opioid Response Strategies Despite Lack Of Federal Funding. Ahead of President Trump's expected announcement declaring the opioid epidemic a national emergency, Modern Healthcare (10/17, Johnson, Subscription Publication, 238K) reports on the need for federal funding to address the issue, and how hospitals and health systems "say they're moving forward on strategies they have developed to respond to the crisis" even without that funding. One example cited in the article is Linden Oaks Behavioral Health, "a mental health and substance abuse treatment provider affiliated with Edward-Elmhurst Health system in the Chicago suburbs." According to Modern Healthcare, "Linden Oaks has deployed continuing education for clinicians to improve their prescribing habits," and "has also altered its electronic medical record system to automatically prescribe naloxone when patients are over a certain high-dose threshold on their opioid prescriptions. Clinicians can also look up information from the state's prescription drugmonitoring program within the EHR itself rather than having to go to an outside system." Investigation Of Alleged Fentanyl Shipping Operation Leads To Multiple Indictments. The Oregonian (10/17, Bernstein, 878K) reports 38-year-old Jian Zhang has been "accused of shipping fentanyl from China into the United States, deliveries that resulted in multiple drug overdoses across the country, including four in Oregon in 2015." Along with Zhang, 20 other "people from China, Canada and the United States have been indicted" in connection with an alleged drug trafficking scheme that has been dubbed "Operation Denial." Members of the Portland High Intensity Drug Trafficking Interdiction Task Force have worked on the effort to bust the operation. The Oregonian mentions that OHS was involved in the investigation. The task force is not mentioned by NBC Nightly News (10/17, story 5, 1:40, Holt, 16.61M), the St. Louis Post-Dispatch (10/17, 831 K), and the NPR (10/17, Lucas, 2.4M) website, which also highlight the indictment of Zhang and Xiaobing Yan, who are both Chinese nationals. NPR also mentions that HSI was involved in the investigation. NPR quotes Deputy Attorney General Rod Rosenstein as saying, "For the first time, we have indicted major Chinese fentanyl traffickers who have been using the Internet to sell fentanyl and fentanyl analogues to drug traffickers and individual customers in the United States." PhRMA Calls For Repeal Of Law Limiting DEA's Opioid-Response Capabilities. The Hill (10/17, Delk, 1.68M) reports in its "Briefing Room" blog that the Pharmaceutical Research and Manufacturers of America (PhRMA) called Tuesday for the repeal of the Ensuring Patient Access and Effective Drug Enforcement Act of 2016, which "has come under renewed scrutiny after a new joint report from the Washington Post and '60 Minutes' that pointed to the law as undercutting the Drug Enforcement Administration's ability to crackdown on the flow of the drugs into the market." In addition, PhRMA "urged Congress to reconsider the penalties for DEA-registered drug distributors who fail to ensure the safety of opioid distribution by reporting suspicious purchases of the drugs." Opioid Crisis Causing Increase In Hepatitis C Cases. The Washington Post Healthcare Providers Seek Alternative Pain Treatments In Response To Opioid Epidemic. U.S. News & World Report (10/17, Zezima, 10.38M) reports that "the rampant spread of hepatitis C" is another consequence of the national opioid crisis. The article reports that new cases of the disease "have nearly tripled nationwide in just a few years, driven largely by the use of needles among drug users in their 20s and 30s." (10/17, 1.73M) reports healthcare providers are responding to the nation's opioid epidemic, and the related rise in drug overdose deaths, by "aggressively turning to new approaches" for treating patients with chronic pain. "Emerging 16 T " " EXT-18-248-D-000569 The Wall Street Journal (10/17, Prang, Subscription Publication, 6.45M) reports that UnitedHealth said it earned $2.6 billion, or $2.66 per share for the third quarter, compared to $2.1 billion a year ago. The company anticipates total earnings of about $10 per share for this year. It raised its forecast from $9.75 to $9.90 per share from the previous quarter. Reuters (10/17, Humer) reports that UnitedHealth expects earnings to grow by "13 to 16 percent in 2018 as medical costs remain low, even as it adjusts to new healthcare rules that U.S. President Donald Trump has promised to put in place." The article says UnitedHealth is considered "the bellwether for the industry," and its gains on Tuesday also benefited companies "such as Anthem Inc, Aetna Inc, and Cigna Corp." The piece adds that UnitedHealth has largely exited ACA exchanges, and CEO Dave Wichmann "said the company only had about 30,000 customers receiving subsidies in four states, and that any impact" from Trump's plans to end subsidy payments "would be 'extremely small."' The Minneapolis Star Tribune (10/17, Snowbeck, 1.27M) reports that UnitedHealth's shares rose by five percent during trading on Tuesday. The company intends to "continue to focus investments going forward on its fastgrowing Optum division for health services, including pharmaceutical benefits management, non-hospital health care and technology," according to Wichmann. Bloomberg News (10/16, Tracer, 4.52M) also covers the story. trends focus on improving physical and emotional health and counseling patients to realize their own role in relieving their pain, says Bhiken Naik, an anesthesiology and neurosurgery professor at the University of Virginia Health System," and the article notes that "Centers for Disease Control and Prevention guidelines published in 2016 recommend that physicians turn to cognitive behavioral therapy, exercise and patient education," along with alternative medications, before resorting to opioids. In line with that "growing focus on the possibility of a psychological component to pain that needs attention," the University of Virginia and the University of Pittsburgh Medical Center "are both expanding their Enhanced Recovery After Surgery programs to treat surgery pain using as little opioid medication as possible." Beaver County Becomes Third In Pennsylvania To Sue Pharmaceutical Companies Over Opioid Crisis. The AP (10/17) reports that Beaver County has become the third Pennsylvania county "to sue pharmaceutical companies for allegedly contributing to an opioid addiction crisis that has resulted in thousands of overdoses nationally in recent years." The county's lawsuit "against 14 drug companies and several doctors the county claims have contributed to 279 overdose deaths there since 2012" was announced on Oct. 16 by attorney Bob Peirce, Jr. HEALTHCARE NEWS UnitedHealth Earnings, Expectations. Posts Beats Columnist Warns Federal Retiree Health Premiums Could Increase Markedly If House Budget Proposal Becomes Law. Columnist Joe Davidson Higher Q3 Analysts' The AP (10/17, Murphy) reports that on Tuesday, UnitedHealth Group posted a 26-percent increase in third-quarter earnings, beating Wall Street expectations. The largest insurer in the US "also raised its forecast for 2017 again, and signaled that it expects more growth next year." As a result, the company's shares "shot up past $200 to reach another alltime high after markets opened." Data show UnitedHealth added almost "1 million more customers compared to last year's quarter, largely due to growth in its Medicare and retirement business." writes in the Washington Post (10/17, 10.38M) "PowerPost" blog that along "with President Trump's earlier budget plan, which would slice and dice federal retirement, Capitol Hill and the White House have mounted a multi-front assault on federal worker compensation." He warns that if the Budget Resolution put forward by the House "becomes law, federal retiree health insurance premiums could rise significantly over time because growth in the government's subsidy would be limited to the increase in inflation." 17 EXT-18-248-D-000570 Wisconsin Bill Would Prohibit University Of Wisconsin Employees From Working At Planned Parenthood. The AP (10/17) reports the EMERGENCY RESPONSE AND PANDEMIC PREPAREDNESS Vulnerable Elderly Increasingly Becoming Victims Of Emergencies, Disasters. CNN (10/17, Nedelman, 33.59M) Wisconsin state Senate's health committee is expected to hold a public hearing on a bill that would prohibit University of Wisconsin employees from "from performing abortions or providing training at facilities where abortions are performed, other than hospitals." The bill "targets an arrangement between Planned Parenthood and UW in which faculty members work part-time at the organization's Madison clinic." reports California wildfires and Florida, Texas, and Puerto Rico hurricanes "have put a spotlight on vulnerable seniors - including a number of deaths that authorities have said were preventable." The article discusses the impact of each event on older adults in the affected communities, noting many experts "continue to grapple with how best to protect the elderly, who face difficulties evacuating from disasters, more health issues on average and perhaps even a greater share of the psychological impact." Concerning the deaths of 14 residents of the Florida nursing home at The Rehabilitation Center at Hollywood Hills, the article says the Florida Health Care Association "instructed each facility to prepare seven to 10 days of medication, oxygen and other medical necessities for each resident, according to spokesperson Kristen Knapp." Arkansas Health Care Association Joins Coalition To Support Limits On Payouts For Lawsuits. The Arkansas Democrat Gazette (10/17, Moritz, 319K) reports multiple Arkansas business groups on Monday announced they will join a coalition to raise funding for and support a proposed state constitutional amendment to limit some kinds of payouts in lawsuits. State legislators "voted in the spring to have such rules put before voters as a proposed amendment to the Arkansas Constitution," and the proposal will be decided by constituents in the November 2018 general election. The coalition, Arkansans for Jobs and Justice , is supported by the Arkansas Health Care Association among other groups. NUTRITION & OBESITY Google Maps Pulls Experimental "Calorie Counting" Feature From App After Criticism. The New York Times (10/17, Pennsylvania Regulators Issue More Nursing Home Citations But Understate Incidents' Severity, Experts Say. The Harrisburg (PA) Patriot- Victor, Subscription Publication, 13.56M) reports Google Maps pulled an experimental "caloriecounting" feature , which showed how many calories someone could burn by walking to a certain destination. Some criticized the feature as being insulting for suggesting that people needed exercise, while others said the feature was dangerous for people with eating disorders. News (10/17, Simmons-Ritchie, 553K) says that after investigative reports showed Pennsylvania regulators have neglected "to properly cite and penalize nursing homes for serious failures," the state Department of Health "appears to be taking a tougher line on nursing homes," with the department issuing twice as many immediate jeopardy citations against homes as those over the past three years combined. Advocates for elder care "confirmed that the department appeared to have gotten tougher on bad homes," but some "said ... the department was either still understating the severity of nursing home incidents or their inspectors were failing to uncover incidents to begin with." MEDICARE Expanded Medicare Enrollment Options Give Seniors More To Sort Out. The Palm Beach (FL) Post (10/17, Elmore, 273K) reports, "Hundreds of Palm Beach County residents are calling advisors daily for help to sort out expanded options" for Medicare. "We definitely have more interest this year than last year," said Desirae Mearns, lead project director for Serving Health Insurance Needs of Elders (SHINE), 18 EXT-18-248-D-000571 (R) said Tuesday that the 14.2 percent to 25 percent insurance rate hike approved by state regulators after President Trump ended costsharing reduction payments will not imperil the state's hybrid Medicaid expansion . "Under Arkansas' hybrid expansion program, Medicaid funds are used to purchase private plans for lowincome residents through the insurance marketplace," the AP explains. State Democrats, however, "accused Hutchinson of glossing over the effect Trump's action will have." adding that seniors in Palm Beach County have 46 plan options in 2018 compared to 43 last year. Opinion: CMS Proposal To Exempt Rural Physicians From MIPS Will Do More Harm Than Good. Caravan Health CEO Lynn Barr writes in an op-ed for The Hill (10/17, 1.68M) that the Centers for Medicare and Medicaid Services' "proposed rule to exempt twothirds of the nation's clinicians from the Medicare Incentive Payment System (MIPS) will do more harm than good" and furthermore would "disable the infrastructure of electronic health records (EHRs) that has been subsidized with $37 billion taxpayer dollars." Rural clinicians are exempt from quality reporting and "have provided lower quality care," Barr writes, adding that CMS' proposal to exclude reporting for pneumococcal and influenza vaccines - two particularly "important quality measures" - is shortsighted. "Our data clearly shows that more vaccines means fewer patients going to the hospital and fewer pneumonia-related deaths," particularly for seniors. MEDICAID Michigan Democrats Say Proposed Medicaid Cuts "Devastating" For Vulnerable People. Mliv e {Ml} (10/17, Slagter, 947K) reports on a panel of Democratic state and local officials that convened to discuss "the best way to push back against the president's proposed $700 billion cut to Medicaid funding in 2018." The group said the proposed Medicaid cuts would be "devastating" to senior citizens and people with disabilities and that opponents should emphasize the personal impact of the reductions. & CHIP HEAL TH & MEDICAL NEWS "Bickering" Over CHIP, Community Health Centers Reportedly Harming Paige Winfield Nation's Healthcare. Pharmaceutical Companies Deny Responsibility For Drug Pricing At Senate Hearing. Bloomberg News (10/17, Cunningham writes in the Washington Post (10/17, 10.38M) "The Health 202" about the ongoing discussions between Democrats and Republicans over how to pay "for states to keep running the Children's Health Insurance Program and for community health centers to care for lowincome people," and for how long to extend the funding. Cunningham is critical of lawmakers for their "bickering," arguing that "if Congress were serious about funding the two programs without causing crippling uncertainty for states and providers, it could have tackled the issue months ago." She also criticizes President Trump for "signing an executive order that many health-care experts warned could destabilize the marketplace even further by allowing individuals and smallbusiness employees to buy narrower coverage through trade associations." Edney, 4.52M) reports leading drug industry lobbyists at a Senate Health, Education, Labor, and Pensions hearing alleged pharmacy benefit managers (PBMs), hospitals, and other groups are to blame for prescription medication prices. Groups testifying, including the Pharmaceutical Research and Manufacturers of America (PhRMA), continued to "say that the measures used to assess them are incorrect, and that they only get a portion of the profit their critics say they do." PBMs at the meeting, however, "pointed the finger back at pharmaceutical companies, and said the cut they take as middlemen has no connection to how drugmakers set prices." The Washington Examiner (10/17, King, 465K) reports the Pharmaceutical Care Management Association, which represents PBMs, refuted PhRMA's claims that PBMs and insurers focus "on list prices, which are not reflective of actual spending trends." The article notes Congress has passed bills intended to speed up generic approval at the FDA, and that Sen. Al Franken (D-MN) at the hearing questioned Arkansas Governor Says Insurance Rate Hikes Will Not Threaten State Medicaid Expansion. The AP (10/17, DeMillo) reports Arkansas Gov. Asa Hutchinson 19 EXT-18-248-D-000572 health care system and curb medical spending." The new bill would mandate that "drug companies for the first time to submit data to the state Health Policy Commission and be scrutinized by the watchdog agency," and "sets a target for controlling commercial spending on hospital care by slowing the rate of price growth at the most expensive hospitals." why drug prices are so high and "pointed out that taxpayers pay for research at the National Institutes of Health, and U.S. customers pay higher prices for the finished product." Senator Questions Pharmaceutical Industry About Doing Away With Rebates. STAT (10/ 17, Swetlitz, 43K) reports that Sen. Lamar Alexander (R-TN) "asked a panel of pharmaceutical industry representatives at a Senate committee hearing" about whether drugmakers and pharmacy benefit managers would be willing to do away with rebates. "Why don't we just get rid of rebates and let you negotiate directly with manufactures , take that $100 billion a year, and just reduce the list price? Wouldn't it be simpler for us to understand where the money goes?" Alexander asked Mark Merritt, president and chief executive officer of the Pharmaceutical Care Management Association. Industry representatives said they would be willing to consider the proposal, although they expressed doubt about the feasibility of enacting such a reform. Appeals Court Vacates Verdict In Talcum Powder Cancer Case. Bloomberg News (10/17, Fisk, 4.52M) reports a Missouri appeals court has vacated the $72 million verdict in Fox v. Johnson & Johnson, ruling the case shouldn't have been tried in St. Louis. "The verdict to the family of Jacqueline Fox, who died in 2015, was the first of a series of jury awards in the St. Louis court," where juries "have awarded a total of $300 million in verdicts" related to claims that Johnson & Johnson's talc products cause ovarian cancer. According to the AP (10/ 17, Stafford), "the appeals court cited a Supreme Court ruling in June that placed limits on where injury lawsuits could be filed, saying state courts cannot hear claims against companies not based in the state where alleged injuries occurred." In response, "Jim Onder, who is representing many plaintiffs in the lawsuits, has argued that Missouri is a proper jurisdiction because Johnson & Johnson packages and labels some products in Missouri." Also reporting are Reuters (10/17, Raymond), the St. Louis Post-Dispatch (10/17, Currier, 831 K), and Fierce Pharma (10/17, Sagonowsky). Families Of Deceased Troops Allege Pharmaceutical Companies "Knowingly Financed" Anti-American Militia In Iraq. USA Today (10/ 17, Madhani, 8.62M) reports a group of families of "dozens of U.S. troops killed or injured" during the Iraq war filed a federal lawsuit on Tuesday "against several U.S. and European pharmaceutical and medical supply companies , alleging that the corporations knowingly financed the anti-American militia Mahdi Army through bribes and kickbacks to officials at a government ministry controlled by the group." The lawsuit names "some of the biggest names in the industry - including GE Healthcare, Johnson & Johnson, Pfizer, AstraZeneca and Roche," and alleges they often paid kickbacks to officials in the Iraqi Ministry of Health, who "in turn used the proceeds to help fund the militia that carried out attacks against U.S. troops in Iraq." Gene Tumor Boards Increasingly Providing Guidance On Cancer Care. The A P ( 10/18, Marchione) reports that patients with cancer are increasingly "having their care guided by gene tumor boards," panels of experts that study "the patient's cancer genes and match treatments to mutations that seem to drive the disease." The gene tumor boards aim for "precision medicine, the right drug for the right person at the right time, guided by genes ." The AP adds that "Some doctors worry that tumor boards' recommending off-label treatments diverts patients from research that would benefit all cancer patients," and mentions that the "American Society of Clinical Oncology's TAPUR study tests off-label drugs and shares results with their makers and federal regulators." Massachusetts Senate Considers Bill To Require Data Submissions From Drug Companies. The Boston Globe (10/ 17, McCluskey, 969K) reports Massachusetts Senate legislators on Tuesday revealed "sweeping health care legislation" addressing issues such as prescription treatment costs and hospital prices, which "proponents say will improve the state's 20 EXT-18-248-D-000573 Mouse Study Finds Link Between Stress And Digestion In Female Mice. in light of a petition filed earlier this year that called on the FDA to ban lead acetate from hair dyes. The New York Post (10/17, Steussy, 4.31M) reports new research published in Nature's Scientific Reports suggests stress may have the same effect on human digestion as a fattening diet. Researchers at Brigham Young University conducted the mouse study, which looked at the mice's gut microbiota; they found that the gut microbiome of female mice subjected to stress tests "actually changed to resemble that of an obese mouse," which "suggests that stress might impact metabolism just as much as diet, the researchers wrote ." Male rats, however, "didn't have the same microbiome shift, but they did become more anxious and less physically active." Transenterix CEO Says Senhance Won't Compete Directly With Intuitive Surgical's Da Vinci. Reuters (10/17, Banerjee) reports Transenterix CEO Todd Pope on Tuesday "played down ...the threat posed by his company's surgical robotic system," called Senhance, "to market leader Intuitive Surgical Inc, saying he did not expect the two to compete head on." Transenterix's share price surged - and Intuitive Surgical's fell - at the end of last week after the US Food and Drug Administration cleared Senhance for use, but "Pope said Senhance had a lot of ground to cover before it might have to compete directly with lntuitive's Da Vinci device, which has dominated robotic surgery purchasing since it was approved in 2000." New Hampshire Gov. Removes Member From Cancer Cluster Panel. The AP (10/17) reports New Hampshire Gov. Chris Sununu said Tuesday he's removed Steve Kenda, a past Republican candidate for state Senate and governor, from the Seacoast Cancer Cluster Commission over an op-ed piece written by Kenda denying the existence of a cancer cluster. According to the AP, Sununu "said Kenda's participation has become too much of a distraction" from the purpose of the 21-member commission, which has for several years "been investigating a greater-than-expected number of cases of two types of rare childhood cancers in the seacoast region: rhabdomyosarcoma and pleuropulmonary blastoma." Johnson Closure, Production Healthcare & Johnson's Animas Cessation Of Insulin Are Reflective Of Broader Issues. The Los Angeles Times (10/17, Lazarus, 4.49M) discusses the recent announcement from Johnson & Johnson saying the company is closing its Animas subsidiary and ceasing its production of insulin pumps, which creates new challenges from J&J customers that the Times says "mirror problems all too common in the healthcare industry - the turmoil that can arise when a medical-device or drugmaker halts sales, or when an insurer decides to no longer cover a specific pill, gadget or treatment." The article examines how such problems can affect healthcare customers and offers insight on how to proceed. Scientific American Editors Voice Support For Cosmetics Safety Bill. In an article for the November 2017 issue, the editors of Scientific American (10/17, 878K) express support for the Personal Care Products Safety Act, which Sens. Dianne Feinstein and Susan Collins reintroduced in Congress last May. "The bill would require, among other things, that all cosmetics makers pay annual fees to the agency to help finance new safety studies and enforcement - totaling approximately $20 million a year," which the FDA would use to "assess the safety of at least five cosmetics chemicals a year." The legislation "also gives the agency the authority to pull products off the shelves immediately when customers have reported bad reactions, without waiting for a review that can take multiple years." The editors highlight the importance of the bill, and the issues it addresses, DC Council Disapproves Of Extending Contract To Manage City's Only Public The Washington Post (10/17, Hospital. ltkowitz, 10.38M) reports six members of the Washington, DC council "expressed disapproval" of the request by Veritas of Washington LLC to renew its $4.2 million consulting contract to manage the United Medical Center, which is "the city's only public hospital." The firm was hired last year "to stabilize the only full-service hospital east of the Anacostia River," but has shown "little progress in improving the hospital's finances or quality of care." The Post adds the company is "led by campaign donors to D.C. Mayor Muriel E. Bowser (D)." Because of the disapproval, the 21 EXT-18-248-D-000574 chronic delays with false paperwork and secret lists," and that the facility in Omaha was not on a list of 40 facilities that reportedly still had secret lists in 2016. VA officials declined to comment on how many employees were involved in maintaining the list or how many veterans were affected. council will have 45 days instead of 10 to review the contract. People With Adverse Childhood Events Found More Likely To Suffer Health Problems As Adults. The Denver Post (10/17, Baumann, 817K) reports on a study from the Colorado Department of Human Services and the University of Denver finding that "children who grow up in a dysfunctional or abusive home are more likely to develop depression and cancer as adults, and they're more likely to one day have children with health issues as well." The study was based on a survey of 3,677 Colorado residents 18 and over, and "measured adverse childhood experiences, which are events that range from physical, sexual or emotional abuse and different types of household dysfunctions such as family member incarceration." Overall, those who reported one such incident "were twice as likely to be diagnosed with depression, and those with four or more incidents were nearly twice as likely to suffer from cancer and almost six times more likely to experience depression." Their children also "were two to five times as likely to be diagnosed with Attention Deficit Disorder." Hepatitis A Deaths Now Up To 19 In San Diego County. The San Diego UnionTribune (10/17, Sisson, 668K) reports there have now been 19 deaths and 507 confirmed cases in the ongoing hepatitis A outbreak in San Diego County, CA. Dr. Wilma Wooten, the county's public health officer, said that the county is also investigating another 47 potential cases. Researchers Trying To Identify Early Signs Of Brain Damage In STAT (10/17, Professional Fighters. Robbins, 43K) reports researchers have found that "active fighters," boxers and mixed martial arts fighters, have "higher levels of two brain proteins, called neurofilament light and tau, compared to retired fighters or non-fighters," and that "fighters with greater exposure to repetitive head trauma have lower brain volumes." The findings are part of an ongoing study, and "researchers have enrolled close to 700 mixed martial arts fighters and boxers, both active and retired, in the past six years." The investigators are seeking "to identify early signs of traumainduced brain damage from subtle changes in blood chemistry, brain imaging, and performance tests," which "may show up decades before visible symptoms such as cognitive impairment, depression, and impulsive behavior." Second TB Case Reported In Durham County, North Carolina. The Durham (NC) Herald Sun (10/17, Johnson, 66K) reports on a second tuberculosis case in Durham County, North Carolina, explaining that "a student at Northern High School is being treated," as is a student at UNC Chapel Hill. Both "are being treated at home and will remain off campus until the threat of spreading the disease is over." The county health department will conduct "TB blood tests on people who were exposed at Northern." The Herald Sun adds, "Durham County reported 11 cases of active tuberculosis in 2016." US District Judge Orders Flint To Pick A Long-Term Water Source. The Detroit Free Press (10/17, Matheny, 1.07M) reports US District Judge David M. Lawson issued a summary judgment ordering Flint to select a longterm water source. The ruling "comes after Flint's City Council has balked for months at entering into a long-term deal for water supplies from the city of Detroit via the regional Great Lakes Water Authority." VA Facility In Omaha Maintained Secret Waiting List Of Veterans Seeking Mental Health Appointments. The AP (10/17) reports the Department of Veterans Affairs' Nebraska-Western Iowa Health Care System "maintained an unauthorized, secret waiting list of veterans for some Omaha mental health appointments, according to US Department of Veterans Affairs documents." The article points out that "the VA set up strict requirements for establishing waiting lists following a 2014 scandal that showed VA employees were covering up Researchers Identify Four Genes In Humans, Dogs, And Mice That May Be Linked To OCD. The NPR (10/17, Chen, 2.4M) "Shots" blog reports that researchers 22 EXT-18-248-D-000575 The Wall Street Journal (10/ 17, Rockoff, Cimilluca, Subscription Publication, 6.45M) reports lmpax Laboratories and Amneal Pharmaceuticals recently agreed to merge in a deal that would establish the US' fifth-largest generic medication producing company in terms of revenue. They said on Tuesday that the all-stock transaction would grant lmpax shareholders 25 percent of a new company , while owners of Amneal would take the remainder. The new group will be called Amneal Pharmaceuticals and is expected to be worth as much as $6.4 billion. Reuters (10/17) reports Cantor Fitzgerald analysts wrote in a client note on the deal that the merger increases chances for lmpax to grow from a mid-size drug maker to a leading generics and specialty medication company . The article says the combined company will produce "a diverse pipeline with more than 300 products either filed with the FDA or in active stages of development, Cantor analysts said." The San Francisco Business Times (10/17, Leuty, Subscription Publication, 904K) reports lmpax ran "into a string of issues in recent years" while attempting to diversify beyond generic treatments, with FDA inspections exposing "problems a couple years ago" at a California facility. The Philadelphia Inquirer (10/ 17, Loyd, 1.71 M) and Fierce Pharma ( 10/17, Helfand) also report. identified "four genes with the strongest links to OCD to date ." The researchers compared the DNA of dogs and mice with compulsive tendencies to the DNA of people with and without OCD. The findings were published online Oct. 17 in Nature Communications. Newsweek (10/17, Firger, 991 K) reports that the study "may help scientists develop more precise and effective treatments for the psychiatric condition." Excessive Exercise May Be Linked To Higher Risk Of Buildup Of Plaque In Heart Arteries By Middle Age In Caucasian Men, Study Suggests. The New York Daily News (10/17, Scotti, 3.61M) reports that research suggests "Caucasian men who exercise three times above the US national guidelines for working out (150 minutes per week) are 86% more likely than black men, and those who exercise less, to develop a buildup of plaque in their hearts by the time they're middle aged." The New York Post (10/ 17, 4.31M) runs a SWNS article reporting that investigators "compared 25-year exercise patterns and made the surprising discovery that very active white men are 86 percent more likely to experience a buildup of plaque in the heart arteries by middle age." However, "this didn't apply to black men, they discovered." The findings were published in Mayo Clinic Proceedings. Column: Allergan Restasis Case Exemplifies How Companies Manipulate Patent System. Bloomberg NAFLD, Nonalcoholic Steatohepatitis The Fastest-Growing Reasons For Liver Transplants In Young Americans, Research Indicates. View (10/17, 4.52M) columnist Joe Nocera offers commentary on Allergan's attempts to transfer its Restasis patents to the Saint Regis Mohawk Tribe --"a now-infamous patent ploy" - positing that the legal maneuvering represents "trickery" undertaken by many companies in the industry "to keep generics off the market." According to Nocera, the "primary way" branded drug makers prevent generic competition "is by abusing the patent system ." He adds that a federal judge who ruled the Allergan patents are invalid simply "called Allergan out on" its "scam." Nocera mentions Allergan issued a number of "citizen's petitions" to the FDA and sued compounding company lmprimis on allegations that it violated FDA regulations. Reuters ( 10/17, Crist) reports that research indicates "nonalcoholic fatty liver disease [NAFLD] and its more aggressive form, nonalcoholic steatohepatitis, have become the fastest-growing reasons for liver transplants in young Americans." Investigators found that "the number of liver transplants performed for NASH increased from 0.53% in 2002 to 4.46% in 2012, a nine-fold jump ." Reuters adds that "due to increasing childhood obesity, hypertension and diabetes ...more young adults are reaching endstage liver disease early in life, researchers say." The findings were published online in Journal of Clinical Gastroenterology . lmpax Laboratories Inks Deal To Merge With Amneal Pharmaceuticals. 23 EXT-18-248-D-000576 (10/17, 5.11M) contributor Matthew Herper considers lgnyta Pharmaceuticals' cancer treatment entrectinib that shrank one patient's tumors and "has kept them in check for more than a year," and, according to research presented at the World Conference on Lung Cancer, "shrank tumors in 79% of patients and kept working for a median 28.6 months, about 10 months longer than the current drug, Pfizer's Xalkori, did in separate clinical trials." Herper writes that nonetheless, the study "raises questions about whether it's possible to compare similar cancer medicines, and whether it's possible to keep innovating after a few gene-targeted drugs have been invented." Troy University Researchers Developing Anti-Depressants Through Zebrafish Studies. The New York Daily News (10/17, Scotti, 3.61M) reports researchers at Troy University in Alabama are using zebrafish to develop anti-depressant treatments for humans because fish reportedly are "a reliable animal to use in identifying depression." According to one university researcher, the "neurochemistry (between fish and people) is so similar that it's scary." The National Institute of Mental Health estimates that nearly "16 million people had at least one major depressive episode in 2012." District Judge Invalidates Allergan's Restasis Patents. Reuters (10/17, Wolfe) Study Reveals Association Between Depression, Sagging Testosterone Levels In New Fathers. In "Well," the New reports US district judge William Bryson ?n Monday ruled against Allergan's patents for its dry-eye treatment Restasis, which the. compa~y transferred to New York state's Saint Regis Mohawk Tribe last month on claims that the tribe's status as a sovereign nation would prevent the patents from being reviewed by the US patent office. Bryson invalidated the patents for the $1.5 billion treatment, calling it an attempt by Allergan to "rent" the tribe's sovereign immunity. Allergan, however, said the move was justified because the same patents were already under review in federal court, while critics "said it was a cynical attempt to prolong the company's monopoly on Restasis." York Times (10/17, Quenqua, Subscription Publication, 13.56M) reports research indicates that postpartum depression "may occur in from 7 percent to 1O percent of new fathers , compared to about 12 percent of new mothers, and that depressed dads were more likely to spank their children and less likely to read to them." Now, research published in the September issue of the journal Hormones and Behavior "has found a link between depression and sagging testosterone levels in new dads, adding physiological weight to the argument that postpartum depression isn't just for women anymore." In addition, the study revealed that "while high testosterone levels in new dads helped protect against depression in fathers, it correlated with an increased risk of depression in new moms." The study a~stract points out some 149 couples took part In the study. District Judge Refuses Pharmaceutical Companies' Request To Block Nevada Drug Pricing Law. The Las Vegas Review-Journal (10/17, Bekker, 458K) reports that on Tuesday , US District Judge James Mahan refused a request by the Pharmaceutical Research and Manufacturers of America and the Biotechnology Innovation Organization "to immediately block a Nevada law requiring them to detail diabetes drug prices and disclose manufacturing costs and research investments come July." Mahan said he did not find "immediate and irreparable harm" in the case because of the law's timeline. The companies allege in the lawsuit that the law violates federal patent and industry trade secret rules. Men Who Receive Blood Donated By Previously Pregnant Women May Face Increased Risk Of Death Following The Transfusion, Study Indicates. STAT (10/17, Begley, 43K) reports, "Men who received a blood transfusion from a woman who had ever been pregnant had a higher risk of dying prematurely than men who got blood from a man or a never-pregnant woman," researchers reported. HealthDay (10/17, Thompson , 11K) reports researchers arrived at that conclusion after examining data on some 31,000 patients in Holland who "received 59,320 transfusions in all Experts Consider Whether lgnyta Pharmaceuticals' Cancer Treatment Can Be Compared To Pfizer's. Forbes 1' Alf ll Al\ ,(Q'!ERS~G~T 24 EXT-18-248-D-000577 from one of three types of donors - men, neverpregnant women and women who'd been pregnant." Notably, "after receiving a single transfusion, the three-year death rate among men was 13.5 percent for those who received male blood, 13.1 percent for those who got neverpregnant female blood, and nearly 17 percent for those who received blood from a previously pregnant female." The findings were published in the Journal of the American Medical Association. Reuters ( 10/17, Rapaport) and Scientific American (10/17, Weintraub , 878K) also cover the story. More Hospitals Investing In Housing And Support For Homeless To Reduce ER Visits. Kaiser Health News (10/18, Bartolone) reports on a "growing number of hospitals nationwide" that have "invested in housing programs in recent years, from Florida to Chicago and farther west," with the goal of ending the cycle of emergency room use by homeless people by providing them housing along with a case worker. Rand Corp. researcher Sarah Hunter says, "There's pretty good evidence that it's more cost-effective to provide housing with supports than have these people live on the streets and just cycle in and out of emergency rooms and in-patient stays." The piece reports that the nonprofit hospitals' investment in these programs helps them "meet their community service obligations in exchange for tax breaks." Physician Warns Of Dangers Of Online Companies Selling Designer Substances. In STAT (10/17, 43K) "First Opinion," Abraham Nussbaum, MD, chief education officer at Denver Health, an associate professor of psychiatry at the University of Colorado School of Medicine, writes about the dangers of online companies "selling compounds that have never been approved for human use but that are so similar to existing drugs they attract users ...seeking an alternative to" physicians and dealers. Ostensibly these "designer" substances are sold for the purposes of "research." Dr. Nussbaum believes such companies "sideline the doctor, the pharmaceutical industry, and its regulators from the patient-physician relationship" and pose a danger to people buying substances from them. GLOBAL HEAL TH China Confirms H5N6 Bird Flu Outbreak In Central Province. Reuters (10/17, Gu, Mason) reports China's Ministry of Agriculture confirmed that there is "an outbreak of bird flu at broiler chicken farms in" the city of Hexian in Anhui province. The outbreak in the central province has been caused by the H5N6 strain. Op-Ed: Canada Must Push For National Registry Of Payments From Companies To Physicians. Nav Persaud Oversized Eyedrops Waste Patient's Money And Medicine By Design. NPR of Toronto's St. Michael's Hospital and the University of Toronto, Joel Lexchin of Toronto's University Health Network, and Andrew S. Boozary of the University of Toronto and the Harvard Public Health Review write in an op-ed in STAT (10/17, 43K) that Canadian province Ontario "took a historic step" by introducing legislation to increase transparency on how drug companies interact with prescribers in an effort to understand how physicians receive payments from manufacturers. The authors advocate for this on a national scale and suggest the establishment of a registry of payments similar to that which is in place in the US. (10/18, Allen, 2.4M) reports on its "Shots" page that ProPublica has found that pharmaceutical companies make eyedrops that overflow your eyes by design. The article says that for at least twenty-five years, those in the "eye care industry," including doctors, pharmaceutical officials, and researchers, have known "that eyedrops are much larger than the eye can hold." The article tells the story of a project in the early 1990s as Alcon where the team created a "microdrop" that would reduce waste but still maintain effectiveness. The product was "killed" because of the cost of getting FDA approval and the risk that it would lead to decreased sales. NPR also reports of similar research on the efficacy of smaller eyedrops that was funded by Allergan, yet Allergan does not make eyedrops in smaller sizes to date. NATIONAL NEWS House Panel Sets Puerto Rico Recovery Hearing For Next Week. 25 EXT-18-248-D-000578 families of the fallen, the President's taking another swing at Barack Obama on the gravest of presidential obligations." NBC played an audio clip of Trump saying in a Tuesday interview with Fox News Radio, "I think I've called every family of somebody that's died, and it's the hardest call to make .. .. As far as other representatives, I don't know. You could ask General Kelly, did he get a call from Obama?" Alexander added, 'The President invoking the memory of his chief of staff's son, Robert Kelly, a Marine killed in 2010." On the CBS Evening News (10/17, story 5, 2:40, Mason, 11.17M), Margaret Brennan reported, "White House officials claim to be unaware of whether Mr. Trump had spoken to Kelly before making the remark . The retired Marine Corps general has actively avoided calling attention to his son's death, making it clear he does not want it to be exploited." Brennan added, 'Today , despite the President's prodding, Kelly declined to comment. But a White House official, who requested anonymity, told CBS News, 'I can tell you Obama did not call General Kelly after the death of his son.' But White House records show that Kelly and his wife did attend a closed-door breakfast with Mr. And Mrs. Obama to honor Gold Star families a year after their son's passing." On ABC World News Tonight (10/17, story 3, 3:10, 14.63M), David Muir reported that "Kelly has indicated to the past in reporters that he did not want to talk publicly about the death of his son." ABC's Cecilia Vega added that "Kelly has repeatedly made it clear to reporters he does not want to talk about his son's death. And he would not go on the record today. But the White House tells us he never got a call from ...Obama . Obama aides do not dispute that. But they do say Kelly did attend a White House breakfast for Gold Star families, where he sat at the first lady's table." The Wash ington Post ( 10/17, Parker, 10.38M) reports, "For the past seven years ...Kelly has gone out of his way to keep the death of his son free from politics." However, Trump on Tuesday "thrust [Kelly's) son into the public and political glare, invoking the younger Kelly as part of a continuing attack on ...Obama." The President's "remark ...was unplanned, said two White House officials, who said they were caught off-guard by Trump's comments . One said Kelly may have mentioned some details surrounding his son's death to the president in private - and the president then repeated them in public, a relatively frequent occurrence with Trump." Reuters (10/17, Cowan) reports that a House panel said Tuesday that it has scheduled an Oct. 24 hearing "to examine Puerto Rico's hurricane recovery efforts and the role of a financial oversight board in those efforts." The House Committee on Natural Resources, which last year worked on legislation creating the board to help Puerto Rico manage its debt, will hold the hearing. Puerto Rican Delegate: Trump Has Given Everything We've Asked For. Townhall (10/17, Vespa, 523K) reports Puerto Rico's delegate, Jenniffer Gonzalez-Colon, said in a recent interview with USA Today "that everything they've asked for, Trump has delivered." Gonzalez-Colon told USA Today, "I will tell you that everything that the president said that he was going to send to the island, it's getting there. The resources are there. The help is there." Desperate Puerto Ricans Turning To Wells At Superfund Site For Water. NBC Nightly News (10/17, story 11, 1:40, Holt, 16.61M) reported on the "deepening and dangerous water crisis" in Puerto Rico in the aftermath of Hurricane Maria. The EPA says "the desperate are breaking into water wells" at a Superfund site in Dorado "that may actually be contaminated." NBC's Gabe Gutierrez reported from the town that "even though there's a clearly marked danger sign, people were willing to risk it." He noted that "only 17 percent of the island has power, making it hard to pump and treat water as this crisis deepens ." Discussing Obama And Slain Soldiers, Trump Cites Death Of Kelly's Son. President Trump's Tuesday remarks - in which he invoked the death of Chief of Staff Kelly's son while defending his claim one day earlier that former President Barack Obama and other presidents didn't always call the families of slain military members - received widespread media coverage, including reports on all three major network newscasts. Coverage was largely negative, highlighting that Kelly has been reluctant to publicly speak about his son's death. In the lead story for NBC Nightly News (10/17, lead story, 2:25, Holt, 16.61 M), Peter Alexander reported that "as the body of one of the American soldiers killed in Niger this month returns home to Florida and the White House confirms President Trump spoke to all four 26 EXT-18-248-D-000579 Four Dead Soldiers," the Washington Post (10/17, Rucker, Lamothe, 10.38M) reports, "The White House did not receive detailed information from the Defense Department about the four ...soldiers" - slain Oct. 4 in Niger - "until Oct. 12, and that information was not fully verified by the White House Military Office until Monday, according to a senior White House official who spoke on the condition of anonymity to comment on the internal process. At that point, the official said, Trump was cleared to reach out to the four families - both in letters that were mailed Tuesday and in personal phone calls to family members that day." Politico (10/17, McCaskill, 3.6M) reported that Trump "has faced an onslaught of criticism - most notably from former Obama aides - since making the accusation against Obama on Monday afternoon in a Rose Garden news conference when asked about his silence regarding the death of four Green Berets related to an Oct. 4 ambush in Niger. 'The traditional way, if you look at President Obama and other presidents, most of them didn't make calls,"' Trump "alleged without evidence Monday. 'A lot of them didn't make calls. I like to call when it's appropriate, when I think I'm able to do it."' The Hill (10/17, Greenwood, 1.68M) and the Daily Caller (10/17, Pfeiffer, 521 K) also report on Trump's remarks from Tuesday and Monday. Regarding his comment that past presidents did not call fallen soldiers' kin, Trump on Tuesday called the story "fake news," telling Fox News (10/17, 12.87M), "I don't know what Obama's policy was . I write letters and I also call." Trump touted the support he said he was receiving in the polls in spite of negative media coverage. During a Tuesday appearance on Fox and Friends (10/17, 8:40 a.m. EDT, 2.04M), counselor to the President Kellyanne Conway defended Trump's comment that previous presidents have not called fallen soldiers' families, saying that he was "making the point that there's many different ways to reach out" to the kin, and "not everybody calls." Conway also said, "The President made very clear ...what he meant and what he is saying," adding that Trump's "focus is always on the grieving, on the families, on the loss of life, and on protecting our soldiers." Responding to Trump's comment about past presidents calling fallen soldiers' kin, Sen. Ed Markey (D-MA) told CNN's Situation Room (10/17, 5:25 p.m. EDT, 988K) that he was with Obama when the then-President was visiting Similarly, under the headline "Top General's Grief Becomes Political Talking Point For Trump," the New York Times (10/17, Landler, Subscription Publication, 13.56M) reports that Trump "is testing" Kelly's "long-held reluctance to discuss his loss. Mr. Trump, in defending his handling of the deaths of four Green Berets in Niger, falsely claimed on Monday that...Obama did not contact the families of fallen troops . And on Tuesday , Mr. Trump brought to light that Mr. Obama never called Mr. Kelly after the death of his son." The Times adds that Kelly "has not addressed the dispute. But colleagues who worked with him at the Pentagon during that period said they did not recall him expressing unhappiness with the way Mr. Obama handled the death of his son." Writing for McClatchy (10/17, 67K), Kate Irby says that "Kelly had to endure every parent's worst nightmare when his son ...stepped on a land mine in Afghanistan in 2010 and died. Now...Trump is calling into question whether ...Obama ever called Kelly after that happened - dragging Kelly into a spat Trump started between the two presidents over whether Obama called the families of fallen soldiers." The AP (10/17, Woodward, Lemire) similarly reports that Trump "has pulled bereaved military families into a painful political fight of his own making, going so far Tuesday as to cite the death of ' Kelly's "son in Afghanistan to question whether. ..Obama and other presidents did enough to honor the military dead. He's boasted that 'I think I've called every family of someone who's died,' though AP found relatives of two soldiers who died overseas during Trump's presidency who said they never received a call or a letter from him. The White House said he did telephone on Tuesday the families of four soldiers who were killed in Niger nearly two weeks ago, the issue that had spawned the controversy this week." Under the headline "After Trump Brings Chief Of Staff Into Controversy Over Condolence Calls, He Phones Families Of Killed Soldiers," the Los Angeles Times (10/17, Bierman, 4.49M) quotes White House Press Secretary Sarah Sanders as saying in a Tuesday statement, "President Trump spoke to all four of the families of those who were killed in action in Niger. He offered condolences on behalf of a grateful nation and assured them their family's extraordinary sacrifice to the country will never be forgotten." Under the headline "Twelve Days Of Silence, Then A Swipe At Obama: How Trump Handled 27 EXT-18-248-D-000580 dishonest and frankly, I've never seen anything quite like it." In Project Veritas Video, New York Times Editor Rips Trump, Pence. The Washington Times (10/17, Richardson, 541K) reports, "A New York Times senior staff editor called President Trump an 'oblivious idiot' and Vice President Mike Pence 'horrible' and 'worse than Trump' in an undercover video released Tuesday by the watchdog group Project Veritas." The Times says that in the video, "London-based homepage editor Desiree Shoe" rips Trump and Pence "while acknowledging that 'our main stories are supposed to be objective. 'I feel like Trump is a just a sort of an idiot in a lot of ways, just an oblivious idiot,' she" says "in the hidden-camera footage apparently taken at a bar." Shoe added, "If you impeach him, then Pence becomes president, Mike Pence, who's f-ing horrible, I think maybe worse than Trump. I'm speaking off the record." The Times says that Shoe "has worked for the NYT since 2009." Professor: New York Times' New Social Media Policy "Hide[s] Reporter Biases." The Washington Times (10/17, Richardson, 541K) reports that the New York Times' "new policy on social media may rid the paper of perceived bias, but critics say it leaves unchecked the actual bias permeating" its "reliably liberal pages." Said Cornell Law School professor William A. Jacobson, "I believe in transparency, and The New York Times' new social media guidelines achieve the opposite. The guidelines are designed to hide reporter biases that makes it harder for the public to judge the credibility of reporting. Particularly in an age where we are asked to accept anonymously sourced reporting on the Trump administration, the public should know more about the political biases of those asking us to trust them on sourcing." The New York Times' new "policy prohibits reporters from making social media posts that 'express partisan opinions, promote political views, endorse candidates, make offensive comments or do anything else that undercuts The Times' journalistic reputation."' families of soldiers who lost their lives in Benghazi. Florida Democrat Criticizes Trump's "Insensitive" Remarks To Widow Of Slain Soldier. The Miami Herald (10/17, Cohen, 701K) reports, "Sgt. La David T. Johnson of Miami Gardens, the soldier and father who was killed in Niger, returned home Tuesday afternoon." He "was saluted with a ceremonial homecoming at Miami International Airport." The Herald adds that Trump "called Johnson's pregnant widow Tuesday afternoon." The President "told his widow, who was in a car heading to the airport with her family and US Rep. Frederica Wilson, D-Miami Gardens, that 'he knew what he signed up for ...but when it happens it hurts anyway,' according to Wilson, who heard the call on speakerphone in the car." Wilson told the Herald, "I think it's so insensitive. It's crazy .... You don't say that to someone who lost family, the father, the breadwinner. You can say, 'I'm so sorry for your loss. He's a hero."' WPost's Von Drehle Questions Trump's In his Washington Post (10/17, Patriotism. 10.38M) column, David Von Drehle says that Trump's "impulsive attack on his predecessors" relating to the calling of the families of slain soldiers "has raised again a question that has haunted me since his inaugural address. Is Trump patriotic?" Von Drehle adds, "Patriotism doesn't require us to praise what is not praiseworthy. Like any other American, Trump is free to criticize as he sees fit. But when an elected leader disparages, without cause, the good faith of other elected leaders, he is tearing the country down .... I don't think we've ever been led by a person with such a low opinion of America ." Trump Says He Was "Surprised" By The "Dishonesty In The Media." Politico (10/17, Nelson, 3.6M) reported that during a Tuesday interview with radio host Chris Plante, President Trump said "that he was 'surprised' by what he perceived as the media's continued antipathy towards him after last year's election, characterizing CNN and NBC News 'a joke' and 'a total joke,' respectively." Said Trump, "Actually, dishonesty in the media is one of the things that surprised me the most. I thought after I won, the media would become much more stable and much more honest. They've gone crazy." Trump added, "CNN is a joke. NBC is a total joke. You watch what they report, it bears no relationship to what I'm doing. But the media is absolutely Trump Warns McCain, "I Fight Back And It Won't Be Pretty." The CBS Evening News (10/17, story 4, 2:40, Mason, 11.17M) reported that after Sen. John McCain "blast[ed] President Trump's ideas with words like 'halfbaked' and 'unpatriotic ."' The President on Tuesday "warned McCain to 'be careful.' The 28 EXT-18-248-D-000581 Vietnam war hero shot back, 'I've faced tougher adversaries."' The AP (10/17, Thomas) reports that in a radio interview, Trump said, "I'm being very, very nice but at some point I fight back and it won't be pretty." The New York Post (10/17, Fredericks, 4.31M) reports that the President also said that McCain's deciding vote against the recent Republican healthcare measure was a "shocker." USA Today (10/17, Cummings, 8.62M) reports that McCain "did not mention the president by name" in his Monday speech, but Politico (10/17, Nelson, 3.6M) says that the remarks "were widely interpreted as a shot at Trump's political style, a mix of nationalism, populism and conservatism." The AP (10/17, Thomas) reports that McCain said, 'To abandon the ideals we have advanced around the globe, to refuse the obligations of international leadership for the sake of some half-baked, spurious nationalism cooked up by people who would rather find scapegoats than solve problems, is as unpatriotic as an attachment to any other tired dogma of the past that Americans consigned to the ash heap of history." On Fox News' Fox & Friends (10/17, 8:38 a.m. EDT, 2.04M), Kellyanne Conway denied McCain's assertion that Trump engenders "halfbaked, spurious nationalism." Conway said, "We hope we can rely on Sen. McCain's vote" on a number of issues. Fox News' Special Report (10/17, 2.32M) briefly reported on McCain's Monday night remark and Trump's response on Tuesday. Biden: Trump's Behavior "Absolutely Bizarre." The AP ( 10/ 17) reports that former Vice President Joe Biden, who was presenting a medal to McCain at the National Constitution Center event on Monday, on Tuesday "called Trump's behavior 'absolutely bizarre."' Biden said, "Violating the norms of personal conduct generates more anxiety and fear than any policy prescription that this president has enunciated. This breaking down of international and national norms is the glue that holds the liberal world order together, and holds together our system." The Washington Times (10/17, Miller, 541K) reports that Biden and Ohio Gov. John Kasich were appearing together at a Delaware event to promote bipartisanship. The Washington Post (10/17, Kane, 10.38M) looks at the long relationship between Biden and McCain, who "have been on opposite sides of many crucial national security debates over the last 30 years," but who now find themselves to be "closely aligned ...elder statesmen." WPost Analysis: Trump Creates, Then Shoots Down Series Of "Political Villains." Michael Scherer writes in the Washington Post (10/17, 10.38M) that President Trump has a practice of "conjuring and then belittling a political villain with little more than taps on a phone . ... In just the past few weeks , Trump has started, without any clear provocation, fights with football players who kneel during the national anthem, departments stores that declare 'happy holidays' instead of 'Merry Christmas,' and late-night television hosts for their 'unfunny and repetitive material."' He has also gone after "individual targets" including Senate Minority Leader Schumer, Sen. Bob Corker, Hillary Clinton, Kim Jong-un, ESPN's Jemele Hill, "and a shifting array of reporters, newspapers and networks he labels as the 'fake news."' Scherer says that Trump has used the tactic "for years - defining himself against a negative space, as a tough truth teller who opposes others." White House Urges Corker To "Get Politico Out Of The Name-Calling." (10/17, McCaskill, 3.6M) reports that White House press secretary Sarah Sanders, in a radio interview with Hugh Hewitt, said she was open to speaking with Sen. Bob Corker. Sanders said, "Sadly, Sen. Corker hasn't called me, but if he'd like to visit, I'd be happy to talk to him and certainly see if we could get him back on board and do, frankly, what the people of Tennessee elected him to do .... Hopefully, he'll get out of the name-calling and get back to work here pretty soon." White House Denies Trump Joked Pence Wanted To "Hang" Gays. Politico (10/17, Nussbaum, 3.6M) reports that the White House is denying that President Trump has joked that Vice President Pence "wanted to 'hang' homosexuals as well as other details reported" in a New Yorker profile of Pence. In a statement, White House press secretary Sarah Sanders said, "From start to finish the article relied on fiction rather than facts .... The suggestion that he would make such outrageous remarks is offensive and untrue." The New Yorker said it "stands by its reporting." 29 EXT-18-248-D-000582 BuzzFeed Offers Some Information On Dossier, But Does Not Reveal Source. The Daily Caller ( 10/17, Ross, 521 K) reports that BuzzFeed News has "provided a few new details about how it obtained the infamous Trump dossier," but it "is still refusing to identify its source" for the document. BuzzFeed reporter Ken Bensinger "revealed that he was granted access to the dossier in December after he became aware of 'intelligence reports alleging that there were connections between the Trump presidential campaign and the Russian government,' according to a declaration filed in federal court Monday in Miami." FBI Uncovered Russian Bribery Plot Prior To US Approval Of 2010 Uranium Deal. Fox News' Tucker Carlson Tonight (10/17, 2.78M) reported "the FBI has uncovered evidence of a major Russian bribery effort just before the Obama Administration's approval of a deal back in 2010 that gave Russia control over large amounts of American uranium." The Hill (10/17, Solomon, Spann, 1.68M) reports that the FBI "had gathered substantial evidence that Russian nuclear industry officials were engaged in bribery, kickbacks, extortion and money laundering designed to grow Vladimir Putin's atomic energy business" inside the US. Dan McLaughlin writes in the National Review (10/17, 892K) that this "could be a very big news story, if anyone is willing to follow up on it." Newt Gingrich said on Fox News' Hannity (10/ 17, 9:25 p.m. EDT, 4.05M) that this story indicates "levels of corruption and dishonesty on a scale that I can't remember in American history." Senate Committee Subpoenas Page, Seeks Information From Flynn's Son. USA Today (10/17, Kelly, 8.62M) reports that the Senate Intelligence Committee "has issued a subpoena to compel testimony and documents from former Trump campaign adviser Carter Page," according to a congressional aide. Investigators "have raised questions about Page's alleged ties to Russia, which were detailed in a controversial dossier by former British spy Christopher Steele." Reuters (10/17, Hosenball, Layne) reports that the panel has also asked Michael G. Flynn, the son of ex-National Security Adviser Michael Flynn, "to provide documents and testimony." Mueller's Team Interviews Spicer. Politico (10/ 17, Kami, Dawsey, 3.6M) reports that special counsel Robert Mueller's team met Monday with former White House press secretary Sean Spicer "for an interview that lasted much of the day." Ac~ording to people familiar with the meeting, Spicer was asked about President Trump's firing of FBI Director James Corney and Trump's meetings with Russians officials including Foreign Minister Sergei Lavrov. Mueller Interviewed Cybersecurity Business Insider (10/17, Researcher Tait. 3.83M) reports that Mueller himself has interviewed cybersecurity researcher Matt Tait, "who described being recruited to vet hacked Hillary Clinton emails last year by a GOP operative tied to" the Trump campaign team. The interview took place "several weeks ago." Kushner Adds Harder To Legal Team. The Washington Examiner (10/17, Correll, 465K) reports that Jared Kushner has added attorney Charles Harder to his legal team. Harder "has represented Hulk Hogan and Melania Trump" and "previously represented Harvey Weinstein but discontinued representing him amid mounting sexual harassment and assault revelations." Democrats Reportedly Impatient With Pace Of Russia Probes. Bloomberg News (10/17, Dennis, House, 4.52M) reports, "Some Democrats in Congress are growing impatient with how the GOP is handling" the Russia probes. Senate Jud iciary Committee Democrats "say they want to see more urgency in that panel's efforts," while House Intelligence Committee ranking member Rep. Adam Schiff (D-CA) "says the Trump administration is trying to pressure Congress into ending its investigations prematurely." Obama UN Ambassador Says Unmasking Requests Were Made In Her Name. The Daily Caller (10/ 17, Ross, 521K) reports that Obama Administration UN Ambassador Samantha Power told the House Intelligence Committee last week that someone inside the Administration's "intelligence apparatus made requests to unmask the identity of Americans named in intelligence reports" in her name. Rep. Trey Gowdy (R-SC) told Fox News, "She would say those requests to unmask may have been attributed to her, but they greatly exceed by an exponential factor the requests she actually made." Trump Says Fed Chairman Pick Coming Soon, Source Says Early 30 T " " EXT-18-248-D-000583 November. USA Today (10/17, Jackson, 8.62M) reports President Trump said Tuesday he will select the next Federal Reserve Board chairman "over the next fairly short period of time." Addressing reporters at a joint news conference with Greek Prime Minister Alexis Tsipras, Trump also "all but confirmed" the reported list of five finalists: Former Fed governor Kevin Warsh, Stanford University economist John Taylor, current Fed Governor Jerome Powell, National Economic Council Director Gary Cohn, and current Chair Janet Yellen. He said, "I would say within those five you'll probably get the answer." Reuters (10/17, Holland) reports Trump will likely announce his choice for next Fed chair before his trip to Asia in early November, according to a "source familiar with the situation." The source "said announcing the choice by the time Trump leaves for Asia on Nov. 3 would give the Senate time for the confirmation process." WPost: Yellen Deserves A Second Term. In an editorial, the Washington Post (10/17, 10.38M) writes that President Trump should select Janet Yellen for a second term as Federal Reserve Chairman because of her experience with steadily raising interest rates and with the unwinding of the Fed's asset purchasing program, her encouragement and defense of safeguards on financial institutions, and her relative flexibility compared with the other candidates. The Post concludes that her selection would signal the preservation of the Federal Reserve's independence from politicization and "would send a reassuring message of continuity." Trump Calls On Americans To Say "Merry Christmas" During Holidays. The Washington Times (10/17, Dinan, 541K) reports President Trump said Tuesday that Americans should be comfortable saying "Merry Christmas." Commenting on stores that don't use "Merry Christmas" in their displays, Trump said, "I want them to say Merry Christmas everybody, Happy New Year, Happy Holidays, but I want Merry Christmas." Trump Drops In Forbes 400 Ranking. USA Today (10/17, McCoy, 8.62M) reports President Trump dropped in the annual Forbes magazine rankings of the wealthiest Americans after his fortune shrank by $600 million, to $3.1 billion - "dropping him from 156th place to 248th place in the 2017 Forbes 400 ranking, the magazine reported Tuesday ." Trump now is tied with Snapchat creator Evan Spiegel in the magazine's 2017 ranking. Trump DC Judicial Nominee Addresses Judiciary Committee. The Washington Post (10/17, Marimow, Sullivan, 10.38M) reports that Gregory G. Katsas President Trump's judicial nominee for the US Court of Appeals for the D.C. Circuit and current deputy White House counsel - on Tuesday "told senators considering his nomination that he advised the Trump administration on the travel ban on residents of certain majority Muslim countries, ending protections for young undocumented immigrants and the president's voter fraud commission." During a two-hour hearing, Katsas also "sought to assure the Senate Judiciary Committee that he would recuse himself from any cases involving his work as a government lawyer." The Post observes that Tuesday's hearing comes as Senate Majority Leader Mitch McConnell "is intensifying efforts to install conservative jurists on the federal bench." Dow Tops 23,000 For First Time. NBC Nightly News (10/17, story 3, 2:20, Holt, 16.61M) reported the Dow Jones topped 23,000 for the first time on Tuesday before closing just shy of the 23,000 mark. The Dow has grown 16 percent since January 1, and the market altogether has climbed 28 percent since the election of President Trump. USA Today (10/17, Shell, 8.62M) reports that Wall Street observers say the Dow's continued rise has been driven by five key factors: rebounding economies around the world, strong US corporate earnings, low borrowing costs, anticipation of tax cuts, and large US companies' benefiting from a weak dollar and stronger foreign economies. Pruitt Seeks To Assure Senators Over Biofuels Mandate. The Hill (10/17, Henry, Cama, 1.68M) reports EPA Administrator Pruitt "sought to reassure" Midwestern lawmakers on Tuesday that he supported the federal biofuels mandate. In a nearly hour-long meeting in Sen. Chuck Grassley's Senate office that included Sens. Joni Ernst (R-IA), Ben Sasse (R-NE), and Deb Fischer (R-NE), Pruitt "made a political case for the ethanol mandate." The meeting came amid 31 EXT-18-248-D-000584 concerns from lawmakers in both parties about proposed changes to the Renewable Fuel Standard. Fox News Poll: Jones, Moore Tied At 42% In Dec. 12 Special Election. On its website, Fox News (10/17, Blanton, 12.87M) reported that a Fox News poll of 801 Alabama voters, taken Oct. 14-16, shows ex-US Attorney Doug Jones (D) and ex-state Supreme Court Justice Roy Moore (R) tied at 42% each in the Dec. 12 special election for the former seat of now-US Attorney General Jeff Sessions. Fox News added "that among just the 53 percent of Alabama registered voters who are extremely or very interested in the race, Jones" leads Moore 46%-45%. Fox News said that President Trump carried "Alabama by 28 points in 2016, yet the Steve Bannon-backed Moore defeated the president's favored candidate, incumbent Luther Strange, in the GOP primary." The Hill (10/17, Thomsen , 1.68M) reported that the survey "also found that 42 percent of Moore's supporters had some doubts about the candidate, while 48 percent said they strongly support him in the race. Republicans were also less likely to support their nominee than Democrats were to support Jones, with 77 percent of GOP voters saying they'd back Moore. Eightfive percent of Democrats said the same for Jones. Twenty-eight percent of Jones' backers said they had some reservations about him. But 21 percent of his supporters said they were voting against Moore rather than for Jones." Rand Paul Backs Moore. The Hill (10/17, Shelbourne, 1.68M) reported that Sen. Rand Paul on Tuesday backed Moore's bid, saying in a statement , "Judge Roy Moore has spent a lifetime defending and standing up for the Constitution while fighting for the people of Alabama . We need more people in Washington, D.C. that will stand on principle and defend the Constitution." Writing for the Washington Examiner (10/17, Bedard, 465K), Paul Bedard described Paul's endorsement of Moore as "a huge show of support." Bedard added that Paul's backing "puts a stamp of approval on Moore's anti-Washington campaign which he rode to victory recently in a primary against Sen. Luther Strange, appointed earlier this year to replace former Sen. Jeff Sessions when he became the Attorney General." Sessions Creates Watchdog For Asset Forfeiture Program. The Washington Post (10/17, Horwitz, 10.38M) reports Attorney General Sessions is establishing a Justice Department watchdog to oversee the department's asset forfeiture program. In a memo Tuesday , Sessions "directed Deputy Attorney General Rod J. Rosenstein to hire a director to review all aspects of the department's policy and take action if problems arise." Rep. Darrell Issa, who criticized the department last summer when Sessions announced the asset forfeiture program, said Tuesday of the move, "It's nice to see at least some acknowledgment that civil forfeiture is in need of increased oversight, but the changes really don't go far enough and the core problem still remains." Zinke Booster Now Expresses Concerns About His Public Land Policies. The Washington Post (10/17, Grandoni, 10.38M) reports that Backcountry Hunters & Anglers Executive Director Land Tawney backed fellow Montanan Ryan Zinke's nomination to lead the Interior Department, but is now raising concerns about Zinke's stance on public lands and his "approach to national monuments." Tawney "still has kind words for Zinke, calling him 'a proven leader."' But "as to the question of whether he still regards him as an ally, Tawney split the difference." He said, "What we've always done is we've applauded [Zinke] for the things that we think he's doing that are beneficial to hunters and anglers, then we've held him accountable on the other end of that." Chao Silent On Federal Money For Miami's Metrorail. The Miami Herald (10/17, Hanks, 701 K) reports that Transportation Secretary Chao on Tuesday "deftly avoided" providing information about federal money for Miami's Metrorail during a press conference at Miami International Airport. Chao said, "Resources are an issue. It's a resource issue for all of us . ... From the whole country's point of view, the needs exceed the resources." Chao "didn't mention the issue" of money for expanding Metrorail but "did say the Trump administration may provide help to Miami-Dade beyond money." Three Polls Show Virginia Governor's Race "Within The Margin Of Error." Three weeks before next month's election to succeed term-limited Virginia Gov. Terry McAuliffe (D), Politico (10/17, Shepard, 3.6M) reported that 32 EXT-18-248-D-000585 a trio of "new public polls show" the battle between ex-RNC chief Ed Gillespie and Lt. Gov. Ralph Northam (D) "within the margin of error." A Monmouth University survey of 408 Virginia likely voters , taken Oct. 12-16, shows Gillespie leading Northam 48%-47%, with Libertarian Cliff Hyra at 3% and 3% undecided. Northam led 49%-44% in last month's poll. Meanwhile, a Christopher Newport University survey of 642 Virginia likely voters, taken Oct. 9-13, shows Northam leading Gillespie 48%-44%, with Hyra at 3% and 5% undecided. Northam led 49%-42% in last week 's poll. And a Roanoke College poll of 607 Virginia likely voters , taken Oct. 8-13, shows Northam leading Gillespie 50%-44%, with Hyra at 2% and 4% undecided . Northam led 47%-43% in last month's poll. The Hill (10/17, Hagen, 1.68M) reported that the Monmouth survey "is the first public poll that shows Gillespie leading." The Washington Free Beacon (10/17, Crookston, 158K) also reports on the results of three polls released on Tuesday. Democrat Northam Has Over Twice As Much Cash On Hand Than Gillespie. The AP (10/17, Suderman) reports that Northam holds "a hefty cash advantage over'' Gillespie ahead of next month's election. Northam collected over "$7 million in September and had about $5.7 million in the bank at the end of the month ." Gillespie, meanwhile, raised "$4.4 million, with $2.5 million cash on hand for the same period." Gillespie "enjoyed a cash advantage over Northam after the June primaries but has struggled to match the Democrat's fundraising prowess in recent months." The Washington Post (10/17, Nirappil, 10.38M) reports, "Republicans attributed the fundraising lag to a variety of reasons , including donors who were tuned out after the presidential contest and an unfavorable political climate for the GOP in Virginia." Oct. 14-16, shows Murphy leading Guadagno 47%-33%. Obama Joining Parade Of Democrats Who've Stumped For Murphy. The New York Times (10/ 17, Corasaniti , Burns, Subscription Publication, 13.56M) reports, "An Obama administration reunion tour is unfolding in New Jersey, as a cavalcade of Democratic luminaries has paraded into the state in recent days, including former Vice President Joseph R. Biden Jr., former Secretary of Labor Thomas E. Perez and former Secretary of State John Kerry, urging voters to" back Murphy's bid. The Times adds that President Obama is slated to stump with Murphy "on Thursday at a rally in Newark , making his first public foray on the campaign trail in support of a Democratic candidate since leaving office. And Hillary Clinton will be a guest of honor at a closeddoor fund-raiser for Mr. Murphy on Sunday in Harrison, N.J., her first campaign event since last year's election ." Murphy served as ambassador to Germany in the Obama Administration. Democrats Blast Guadagno Over "Bridgegate." The AP (10/17) reports that the Murphy camp on Tuesday received "a boost from the mayor whose town was gridlocked in the socalled Bridgegate scandal. Democratic Mayor of Fort Lee Mark Sokolich joined fellow Democrats Rep. Bill Pascrell, state Sen. Loretta Weinberg and Hoboken Mayor Dawn Zimmer Tuesday to attack ...Guadagno" on "the same day Murphy unveiled a new 30-second TV spot that says Christie and Guadagno's biggest triumph 'was a traffic jam .' Two former allies of Christie 's were convicted in federal court in the 2013 political payback scheme that saw local access lanes to the George Washington Bridge closed." Pence's Fundraiser Benefiting Collins Draws "About 80" Protesters. The Buffalo (NY) News (10/17, O'Brien , 362K) reports, "About 80 people protested outside a suburban Buffalo restaurant Tuesday as Vice President Pence arrived to raise" cash for Rep. Chris Collins (R-NY) , "one of the Trump administration 's staunchest backers in Congress." The News adds that Collins, "with Pence's help, expects to raise $400,000 at [the] event." Two Polls Show Democrat Murphy Up Double Digits In New Jersey NJ News (10/17, Governor's Race. Brodesser-Akner, 1.21M) reported that a Farleigh Dickinson University PublicMind poll of 658 New Jersey likely voters , taken Oct. 11-15, shows exGoldman Sachs executive Phil Murphy (D) leading Lt. Gov. Kim Guadagno (R-NJ) 47%-32% in next month's election to succeed term-limited Gov. Chris Christie (R-NJ). On its website, Fox News (10/17 , Balara, 12.87M) reported that a Fox News poll of 679 New Jersey likely voters, taken California House Republicans Get Large Financial Boost From PAC's Fundraiser With Pence. The Los Angeles Times (10/17, Mai-Due, 4.49M) reports , "California 33 EXT-18-248-D-000586 establishment. ' For months, the National Republican Senatorial Committee has been media training Rosendale," who's "also a client of the consulting firm On Message, Inc., one of the most 'establishment' consulting firms in Washington ." Politico added , 'The overlap between the 'establishment-backed ' candidates and those Bannon is elevating in hopes of taking down the establishment has some accusing him of being more interested in a one-man show than his 'season of war against a GOP establishment."' Nicholson Hails "Huge Endorsement" By Bannon In GOP Primary. In a report on Sen. Tammy Baldwin's (D-WI) 2018 reelection race, the AP (10/17, Bauer) focuses on the GOP primary, saying that businessman Kevin Nicholson (R) has "won the backing of former presidential strategist Steve Bannon in Wisconsin's US Senate race, a surprise move that sent shockwaves Tuesday through the" Republican contest. Nicholson is battling state Sen. Leah Vukmir (R-W I) in the GOP primary. The AP says, "The endorsement by a political action committee backed by Bannon, " the Great America PAC, "comes after both Nicholson and Vukmir met separate ly in private with Bannon." Nicho lson "tweeted on Tuesday that he was 'humbled by this huge endorsement' by Bannon." Republican House members have received more than $ 1 million from a commi ttee that recently benefited from a fundraiser with Vice President Pence . California Victory 2018 - a joint fundraising committee that helps" PACs "belonging to Pence and Rep. Kevin McCarthy as well as congressional campaign accounts of McCarthy and seven California Republicans received proceeds from a string of Pence fundraisers across the state last week ." Endorsing Flake Primary Foe Ward, Bannon Rips McConnell, Senate Republicans. The AP (10/17, Beaumont, Christie) reports that ex-White House chief strategist Steve Bannon on Tuesday "doubled down on his criticism of the GOP establishment" during a fundraising event benefiting ex-state Sen. Kelli Ward (R-AZ), who is mounting a 2018 primary challenge to Sen. Jeff Flake (R-AZ). Appearing in Scottsdale, Bannon "heaped disdain on Senate Majority Leader Mitch McConnell and other incumbent Republicans , saying they failed President Donald Trump by not backing his agenda and are openly critical of their own president." Said Bannon, who was joined at Tuesday's event by conservative talk show host Laura Ingraham, "If you saw how they try to rip him apart every day, how they are trying to destroy him every day . And yes, I'm talking about Mitch McConnell and the Senate Republicans. " The Arizona Republic (10/17 , Nowicki, 968K) reports that Bannon's appearance "was the biggest indicator to date that the allies of ...Trump are settling on Ward as their preferred challenge r to Flake." The Republic adds that Bannon blasted McConnell, "and vowed that the Republican elite are destined to 'reap the whirlwind' and 'that whirlwind is Kelli Ward. "' The "remarks were another salvo in the 'war' Bannon has declared on the GOP establishment. 'It's an open revolt, and it should be,' Bannon sa id before introducing Ward at her campaign 's formal kickoff event. " Politico Analysis: Some Bannon Candidates Also Backed By GOP Establishment. Politico (10/17 , Karni , 3.6M) reports that Steve Bannon recently backed state Auditor Matt Rosendale 's (R) Montana Senate bid "as part of his war on the GOP establishment." However, Bannon's "interest in Rosendale - as well as many of the other candidates" he's backing - "has some Washington GOP power brokers confused by his definition of 'anti- Hill Analysis: Trump's Support Gives Barletta Edge In Crowded Primary. In a report on Sen. Bob Casey's (D-PA) 2018 reelection race, T he Hill (10/17 , Kamisar , Hagen , 1.68M) said that Rep. Lou Barletta (R-PA) "is seen as the leading GOP candidate to take on" the incumbent Democrat , "with his chances boosted further after a de facto endorsement from President Trump last week. During a Harrisburg, Pa., rally last Wednesday, Trump lauded " Barletta "as a 'great guy' who will 'win big,"' and "then repeated the praise during an interview with Fox News host Sean Hannity . Trump's praise will give Barletta , an early Trump endorser during the presidential race and a key campaign surrogate, a major bump in a crowded primary field that also includes wealthy real estate developer Jeff Bartos ." Eight Democrats On CNN's List Of "10 Senate Seats Most Likely To Switch Parties" In 2018. On its website, CNN (10/17, Bradner , 33.59M) offered its list of "the 10 Senate seats most likely to switch parties in the 34 EXT-18-248-D-000587 microsite" hitting Sen. Joe Donnelly (D-IN) "over revelations from this summer that he earned profit from a family company that outsourced jobs to Mexico. The new website is called 'MexicoJoe.com,' a nod to the pejorative nickname that Republicans have bestowed upon Donnelly since the news broke over the summer. It will be a central hub for the SLF's attacks on Donnelly, hosting content including video and news clippings." Donnelly faces reelection next year. November 2018 midterms." Topping the list is the seat of Sen. Dean Heller (R-NV), followed by those of Sens. Claire McCaskill (D-MO); Jeff Flake (R-AZ); Joe Donnelly (D-IN); Joe Manchin (DWV); Heidi Heitkamp (D-ND): Sherrod Brown (DOH); Jon Tester (D-MT); Tammy Baldwin (D-WI); and Bill Nelson (D-FL). Hawley Spokesman Sidesteps Question On Whether Candidate McClatchy Would Back McConnell. (10/17, Wise, 67K) reports that state Attorney Gen. Josh Hawley (R-MO), "Republicans' top recruit to" take on Sen. Claire McCaskill (D-MO) in next year's election, "won't commit to voting for Mitch McConnell as Senate Republican leader if elected in 2018." Asked if the GOP hopeful would back McConnell, Hawley campaign spokesman Scott Paradise "deflected the question," saying in an email, "The Senate is broken and failing the people of Missouri. Josh is running because he is not willing to tolerate the failure of the D.C. establishment any longer. He won't tolerate Claire McCaskill's failure. And he won't tolerate Republican failure, either." McCaskill Acknowledges "Sloppy" Mistake In Claiming She Was Out When Controversial Bill Passed. The Springfield (MO) News-Leader (10/17, Shesgreen, 61K) reports that McCaskill on Tuesday "said she was wrong when she asserted she'd been undergoing breast cancer treatment on March 17, 2016 - the day the Senate passed legislation undermining the Drug Enforcement Agency's ability to stop suspicious shipments of opioids to what they feared were pillmills and illicit pharmacies." The bill "dramatically undercut the DEA's efforts to staunch the flow of millions of opioid pills into communities across the country, according to an investigation by the Washington Post and '60 Minutes,' published on Sunday." Speaking on "Monday with CNN, McCaskill said she didn't go along with the bill and was out for breast cancer treatment when it passed." On Tuesday , however, McCaskill "said her statements on Monday were a 'sloppy embarrassing mistake."' Nelson Raises Nearly $1.SM In Q3, Has $6.3M Banked For Reelection Race. The Tampa Bay (FL} Times (10/17, Leary, 877K) reports that Sen. Bill Nelson (D-FL), who faces reelection next year, "raised $1.75 million in the third quarter of 2017 and now has $6.3 million cash-on-hand. The haul comes as Nelson suspended his campaign for several weeks due to the hurricanes, an aide said." Florida Gov. Rick Scott (R), who is term-limited in 2018, is expected to challenge Nelson in next year's election. Testimony Continues In Menendez's Federal Corruption Trial. In continuing coverage of the federal corruption trial of Sen. Bob Menendez (D) and his longtime friend and donor, eye doctor Salomon Melgen, Bloomberg News (10/17, Weinberg, Voreacos , 4.52M) reports that Menendez's attorneys on Tuesday "sought to show jurors that the New Jersey Democrat was motivated by a desire to improve public policy and not by corrupt intent when he intervened in a Medicare billing dispute at the heart of' the prosecution's case. Testifying for the defense, "Washington lobbyist Alan Reider" discussed "how he helped Melgen contest accusations that he overbilled for Lucentis, a macular degeneration drug that costs doctors $2,000. Reider, a health care lawyer, said he argued to Menendez that Medicare policy that prevented multiple doses of Lucentis from a single bottle was confusing and contradictory." Reider "said his briefing with Menendez in 2012 focused on the multidosing policy rather than Melgen's dispute with the government." Politico (10/17, Friedman, 3.6M) reported that Rieder "said he learned of at least six other doctors who were concerned about 'multi-dosing,' even though prosecutors have argued only Melgen had an interest in changing the SLF Unveils Microsite Targeting Democrat Donnelly On Outsourcing. The Hill (10/17, Kamisar, 1.68M) reported that the Senate Leadership Fund (SLF), a super PAC aligned with Senate Majority Leader Mitch McConnell, on Tuesday was to unveil "a new 35 EXT-18-248-D-000588 government's policy on the issue." Reider, "who testified that he had briefly registered as a lobbyist when representing Melgen" as an attorney , "met with Menendez , who later raised the multi-dosing issue with everyone from bureaucrats at the Centers for Medicare and Medicaid Services to then-Health and Human Services Secretary Kathleen Sebelius. Prosecutors say those meetings were favors Menendez did for Melgen ...in exchange for private jet flights, vacations and hundreds of thousands of dollars in campaign contributions. " The New York Times (10/17, Wang, Subscription Publication, 13.56M) reports that testifying on Tuesday, "Melgen's wife, Flor Melgen, was alternately subdued and defiant in answering questions about the relationship between her husband and Mr. Menendez ." The Times adds that at one point, "after Kirk Ogrosky, a lawyer for Dr. Melgen, asked whether Ms. Melgen had expected to receive anything in return for her donations to Mr. Menendez's campaigns, she replied no. But she then began to explain in Spanish, through an interpreter, that 'every citizen who lives in this country ' might expect a return from a candidate who could 'do good for the community ."' The AP (10/17 , Porter) reports that Ms. Melgen "recalled how then -Republican Florida Gov. Charlie Crist showed up at her Palm Beach County home unannounced in October 2010, when he was running for Senate as an independent. Crist apparently was hoping Menendez , at the time the chair of the Democratic Senatorial Campaign Committee , was there that night, she testified . He wasn 't, but Crist wound up dining and staying overnight. He reimbursed the Melgens $100 for the dinner . 'So at least one politician knows how to pay your husband back,' Justice Department attorney Monique Abrishami said . Defense attorneys immediately objected, and US District Judge William Walls cautioned jurors to disregard attorneys ' 'throwaway questions. "' NJ News (10/17, Moriarty, Spoto, 1.21M) reports , "Defense attorneys raised the subject of [Grist's reimbursement] to try to address the issue of one of the flights prosecutors allege Menendez took on Melgen's dime as part of a bribe. The defense has argued Menendez should not have been charged in that instance because , they say, that Oct. 9 to 11, 2010 , trip to Florida was campaign-related and should have been reimbursed by the DSCC." Poll: 73% Of New Jersey Voters Say Menendez Should Resign Immediately, If Convicted. Meanwhile, Fox News (10/ 17, Balara, 12.87M) reported on its website that in a Fox News poll of 679 New Jersey likely voters, taken Oct. 14-16, 63% of those surveyed said that Menendez "should resign immediately, " if convicted of the corruption charges , while 19% said "he should wait until the next governor is in office." Pence: If Convicted, It Would Be "Inappropriate And Wrong" For Menendez To Remain In Senate. The Wash ington Times (10/ 17, Persons, 541K) reports that during a Tuesday interview with conservative radio host Hugh Hewitt, Vice President Pence said that having Menendez continue to serve in the Senate "would be 'inappropriate' if he's convicted in his federal corruption case ." Said Pence, "I think that'll be a decision for members of the Senate . But having a convicted felon in the United States Senate, I think, would be altogether inappropriate and wrong ." New Wildfires Emerge In Santa Cruz Mountains. ABC World News Tonight (10/ 17, story 5, 1:55, Muir, 14.63M) reported that "as firefighters make progress on the devastating wildfires" in California, new fires emerged in the Santa Cruz Mountains on Tuesday night, leaving five firefighters injured. Sutter Santa Rosa Regional Hospital (SSRRH) evacuated all 77 patients. SSRRH Chief Nursing Executive Robin Allen said, "We believe over 30 physicians at this facility lost their homes, as well as over 40 staff members." Sonoma Sheriff Denies Reports Linking Wildfires To Arson-Related Arrest. The Redding (CA) Record-Searchlig ht (10/ 17, Sandhu, Longoria, 59K) reports that on Tuesday , Breitbart News and lnfoWars "attempted to link the Sunday arrest of' Latino man Jesus Fabian Gonzalez "on suspicion of arson in Sonoma to the massive, deadly cluster of wi ldfires burning in California's wine country, " but the outlets "offered no evidence to link the man's arrest to the fires and their accounts of the man's arrest were disputed the same day by Sonoma County Sheriff Rob Giordano ." Giordano said in a news conference, "There 's a story out there he's the arsonist for 36 EXT-18-248-D-000589 were "branded" with a cauterizing device . Since the late 1990s, "an estimated 16,000 people have enrolled in courses offered by Nxivm (pronounced Nex-e-um), which it says are designed to bring about greater self-fulfillment by eliminating psychological and emotional barriers." With recent revelations of the "secret sisterhood and branding," scores of members are leaving the organization, and interviews with a dozen of them "portray a group spinning more deeply into disturbing practices." these fires. That is not the case. There is no indication he is related to these fires at all." Weinstein Resigns From His Company; Amazon Exec Steps Down. NBC Nightly News (10/17, story 7, 2:10, Holt, 16.61 M) reported Harvey Weinstein on Tuesday officially resigned from the board of his company as more than 50 women accuse him of sexual harassment or assault. The head of Amazon Studios also resigned Tuesday amid sexual harassment allegations, and executive producer Amanda Segel now is accusing Weinstein's brother, Bob Weinstein , of harassing her. The CBS Evening News (10/17, story 9, 0:25, Mason, 11.17M) reported that Spike TV has said it is investigating Segel's claims. A spokesman for Bob Weinstein has "denied the charges." ABC World News Tonight (10/17, story 4, 2:15, Muir, 14.63M) reported that "other Hollywood A-listers are coming forward with their own experiences" of harassment and assault, with actress Reese Witherspoon claiming she was abused by a "Hollywood director" and Jennifer Lawrence making her own claims. Trump Accuser Describes Earlier Harassment Experience. In a USA Today (10/ 17, 8.62M) op-ed , journalist Natasha Stoynoff - who wrote last year in People about being harassed by Donald Trump during a 2005 interview - describes her experience being sexually harassed by an unnamed actor 30 years ago. Stoynoff writes that women are beginning to open up about their experiences of harassment and assault. Women "are not afraid anymore, and there is no room in this world for men of this ilk." Pence Says Walking Out Of Colts Game Was "Right Thing To Do." WX IN- Women Denounce Harassment In California's State Legislature. The New TV Indianapolis (10/17, 178K) reports online that Vice President Pence said Tuesday that his decision to walk out from an Indianapolis Colts game after players knelt during the national anthem was the right choice. In a radio interview with WIBC-FM's Tony Katz, Pence said, "You know we had had plans for a long time to attend that game. Karen and I were looking very much forward to it, but frankly when we saw that so many players took a knee on the sideline we thought it was the right thing to do to leave." Pence did say he and President Trump had discussed the situation before he came to Indianapolis, and he added that while "everybody is entitled to their opinion ...the president and I believe it's not too much to ask for all players to respect our soldiers , respect our flag, respect our national anthem, and that's why we left." In addition to providing video of Pence's interview with Tony Katz, WIBC-FM Indianapolis (10/17, 7K) reports online that Pence also discussed the Administration's domestic and foreign policy accomplishments and the importance of tax reform. Pence said, "And before the end of this year we're going to cut taxes for working-class families and small businesses all across America." York Times (10/17, Nagourney, Medina, Subscription Publication, 13.56M) reports that more than 140 women - "including legislators, senior legislative aides and lobbyists" - have drafted a letter denouncing "what they describe as pervasive sexual misconduct by powerful men" in California's state legislature. Women "complained of groping, lewd comments and suggestions of trading sexual favors for legislation while doing business in Sacramento." The letter "comes as the scandal involving Mr. Weinstein had set off a wave of investigations, recriminations and accusations across the nation, including in state capitals in Rhode Island and South Dakota." NYTimes A 1 : Secretive "Self-Help" Group For Women Requires Members To Be Branded. In a front-page story, the New York Times (10/17, A1, Meier, Subscription Publication, 13.56M) reports on the inner workings of a secretive "self-help" organization, called Nxivm, where women , in order to gain admission , "were required to give their recruiter ...naked photographs or other compromising material" to ensure their silence about the group and then 37 EXT-18-248-D-000590 NFL Owners, Players Meet To Discuss Anthem Protests. NBC Nightly News (10/17, such as Confide and Signal, which are designed to delete data." story 13, 0:20, Holt, 16.61M) reported that NFL team owners and players met on Tuesday in New York to _discuss league protocol on kneeling during the national anthem. While the two sides "called the meeting productive," there was no agreement reached on the anthem protests. During the meeting, protests "erupted" outside. ABC World News Tonight (10/17, lead story, 2:25, Muir, 14.63M) reported NFL Commissioner Roger Goodell announced Tuesday evening that owners did not ask the players to stand for the national anthem. Players at the meeting said progress was made on bringing attention to the reasons that some were kneeling. Players and owners "are expected to get together to discuss" the kneeling issue again "within the next couple of weeks." Bipartisan Group To Urge Trump To Alter Policing Policies. The New York Times ( 10/17, Haberman, Subscription Publication, 13.56M) reports that a "broad coalition" of law enforcement officials and activists "is expected to urge President Trump on Wednesday to adj ust policies on policing and criminality, the first time such a group has spoken out against the Trump administration." According to the Times , "some of the nation's most prominent prosecutors, police chiefs and criminal justice overhaul advocates," including Sen. Thom Tillis (R-NC) and "representatives from the conservative Koch brothers network," will meet in Washington, DC for the National Law Enforcement Summit. Former Attorney General Eric Holder and Sally Q. Yates, "the acting attorney general whom Mr. Trump abruptly fired in the first few days of his presidency, will speak." The presenters "are expected to pose the challenge to Mr. Trump, who ran in 2016 as a 'law and order' candidate but whose attorney general's policies - as well as Mr. Trump's own messaging - have come under increasing criticism from local law enforcement officials." Google Serves "Fake News" Ads On Fact-Checking Sites, NYTimes Finds. A New York Times (10/17, Wakabayashi , Qiu, Subscription Publication, 13.56M) investigation found that enticing fake "headlines served as bait to draw readers to fraudulent sites that masqueraded as mainstream news sites, such as People and Vogue ." The Times found that "fake publishers used Google's AdWords system to place the advertisements on websites that fit their broad parameters," including, ironically, "PolitiFact and Snopes, fact-checking sites created precisely to dispel such falsehoods." The article highlights opinion that this investigation's finding underscores the challenges of avoiding so-called "fake news." Open Society Discloses $18 Billion In Donations From Georges Soros. on its front page, the Wall Street Journal (10/17, A 1, Chung, Das, Subscription Publication, 6.45M) reports that Open Society Foundations said Tuesday that in recent years, George Soros has moved about $18 billion of his money into Open Society. Soros reportedly has no plans to trade the billions now belonging to Open Society, as his family office manages the endowment. The article outlines causes supported by Open Society, including immigration reform, US criminal just ice reform, mentoring programs for black and Latino young men, and indirectly, the Black Lives Matter movement. The New York Times (10/17, Gelles, Subscription Publication, 13.56M) reports that this makes Open Society "the second largest foundation in the United States by assets, according to the National Philanthropic Trust." The Times mentions that Soros had wrongly bet against the stock market after Trump was elected. National Archives Warned Administration To Preserve Documents. Politico (10/17, Dawsey, Bender, 3.6M) cites sources and documents as indicating "National Archives officials have periodically warned White House lawyers that the Trump administration needs to follow document preservation laws." National Archives officials reportedly "told the White House counsel's office the~ were concerned that wasn't happening, particularly early in the administration ." In addition, the nonpartisan watchdog group Citizens for Responsibility and Ethics "is suing the Trump administration over its adherence to the record law, citing the use by White House officials of encrypted smartphone apps to communicate , 38 T " " EXT-18-248-D-000591 created - Benjamin Banneker Academic High School - and the educators "helped by the support and guidance he provided from his position at The Post." Duckworth: Congress Seeking To Remove Protections For Disabled. In a Washington Post (10/17, 10.38M) op-ed, Sen. Tammy Duckworth (0-IL) writes that Congress led by "special interests" in the hospitality and retail industries - are working to undermine the Americans with Disabilities Act by offering legislation that seeks "to shift the burden of ADA compliance away from business owners and onto individuals with disabilities." The argues that if Congress passes the "misguided" ADA Education and Reform Act, "it would send a disgraceful message to Americans with disabilities that their civil rights are not worthy of strong enforcement." EDITORIAL WRAP-UP New York Times. "Mr Trump Outdoes Himself In Picking A Conflicted Regulator." A New York Times (10/17, Subscription Publication, 13.56M) editorial says President Trump has "made a habit of filling important jobs with people dedicated to undermining the laws they're supposed to administer while pampering the industries they're supposed to regulate," and "yet no nomination has been as brazen, as dangerous to public health and as deserving of Senate rejection as that of Michael Dourson to run the EPA office in charge of reviewing chemicals used in agriculture, industry and household products." Dourson's nomination is "enthusiastically endorsed by the chemical industry," but "horrifies environmental groups, public health advocates , firefighters and scientists." The Times says it "would take just a few Republicans to block the nomination," and urges senators to "think hard about the impact their votes could have on the health of Americans for years to come." WSJournal Decries Court Ruling Absolving Prosecutors For Using False Information. The Wall Street Journal (10/17, Subscription Publication, 6.45M) editorializes about Tuesday's ruling by the 2nd Circuit Court of Appeals that absolved prosecutors for the use of false information in the prosecution of hedge fund founder David Ganek. Ganek had sued the prosecutors, seeking damages after the prosecution had put his hedge fund out of business. The appeals court ruled that the prosecutors were immune from liability. The Journal calls this another example of abusive behavior by prosecutors, and it urges the Justice Department to investigate the incident and to discipline the prosecutors. Washington Post. "Janet Yellen Deserves A Second Term As Fed Chair." In an editorial the Washington Post (10/17, 10.38M) writes that President Trump should select Janet Yellen for a second term as Federal Reserve Chairman because of her experience with steadily raising interest rates and with the unwinding of the Fed's asset purchasing program, her encouragement and defense of safeguards on financial institutions, and her relative flexibility compared with the other candidates . The Post concludes that her selection would signal the preservation of the Federal Reserve's independence from politicization and "would send a reassuring message of continuity." "The Hope For Change In Venezuela Suffers A Crushing Blow." A Washington Post (10/ 17, 10.38M) editorial says "hopes that Venezuela could emerge from its catastrophic political and economic collapse by democratic means suffered a crushing and perhaps terminal blow on Sunday" when the government of Nicolas Maduro staged elections for provincial governors. Polls showed the opposition, "which reluctantly WSJournal Applauds Gov. Brown's Veto Of Campus Sexual Assault Bill. The Wall Street Journal (10/ 17, Subscription Publication, 6.45M) editorial board praises California Governor Jerry Brown's (D) Sunday veto of a bill that would have codified the Obama Administration's "Dear Colleague" guidance, which said universities would lose federal funds if they did not create courts to litigate Title IX campus sexual assault claims. The Journal urges politicians to stay focused on their principles in spite of desire to buck the Trump Administration. WPost Offers Farewell To Former Communications Vice President. In an editorial, the Washington Post (10/17, 10.38M) writes offers a farewell message for The Post's former vice president of communications , Vincent E. Reed, who died Tuesday at the age of 89. The Post says Reed "leaves a rich legacy" in the lives of the students who benefited from the school he 39 T " " EXT-18-248-D-000592 agreed to participate, would win up to two-thirds of the races," and yet the results "announced by proregime election authorities were nearly the opposite." The Post argues that Sunday's result suggests that a free and fair democratic election in Venezuela "is no longer possible." "Saying Farewell To A Local Icon Of In an editorial, the National Renown." Washington Post (10/17, 10.38M) writes offers a farewell message for The Post's former vice president of communications, Vincent E. Reed, who died Tuesday at the age of 89. The Post says Reed "leaves a rich legacy" in the lives of the students who benefited from the school he created - Benjamin Banneker Academic High School - and the educators "helped by the support and guidance he provided from his position at The Post." THE BIG PICTURE Headlines From Today's Front Pages. WALL STREET JOURNAL: Senators Reach Deal To Shore Up Health Markets Soros Transfers $18 Billion To Foundation, Creating Instant Giant US-Backed Forces Say They Have Taken Last Islamic State Urban Stronghold The Other Brother: Bob Weinstein Was An Abusive Boss NEW YORK TIMES: 2 Senators Strike Deal On Health Subsidies That Trump Cut Off Raqqa, ISIS 'Capital,' Is Captured, US-Backed Forces Say As Party Gathers, Xi Jinping Displays A Firm Grip On Power Inside A Secretive Group Where Women Are Branded Navy SEALs Were Ready If Pakistan Failed To Free Family Held As Hostages Women Denounce Harassment In California's Capital Wall Street Journal. "The Realtors Take A Tax Hostage." In an editorial, the Wall Street Journal (10/17, Subscription Publication, 6.45M) writes that The National Association of Realtors' attack on GOP tax legislation is based upon their desire to keep middle-class tax rates high to preserve their mortgage interest deduction subsidy. The Journal concludes that Republicans should stand firm against the housing lobby's efforts against the GOP plan. "Jerry Brown's Title IX Veto." The Wall Street Journal (10/17, Subscription Publication, 6.45M) editorial board praises California Governor Jerry Brown's (D) Sunday veto of a bill that would have codified the Obama Administration's "Dear Colleague" guidance, which said universities would lose federal funds if they did not create courts to litigate Title IX campus sexual assault claims. The Journal urges politicians to stay focused on their principles in spite of desire to buck the Trump Administration. "Prosecutorial Impunity." The Wall Street Journal (10/17, Subscription Publication, 6.45M) editorializes about Tuesday's ruling by the 2nd Circuit Court of Appeals that absolved prosecutors for the use of false information in the prosecution of hedge fund founder David Ganek. Ganek had sued the prosecutors, seeking damages after the prosecution had put his hedge fund out of business. The appeals court ruled that the prosecutors were immune from liability. The Journal calls this another example of abusive behavior by prosecutors, and it urges the Justice Department to investigate the incident and to discipline the prosecutors. WASHINGTON POST: Latest Healthcare Effort Quickly Stalls US-Backed Force Says Raqqa Free Of ISIS Despite Decision Against Uber, London's Rivalry Between Traditional, Modern Transit Continues Drug Czar Pick Bows Out Amid Criticism Of Law Judge Largely Halts Latest Version Of Travel Ban FINANCIAL TIMES: US-Backed Forces Claim Victory Over ISIS In Raqqa As Jihadis Flee Airbus Challenges Boeing With Vow To Create US Jobs Wall St Banks Boosted By Lending To Rich Clients Washington Times: Trump Supports Bipartisan Short-Term Fix To Stabilize Obamacare Judge Blocks Trump's Travel Ban For Third Time Islamic State's 'Caliphate' Dissolves, But Ideology, Operations Spread Around World New York Times' Social Media Policy Only Hides Political Bias, Doesn't Eliminate It Biden And Kasich Claim Political Center, Turn Bipartisan Talk Against Trump 40 EXT-18-248-D-000593 After Year In Coffin, Thai King's Body Prepared For Royal Cremation NPR: Travel Restriction Blocked; California Wildfires; NFL Owners Meeting; Amazon Sexual Harassment Scandal. STORY LINEUP FROM LAST NIGHT'S NETWORK NEWS: LAST LAUGHS ABC: NFL Owners Meeting; Bipartisan Healthcare Plan; White House-Fallen Soldiers Call; Weinstein Sexual Harassment Scandal; California Wildfires; Travel Restriction Blocked; Syria-Raqqa Assault ; Ohio-Police Violence ; Cold Medicine Murder; Texas Air Balloon Crash Investigation; Ford Explorers-Call For Recall; Aspiring Kid. CBS: Opioid Epidemic-Marino Nomination Withdrawn; Opioid Epidemic-Hard Hit Area; Texas Air Balloon Crash Investigation; McCain, BidenTrump Criticisms; White House-Fallen Soldiers Call; Syria-Raqqa Assault; Ford Explorers-Call For Recall; Travel Restriction Blocked; Weinstein Sexual Harassment Scandal; Young Political Candidates. NBC: White House-Fallen Soldiers Call; Bipartisan Healthcare Plan; Wall Street Records; Opioid Epidemic-Marino Nomination Withdrawn; Opioid Epidemic-Chinese Imports; Travel Restriction Blocked; Weinstein Sexual Harassment Scandal; United Overbooking Investigation; Texas Air Balloon Crash Investigation; Syria-Raqqa Assault; Ford Explorers-Call For Recall; NFL Owners Meeting; GMO Apple; Brooklyn-Loose Cow; Creative Chemistry Class. NETWORK Late Night Political Humor. Jimmy Kimmel: 'They have a policy where if an animal escapes a slaughterhouse, it gets to go free. Isn't that great? The bull is being sent to a rehabilitation facility for misbehaving cows. That's the good news. The bad news is it is also where they sent Harvey Weinstein ." Trevor Noah: "Speaking of hairy creatures, yesterday President Trump held a surprise press conference with Senate Majority Leader Mitch McConnell, which is kind of the worst surprise ever. 'Surprise, I brought Mitch McConnell!' Boo! What kind of surprise party is [with] Mitch McConnell?" Trevor Noah: "I don't know, something's fishy here. They sound less like real friends and more like Trump trying to get Mitch a green card. This gentleman, I'm going to say Mitch, right, Mr. Immigration Officer, this relationship is special, it's so special.' That's what you said about Melania."' Trevor Noah: "See what [President Trump] said? 'President Obama never called. I call and I write. I also haven't called and I didn't write. But I do, except when I don't, which is now."' TV AT A GLANCE: White House-Fallen Soldiers Call - 8 minutes, 15 seconds Opioid Epidemic - 6 minutes, 25 seconds Syria-Raqqa Assault - 6 minutes, 15 seconds Weinstein Sexual Harassment Scandal - 4 minutes, 50 seconds Ford Explorers-Call For Recall - 4 minutes, 20 seconds Travel Restriction Blocked - 1 minute, 20 seconds STORY LINEUP FROM THIS MORNING'S RADIO NEWS BROADCASTS: ABC: Travel Restriction Blocked; Bipartisan Healthcare Plan; NFL Owners Meeting; MarylandHate Crime Trial; Wall Street News. CBS: Bipartisan Healthcare Plan; Travel Restriction Blocked; Opioid Epidemic; White House-Fallen Soldiers Call; California Wildfires. FOX: Bipartisan Healthcare Plan; California Wildfires; Weinstein Sexual Harassment Scandal. 41 EXT-18-248-D-000594 Copyright 2017 by Bulletin Intelligence LLC Reproduction or redistribution without permission prohibited. Content is drawn from thousands of newspapers, national magazines, national and local television programs, radio broadcasts, social-media platforms and additional forms of open-source data. Sources for Bulletin Intelligence audience-size estimates include Scarborough, GfK MRI, comScore, Nielsen, and the Audit Bureau of Circulation. Data from and access to third party social media platforms, including but not limited to Facebook, Twitter, lnstagram and others, is subject to the respective platform's terms of use. Services that include Factiva content are governed by Factiva's terms of use. Services including embedded Tweets are also subject to Twitter for Website's information and privacy policies. The HHS News Briefing is published five days a week by Bulletin Intelligence, which creates custom briefings for government and corporate leaders. We can be found on the Web at Bulletinlntelligence.com , or called at (703) 4836100. 42 EXT-18-248-D-000595 ,/..!# pr.~S[RVl(fs DEPARTMENT OF HEALTH & HUMAN SERVICES t .::::::1zE----------------- A-D_M_IN _ I_S_T_ R_AT _ I_O_N_F_O_R_ C _ HI_L_D_R_E_N_A_N_D_F _A_M _I_L_ IE-S Mary E. Switzer Building 330 CST, S.W. Washington, D.C. 20201 Case No: 18-F-0029 Civil Action l 8-cv-0248 December 20, 2018 Ms. Katie O'Connor Legal Counsel Campaign for Accountability 611 Pennsylvania Avenue, SE, #337 Washington, D.C. 20003 Dear Ms. O'Connor: This is the fifth interim response of the Administration for Children and Families to Ms. Katie O'Connor's October 27, 2017, Freedom of Information Act (FOIA) request for records related to services for pregnant unaccompanied immigrant minors. Specifically, Ms. O ' Connor sought the following items: 1. All records related to Office of Refugee Resettlement ("ORR") policy regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. This request includes memoranda , directives, policy statements, policy interpretations, policy guidance, talking points, and other similar documents reflecting ORR policy. 2. All records related to ORR Director Scott Lloyd ' s visits to ORR grantee shelters that house unaccompanied immigrant minors. This request includes calendar entries, travel and accommodation requests and approvals, itineraries , briefing memoranda, and meeting notes. 3. All communications , meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and representatives of the Susan B. Anthony List, Concerned Women for America, the Heritage Foundation, the Center for Family and Human Rights ("C-Fam"), National Right to Life, Alliance Defending Freedom, Legal Works Apostolate, or the Knights of Columbus regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters . This request includes communications to or from anyone using email addresses from the following domains: a.@sba-list.org b. @cwfa.org c. @heritage.org d. @c-fam.org e. @nrlc.org f. @adflegal.org g. @legalworks.com h. @kofc.org 4. All communications , meeting notices, meeting agendas , informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and representatives of the White House regarding AMf HICAN PVERSIGHT Case No. 18-F-0029 Civil Action 18-cv-0248 Page 2 of2 services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. 5. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and members and staff of the U.S. Congress regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. Your request was sent to the Office of Refugee Resettlement (ORR) and the Office of the Chief Information Officer for a search for responsive records. Please find enclosed 48 pages of responsive records responsive in part to Items 1, 4, and 5 above. Four-hundred and seventy-eight pages are being sent to other HHS components and other agencies for consultation. Some of the information on the enclosed pages has been withheld under the FOIA exemptions (b)(5) and (b)(6). The FOIA exemption (b)(5) protects inter-agency or intra-agency memorandums or letters which would not be available by law to a party other than an agency in litigation with the agency. The exemption protects agency deliberations, both internal and with agency contractors and consultants, attorney-client privileged records and attorney work product. In this case, the withheld information includes pre-decisional discussions within the agency and between agency staff and contractors about management of ORR programs and/or individual children and sensitive communications between agency staff seeking legal advice and counsel on policy and other matters. The FOIA exemption (b)(6) permits the withholding ofrecords which, ifreleased, would constitute a clearly unwarranted invasion of personal privacy. In this case, the withheld information consists of the names, identities, email addresses, phone number, and/or other private information of private individuals and the cell phone numbers of federal employees. Public disclosure of this information would constitute an invasion of privacy of those individuals whose identifying information was disclosed. In withholding the information, the individual's privacy interest was balanced against any public interest in disclosure. In each instance where information was withheld, it was determined that the individual's privacy interests outweighed any public interest in disclosure of the withheld information. Disclosure of the withheld information would invade the privacy of the subject individuals but would reveal nothing about the operations or activities of the government. Sincerely yours, Acting Director Office of Communications Freedom of Information Office Administration for Children and Families Department of Health and Human Services AM~RICA\J PVERSIGHT Epstein, Kimberly (ACF) "Wolfe, Kenneth (ACF) "; "Marriott, Brian (ACF) "; "Pilato, Anna (ACF) " "Wagner, Steven (ACF) "; "Milner, Jerry (ACF) "; "Wubbenhorst, William (ACF) "; "Lloyd, Scott (ACF) "; "Tota, Kenneth (ACF) "; "Negri, Warren A. (ACF) " Subject: New FOIA requests Date: 2018/04/03 14:16:24 Priority: Normal Type: Note We have received two new FOIA requests from Laura Dillon on behalf of the Democratic National Committee, seeking emails concerning abortion services for minors in federal custody. One request seeks such emails to/from Steve, Jerry Milner, Janis Brown and William Wubbenhorst; the other from mailboxes of key ORR staff. I. All e-ma ils (including attachments) sent or received by any of the following staff in the Administration of Children and Families that pertain to abortion services for minors held in federal custody: o /\MERICAi\ pVERSIGHT I ask that this search include any individua l who held any of t he following positions in the Administration of Children and Families or who performed the duties of any such positions in an acting capacity from September 1, 2017 to the present: • Assistant Secretary, including - but not limited to - Steven Wagner • Commissioner for the Administration on Children , Youth, and Families, including - but not lim ited to - Jerry Lee Milner • Associate Commissioner of the Children's Bureau, including - but not limited to - Jerry Lee Milner • Childr en's Bureau Region 6 Program Manager, includingbut not limited to - Janis Brown EXT-18-248-E-000001 • Commissioner of the Family and Youth Services Bureau Associate Commissioner of the Family and Youth Services Bureau, including - but not limited to-William Wubbenhorst My request covers September 1, 2017 to the present • All e-mails (including attachments) sent or received by any of the following staff in the Office of Refugee Resettlement that pertain to abortion services for minors held in federal custody, or that otherwise contain any of the following search terms in the subject, body, or attachments: o I ask that this search include any individua l who held any of the fo llowing positions in the Office of Refugee Resettlement or who performed the duties of any such positions in an acting capacity from September 1, 2017 to the present: • Director , including - but not limited to - Edward Scott Lloyd and Kenneth Tota • Principal Deputy Director, including - but not limited to - Pedro Moreno • Deputy Director for Children 's Programs , including - but not limited to - Jonathan White • Director of the Division of Refugee Assistance , including - but not limited to - Carl Rubenstein o Search terms : • "Abort" • "Contraception" • "Pro-life" • "Pro-choice " • "Anti-life" • "Anti-choice" • "Pregnant" • "Pregnancy" • "Pregnancies" • "Ultra sound" • "Life-affirming" • "Planned Parenthood " • "ACLU" • "A .C.L.U ." • "Amer ican Civil Libertie s" • "Parental consent" • "Unborn baby" • "Unborn babies" /\MERICAi\ pVERSIGHT EXT-18-248-E-000002 • "Unborn child" • "Fetus" My request covers September 1, 2017 to the present. II. Epstein, Kimberly (ACF) "Wolfe, Kenneth (ACF) "; "Marriott, Brian (ACF) "; "Pilato, Anna (ACF) "; "Wagner, Steven (ACF) "; Recipient: "Milner, Jerry (ACF) "; "Wubbenhorst, William (ACF) "; "Lloyd, Scott (ACF) "; "Tota, Kenneth (ACF) "; "Negri, Warren A. (ACF) " Sent Date: 2018/04/03 14:16:24 /\MERICAi\ pVERSIGHT EXT-18-248-E-000003 Wagner, Steven (ACF) "Epstein, Kimberly (ACF) "; "Wolfe, Kenneth (ACF) "; To: "Marriott, Brian (ACF) "; " Pilato, Anna (ACF) " "Milner, Jerry (ACF) "; "Wubbenhorst, William (ACF) "; " Lloyd, Scott (ACF) "; "Tota, Kenneth (ACF) "; (FYDIBOHF23SPDL T)/cn =Recipients/cn = Sc0919fe56454c2b8e7c59c38646ebec " Negri, Warren A. (ACF) " Subject: Re: New FOIA requests Date: 2018/04/04 08:46:59 Priority: Normal Type: Note Thank you Kim. Please brief me on wha t you 've identified before providing to requester. Thanks much. On: 03 April 20 18 14 :16, /\MERICAi\ pVERSIGHT EXT-18-248-E-000004 "Epstein, Kimberly (ACF )" wrote: We have received two new FOIA requests from Laura Dillon on behalf of the Democratic National Committee, seeking emails concerning abortion services for minors in federal custody. One request seeks such emails to/from Steve, Jerry Milner, Janis Brown and William Wubbenhorst; the other from mailboxes of key ORR staff. I. • All e-mails (including attachments) sent or received by any of the following staff in the Adm inistration of Children and Families that pertain to abortion services for minors held in federal custody: • /\MERICAi\ pVERSIGHT • I ask that this search include any individua l who held any of the following posit ions in the Administration of Children and Families or who performed the duties of any such positions in an acting capacity from September 1, 2017 to the present : • • Assistant Secretary, including - but not limited to - Steven Wagner • • Commissioner for the Adm inistration on Children, Youth, and Families, including- but not limited to - Jerry Lee Milner EXT-18-248-E-000005 • • Associate Commissioner of the Children's Bureau, including but not limited to -Jerry Lee Milner • • Children's Bureau Region 6 Program Manager, including - but not limited to - Janis Brown • • Commissioner of the Family and Youth Services Bureau Associate Commissioner of the Family and Youth Services Bureau, including - but not limited to-William Wubbenhorst My request covers September 1, 2017 to the present • All e-mails (including attachments) sent or received by any of the following staff in the Office of Refugee Resettlement that pe1tain to abortion services for minors held in federal custody, or that otherwise contain any of the following search terms in the subject, body , or attachments: o I ask that this search include any individual who held any of the following positions in the Office of Refugee Resettlement or who performed t he duties of any such positions in an acting capacity from September 1, 2017 to the present: • Director, including - but not limited to - Edward Scott Lloyd and Kenneth Tota • Principal Deputy Director , including - but not limited to - Pedro Moreno /\MERICAi\ pVERSIGHT EXT-18-248-E-000006 • Deputy Director for Children's Program s, including - but not limited to - Jonathan White • Director of the Division of Refugee Assistance, including - but not limited to - Carl Rubenstein o Search terms : • "Abort" • "Contracept ion" • "Pro-life" • "Pro-choice" • "Anti -life" • "Anti-choice" • "Pregnant" /\MERICAi\ pVERSIGHT EXT-18-248-E-000007 • "Pregnancy" • "Pregnancies" • "Ultrasound" • "Life-affirming" • "Planned Parenthood" • "ACLU" • "A.C.L.U." • "American Civil Liberties" • "Parental consent" • "Unborn baby" • "Unborn babies" • "Unborn child" /\MERICAi\ pVERSIGHT EXT-18-248-E-000008 • "Fetus" My request covers September 1, 2017 to the present. II. III. • • Wagner, Steven (ACF) "Epstein, Kimberly (ACF) "; "Wolfe, Kenneth (ACF) "; "Marriott, Brian (ACF) "; " Pilato, Anna (ACF) "; "Milner, Jerry (ACF) "; "Wubbenhorst, William (ACF) "; "Lloyd, Scott (ACF) "; "Tota, Kenneth (ACF) "; "Negri, Warren A. (ACF) " Sent Date: 2018/04/04 08:46:58 Delivere d Date: 2018/04/04 08:46:59 /\MERICAi\ pVERSIGHT EXT-18-248-E-000009 Lloyd, Scott (ACF) "Wagner, Steven (ACF) "; "Wynne, Maggie (HHS/IOS) "; "Bowman, Matthew (HHS/OGC)" CC: "Hayes, Jonathan (ACF) " Subject : FW: Termination of Pregnancy Date : 2018/07/26 15:33:00 Priority: Normal Type : Note From: Sualog, Jallyn (ACF) Sent: Thursday, July 26, 2018 3:19 PM To: Lloyd, Scott (ACF) Subject: FW: Termin ation of Pregnancy Scott, See below update for UAC in NY requesting TOP. Jallyn N. Sualog Deputy Directo r for Chi ldre n's Programs Office of Refugee Resettlement Administration for Children and Families U.S . Department of Healt h and Human Services 330 C Street SW Washington , DC 20201 Jallyn. Sualog @acf .hhs.gov 0: (202) 401 -4997 C: (202) l(b)(6) I From: Bartholomew, Michael (ACF) Sent: Thursday, July 26, 2018 2:30 PM To: Sualog, Jallyn (ACF) Cc: Misegades, Lara (ACF) ; Patel, Mita (ACF) (CTR) Subject: FW: Termination of Pregnancy HI Jallyn , /\MERICAi\ pVERSIGHT EXT-18-248-E-000010 I wanted to give you an update on this case: As you recall: UAC is a 15 yo l(b)(6) Iwho was admitted to Homestead and screened positive for pregnancy . Wh ile at Homestead, the minor denied sexua lly activity. She was transfer red to Boystown. At Boystown, she was reported to be ~ 12 weeks gestation and had an OB/GYN visit on 7/ 10. She has requested a tennination of pregnancy. Per CC Boystown : Following the Garza informational meeting this mornin with the pregnant (b)( 6 ) has expressed minors in care, one of the minors (b)(6) that, after evaluating the options presented to her, she wishes to terminate her pregnancy as soon as possible . The Minor's famil y is in full support of the minor's decision and they would like for the minor to terminate her pregnancy prior to reunification with the sponsor. At this moment, the sponsor has not provided any reunification documents due to fear of providing IDs and fingerprints; he is willing to help but he is consulting with his lawy er prior to submitting documentation to the CM. Seeing as this case is already behind, we are requesting the minor be transferred to another facility so she is able to receive the care that she is requesting as reunification with the sponsor has not yet begun . Please advise and assist . Thank you. The minor was transfer and is current ly at Rising Ground (formerly Leake and Watts) in NY. In the SIR, the pregnancy is a result of consensual sexual relations with her 16 yo boyfr iend in COO. From the SIR, she has reviewed her options and confinned her request for tennination. The minor has talked with the ACLU attorney and the child has been offered spiritual services. The attorney has exped ited an appo intment with Planned Parenthood. An appo intment is pend ing per DHUC knowledge . The program asked if an SMR is needed because of procedma l sedation and as we discussed an SMR is not warranted. The program will continue to work towards reunification with the child's uncle. Please let me know if you need anything further. Michael Michael L. Bartho lomew, M.D ., FAAP CDR, U.S. Public Health Service Director , Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Bui lding 330 C St SW, MS 5123 Washington , DC 20201 Phone : 202 -401-5375 michael. bartholomew @acf.hh s.gov /\MERICAi\ pVERSIGHT EXT-18-248-E-000011 www.acf. hhs.gov From: Bartholomew , Michael (ACF) Sent: Wednesday , July 18, 2018 11:50 AM To: Sualog, Jallyn (ACF) Cc: De LA Cruz , Jame s (ACF) ; Mi segade s, Lara (ACF) Subject: RE: Termination of Pregnancy Hi Jallyn, The UAC recently arrived to the program and the process has yet to begin. Other documentation indicates that the potential sponsor is conferring with his own legal counsel and does not want to submit requested items for spo nsors hip consideration at this time. Michael Michael L. Bartholomew, M.D., FAAP CDR, U.S. Public Health Service Director, Division of Health for Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Re settlement Administration for Children and Families U.S. Department of Health and Human Services Mary E. Switzer Building 330 C St SW, MS 5123 Washington, DC 20201 Phone: 202-401-5375 michae l.baith olomew@acf.h hs.g ov www .acf.hhs.gov From: Sualog , Jallyn (ACF) Sent: Wedn esday , July 18, 2018 7:02 AM To: Bartholomew, Michael (ACF) Cc: De LA Cruz , Jame s (ACF) ; Mi segade s, Lara (ACF) Subject: Re: Termination of Pregnancy What's the statu s ofreunificat ion? On: 18 July 2018 06:57 , "Bartholomew , Michael (ACF)" wrote: Hi Jallyn , I am bringing this to your attention for guidance. /\MERICAi\ pVERSIGHT EXT-18-248-E-000012 Advise is being sought by the FFS and the program on how to proceed . v/r Michael Michael L. Bartholomew , M.D. , FAAP CDR , U.S. Public Health Service Director, Division of Health for Unaccompanied Chi ldren (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and Families U.S . Department of Health and Human Services Mary E. Switzer Building 330 C St SW, MS 5123 Washington, DC 20201 Phone : 202-401-5375 michael. bartho lomew@acf. hhs.g ov www.acf.h hs.gov From: Valdez , Eley (ACF) Sent: Tuesday , July 17, 2018 5: 19 PM To: Bartho lomew , Michael (ACF) ; De LA Cru z, James (ACF ) Cc: Vo lovar, Jill (ACF) Subject: Term ination of Pregnancy Importance: High All, Checking to see if there if any specific updated guidance I need to follow for a terminations of pregnancy. • I have outdated memo but I will tailor and submit; if there' s an updated one p lease let me know. • SIR was completed in relations to minor pregnancy and wishes to terminate. • Minor is 12 weeks pregnant and NY state has a max of 24 week s for terminat ions • NY state does not require that women (underage or not) receive counse ling before an abo1tion • Minors do not need parental con sent • There isn 't a notification or residency requ irement pr ior to terminating pregnancy . • Abortions are paid by NY state , regardless if the pregnancy is result of consensual sex or rape. /\MEf ll Al\ pVERSIGHT EXT-18-248-E-000013 Please advise. Eley Valdez, M.A. , J.D. Federal Field Specialist -N01theast Region U.S . Department of Health and Human Services Division of Unaccompanied Children Operations (DUCO) Office of Refugee Resettlement Mobile: 202fbl(6l I E-mail : elcy. valdez@acf.hh s.gov http://www.acf. hhs.gov/program s/orr/program s/ucs For after hours, weekends and holidays concerns that require immediate assistance/emergencies please contact ORRIDUCO Hotline -Intakes 202-401-5709 11 = = Sende r: I Lloyd, Scott (ACF) "Wagner, Steven (ACF) "; "Wynne, Maggie (HHS/IOS) "; Recipient : "Bowman, Matthew (HHS/OGC) "; "Hayes, Jonathan (ACF) " Sent Date : 2018/07/26 15:33:54 Delivered Date: 2018/07/26 15:33:00 From: Bartho lomew, Michael (ACF) To: "De LA Cruz, James (ACF) " CC: "Misegades, Lara (ACF) " Subject : FW: Ter minat ing pregnancy Date : 2018/07/17 14:06:00 Priority: Normal Type: Note Jim, I am not sure what the current guidance is to the program in this case. Do you know what guidance to issue to the program? /\MERICAi\ pVERSIGHT EXT-18-248-E-000014 They are needing a response. Michael Michael L. Bartholomew, M.D., FAAP CDR, U.S. Public Health Service Director, Division of Health fo r Unaccompanied Children (DHUC) Unaccompanied Children Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services Mary E. Swit zer Building 330 C St SW, MS 5123 Washington, DC 20201 Phone: 202-401-5375 michael. bart ho lomew@acf. h hs.gov www.acf.hhs.gov From : Kiett, Dana (ACF) Se nt: Tuesday, July 17, 2018 9:24 AM To: Valdez, Eley (ACF) ; Patel, Mita (ACF) (CTR) ; ORR DHUC ; Bartholomew, Mich ael (ACF) ; Misegade s, Lara (ACF) ; l(b)(6) l(b)(6) t ~-~ Cc:(b)(6) risingground .org>; Buckley, Kirst en (ACF) ; Pragman, Maria (ACF) (CTR) Subject : RE: Term inat ing pregn ancy Thanks, Mita. Is there anything I need to do on my end? Dana From : Valdez, Eley (ACF) Se nt: Tuesday, July 17, 2018 8:58 AM To : Patel , M ita (ACF) (CTR); ORR DHUC ; Bartholomew , Mich ael (ACF) ; M isegades, Lara (ACF) ; !(b)(6) @risingground.org > Cc:l(b)(6) @risingground.org >; Buckley, Kirst en (ACF) ; Kiett, Dana (ACF) ; Pragman, Maria (ACF) (CTR) Subject: RE: Term inat ing pregn ancy Thank you , Mita . Eley Valdez, M.A., J.D. Federal Field Specialist -Northeast Region /\MERICAi\ pVERSIGHT EXT-18-248-E-000015 U.S. Department of Health and Human Services Division of Unaccompanied Children Operations (DUCO) Office of Refugee Resett lement I Mobile: !(b)(6l E-mail: elcy.valdez@acf .hhs.go v http://www .acf.hhs.gov/program s/orr/programs/ucs For after hours, weekends and holidays concerns that require immediate assistance/emergencies please contact ORR/DUCO Hotline-Intakes 202-401-5709 = = cid:image001.png@01D41DAF.DB6F3E10 From: Patel, Mita (ACF) (CTR) Sent: Tuesday, July 17, 2018 8:43 AM To : ORR DHUC; Bartholomew, Michael (ACF); Misegades, Lara (ACF) Cc: Stephen Mat os; Buckley, Kirsten (ACF); Kiett, Dana (ACF); Valdez, Eley (ACF); Pragman, Maria (ACF) (CTR) Subject: RE: Term inating pregnancy + Dana Kiett (PO), Eley Valdez (FFS), Maria Pragman (CFS) From : Patel, Mita (ACF) (CTR) Se nt : Tuesday, July 17, 2018 8:38 AM To : ORR DHUC ; Bartholomew, Michael (ACF) ; Misegades, Lara (ACF) Cc:~b)(6) @risingground.org>; Buckley, Kirsten (ACF) Subject : RE:Terminating pregnancy Hello Stephen, I am adding DCSMedical t o t his message. Best, Mita Fromf bl(5) ~r isingground.org> Se nt : Tuesday, July 17, 2018 8 :27 AM To: Buckley, Kirst en (ACF) ; Patel, M ita (ACF) (CTR) Subject : Terminating pregnancy Good morning Kirsten and Mita, I am e-mailing you in reference to a minor who was transferred to us yesterday from catholic charities due to minor wanting an abortion and they don't offer those services for her over there. She was counseled over there and that's the minors decision. She is 12 wks and wanted to know if minors still will be able to go to plan pa renthood for this as we did in the past with a Dr. /\MERICAi\ pVERSIGHT EXT-18-248-E-000016 referral? I am not sure if things changed for proc ess with minors wanting to terminate pregnanc y Please advise ... Thank you . so I j ust wanted to be sure . f b)(6) Medical/Travel Coord inator. 914f bl(6) !Outlook for iOS Rising Ground - POH. I CONFIDEN TIALITY NOTICE: This email and any files transm itted with it are confidential and intended solely for the individual(s) to whom ii was addressed. If you are not the named addressee you should not disseminate, distribute , copy or alter this emai l. The information contained in this email has been disclosed to you from confidentia l records, which are protected, by New York State Law OMH 33.13 and I or Federal Regulations 42 CPR Part 2. Disclosure of this information without specific wr itten consent of the person to whom it pertains , or their legal guardian, is strictly prohibited. A ny unauthorized disclosure of this information is in violation of the law and may result in serious legal consequences including fines or a jai l sentence or both. A general authorization for the release of medical or other information is not acceptable for further disclosure. Disclosure of Confidential HIV informat ion that occurs as a result of a general authorization for the release of medical or other information is in violation of the law and may result in serious legal consequences including fines or a jail sentence or both. Any views or opinions presented in this email are solely those of the author and might not represent those of Rising Ground, Inc .. Rising Ground and any of its subsidiaries each reserve the right to monitor all email communications through its networks. Warning: Although Rising Ground, Inc. has scanned this email for viruses and content and taken reasonable precautions to ensure no viruses are present in this email, the company cannot accept responsibil ity for any loss or damage arising from the use of this email or attachments. Sender : Recipient: Bartholomew, Michael (ACF) "De LA Cruz, James (ACF) "; "Misegades,Lara (ACF) " Sent Date: 2018/07/17 14:06:20 Delivered Date: 2018/07/17 14:06:00 Misegades,Lara (ACF) To: "Sualog, Jallyn (ACF) " "Bartholomew, Michael (ACF) "; "De I.A Cruz, James (ACF) " Subject: FW: : Pregnancy; l(b)(5) CC: I Date : 2018/07/13 09:35:37 Priority: Urgent Type : Note Good morning, Jallyn - DHUC is elevating the below notification. I UAC is a 15 yo l(b)(6) who was admitted to Homestead and screened positive for pregnancy. While at Homestead, the minor denied sexually activity. She was transferred to and is currently placed at /\MERICAi\ pVERSIGHT EXT-18-248-E-000017 Boystown . She is reported to be ~12 weeks gestation and had an OB/GYN visit on 7/10 . She has reques ted a termination of pregnancy : more details are provided by the case manager below. Thank you, Lara From : Ventura, Magdalia (ACF) Sent: Friday, July 13, 2018 8:25 AM To: (b)(6) b)(6) Cc : (b)(6) b 6 1M(6) tq)ccadm.org>; =b...,_6 =----_ ___, f-=-~ ...r= ; ORR DHU Subject:: Pregnancy/ J.M.SR. != (b...,_)(6'-'-l ___ __, Good Morning Romy, I am adding the medical team and Jim to this email for their guidance on how we need to proceed . Maggie Ventura, BSW, LSW Federal Field Specialist/ Florida Region Division of Chi ldren's Services Office of Refugee Resettlement Administrat ion fo r Chi ld ren and Families U.S. Department of Hea lth and Human Services 202-868-9706 magdalia.ventura@acf.hhs .gov www .acf.hhs .gov/programs/orr/ I 5 fbl( ) l@ccadm .org > From : !(b)(6) Sent: Thursday, July 12 , 2018 6:49 PM /\MERICAi\ pVERSIGHT EXT-18-248-E-000018 To: Ventura , Magdalia (ACF} > Cc: l(b)(6) j(b)(6) @ccadm.org >; Husted, Karen I (ACF >; !{b)(6) (b)(6) ccadm.org >; l(b)(6_ l ,q(b)(6) @ccadm.org >; b 6 j > I Subject: Pregnancy/ J.M.SR !{bl(6l I Good evening Maggie , Following the Garza informational meetin this mornin with the pregnant minors in care , one of the (b)(6) has expressed that , after evaluating the options minors l(b)(6) presented to her, she wishes to terminate her pregnancy as soon as possible. The Minor's family is in full support of the minor's decision and they wou ld like for the minor to terminate her pregnancy prior to reunification with the sponsor. At this moment, the sponsor has not provided any reunification documents due to fear of providing IDs and fingerprints; he is willing to help but he is consult ing with his lawyer prior to submitting documentation to the CM . Seeing as this case is already behind, we are requesting the minor be transferred to another facility so she is able to receive the care that she is request ing as reunification w ith the sponsor has not yet begun. Please advise and assist. Thank you. I Kind regards, l(b)(6) Lead Case Manager Children's Village Boystown Cathol ic Char ities l(b)(6) ~ccadm.org tel l(b)(6) http://www .ccadm .org http://www .facebook .com/ccadm The information conta ined in this transmission may contain privileged and confidentia l information , including patient information protected by federa l and state privacy laws. It is intended only for the use of the person(s) named above. If you are not the intended recipient, you are hereby notified that any review , dissemination , distribut ion, or duplication of /\MERICAi\ pVERSIGHT EXT-18-248-E-000019 this communication is strictly prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. Sender : Misegades, Lara (ACF) "Sualog, Jallyn (ACF) "; "Bartholomew, Michael (ACF) "; "De LA Cruz, James (ACF) " Sent Date: 2018/07/13 09 :35:36 Delivered Date : 2018/07/13 09 :35:37 From: Misegades, Lara (ACF) To: "Sualog, Jallyn (ACF) " "Bartholomew, Michael (ACF) "; CC: "De LA Cruz, James (ACF) " I Subject: FW: : Pregnancy A(b)(6) l/h\In\ Date: 2018/07/13 09 :35 :37 Priority: Urgent Type: Note Good morning, Jallyn - DHUC is elevating the below notification. I UAC is a 15 yo l(b)(6) who was admitted to Homestead and screened positive for pregnancy. While at Homestead , the minor denied sexually activity. She was transferred to and is currently placed at Boystown . She is reported to be -12 weeks gestation and had an OB/GYN visit on 7/10. She has requested a terminatio n of pregnancy; more details are provided by the case manager below. Thank you, Lara From: Ventura, Magdalia (ACF) Sent: Friday, July 13, 2018 8:25 AM < f bl (6) ~ccadm.org> To: l(b)(6) I /\MERICAi\ pVERSIGHT EXT-18-248-E-000020 Cc:l(b)(6) @ccadm .or >; rb)(6) @ccadm .org>; "-'l (b.._.} (6 '-'-} _ _, k!ili&J4(b)(6) IDccadm.org>: i(b)(6) I (b)(6) ccadm .org> ; De LA Cruz , James (ACF) ; ORR DHUC ; Volovar , Jill (ACF ) Subject: : Pregnancy / l(b)(6) A#XXX ~~ (b_)(6_) -- I Good Morn ing ~ I am adding the medical team and Jim to this email for their guidance on how we need to proceed. Maggie Ventura, BSW, LSW Federal Field Specialist/Florida Region Division of Chi ldren 's Services Office of Refugee Resettlement Administrat ion for Chi ldren and Families U.S. Department of Health and Human Services 202-868-9706 magdal ia .ventura@acf.hhs .gov www .acf .hhs .gov/programs/orr / From: fbl(6) @ccadm .org > Sent: Thursday, July 12, 2018 6:49 PM To: Ventura , Magdalia (ACF) > Cc: fb)(6) @ccadm.org >; b 6 >; b 6 ccadm.org tel l(b)(6) http://www.ccadm.org http://www.facebook.com/ccadm The information contained in this transmission may contain privileged and confidentia l information , including patient information protected by federa l and state privacy laws . It is intended only for the use of the person(s) named above . If you are not the intended recipient , you are hereby notified that any review , dissemination , distribution, or duplication of this communication is strictly prohibited . If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. Sender: Misegades, Lara (ACF) "Sualog, Jallyn (ACF) "; "Bartholomew, Michael (ACF) "; "De LA Cruz, James (ACF) " Sent Date: 2018/07/13 09:35:36 Delivered Date: 2018/07/13 09:35:37 /\MERll Al\ pVERSIGHT EXT-18-248-E-000022 Pilato, Anna (ACF) ! ~b)(6) bisuccessfulsurvivors.org> "; "Wagner, Steven (ACF) "; "Negri, Warren A. (ACF) "; "Lloyd, Scott (ACF) "; "Wubbenhorst, William (ACF) "; "Milner, Jerry (ACF) "; "Sellers, Angela (ACF) " kbH6l CC: "Ashton, Sheraud (ACF) " Subject : Re: CONFERENCE CALLre national launch of LOVEIS ACTIONCOMMUNITYINITIATIVE Date : 2018/04/19 21:16:41 Priority : Normal Type: Note Hello ~l wrote: Greet ings, the OTIP folks have sched uled a call for Tue, Apr 24 - 3pm eastern. Can we make that work for you? /\MERICAi\ pVERSIGHT EXT-18-248-E-000023 !(b )(6) l(b )(6) l(b)(6) www.successfulsurvivors.org TODAYSHOW Intervi ew Here are tips for having tough conversation s with kids. Let's connect! Skype: !(b-'-'...... )(6-'l ___ __. Facebook/successfu lsurvivorsfoundation / Y ouTube: l(b)(6) Instagram: Successfulsurvivor Linkedln /\MERICAi\ pVERSIGHT l(b)(6 l EXT-18-248-E-000024 Twitter: l(b)(6) Possibly imperfect. Please excuse brevity and any errors. Begin forwarded message: From : l, Deb Augu stine , Katherine Chon , /\MERICAi\ pVERSIGHT EXT-18-248-E-000025 ~.;..._-~ ~===~ ,.__ __ __.I { b)(6) mail.com>, (b)(6) (b)(6) ®gmail.com>, !(b)(6) I Cc: "Pilato, Anna (ACF)" , "Lloyd, Scott (ACF)" , "Milner, Jerry (ACF)" , "Wubbenhorst, William (ACF)" , carolyn .hightower@acf.hhs .gov, warren.neg ri@acf.hhs.g ov, _ 6) Angela.Sellers@ACF.hhs.gov, l_____ ~ Thank you for all you do for kids and families. /\MERICAi\ pVERSIGHT EXT-18-248-E-000026 !(b)(6) l(b)(6) l I~successfulsurvivors.org>"; !lb\/6\ "Wagner, Steven ( < o=Exchangelabs/ou=Exchange Administrative Group (FYDI BOHF23SPDL T)/cn =Recipients/cn = 3cec05da5lab4c7c978051f08d947637-Wagner, Jam>"; "Negri, Warren A. (ACF) "; "Lloyd, Scott (ACF) "; Recipient : "Wubbenhorst, William (ACF) "; "Milner, Jerry (ACF) "; "Sellers, Angela (ACF) "; "Ashton, Sheraud (ACF) " Sent Date: 2018/04/ 19 21:16:40 /\MERICAi\ pVERSIGHT EXT-18-248-E-000027 Delivered Date:12013f04f19 21:15:41 Milner, Jerry (ACF) I ,¥b)(6) tlisuccessfulsurvivors.org > "; "Wubbenhorst, William (ACF) "; "Lloyd, Scott (ACF) " kbH6l "Negr i, Warren A. (ACF) "; CC: "Dukes, Amanda (ACF) " Subject : Re: CONFERENCECALL TUESDAY, APRIL 24TH 3 p.m. Dial llhlln l l pc 1rh \/ li \ II Date : 20 18/04/23 13:04:44 Priority : Norma l Ty pe : Note Thanks and I'm sorry but I am keynoting another conference tomorrow and won't be able to join. On: 23 April 2018 12:03, .._l (b..._ )(6.._ l ____ __,Ifbl (5l @successfulsurvivors.org >wrote: Good morning! Would you please advise if you can join the 15 minute conference call tomorrow at 3 p.m. to discuss the national launch of the LOVE IS ACTION COMMUNITY INITIATIVE? We greatly value your input, and so hope that you can make it. If this timing doesn't work for you, would you please provide alternative times? /\MERICAi\ pVERSIGHT EXT-18-248-E-000029 Thank you! !(b)(6) l(b)(6) l(b)(6) www.successfu lsurvivors .org TODAYSHOW Intervi ew Here are tips for having tough conversations with kids. Let's connect! l ___ Skype: "-l (b.;..;. )<6..... /\MERICAi\ pVERSIGHT ___, EXT-18-248-E-000030 Facebook/successfulsurvivorsfoundation/ 6l Y ouTu be: ICb)( Instagram: Successfulsurvivor 6l Linkedin lCbl( Twitter: l(b)(6) Possibly imperfect. Please excuse brevity and any errors. On A r 19, 2018, at 1:33 PM, l~ (b~ )(6 ~) ---~ 5 (b}( } successfulsurvivors.or >wrote: Greetings, the OTIP folks have scheduled a call for Tue, Apr 24 - 3pm eastern. Can we make that work for you? /\MERICAi\ pVERSIGHT EXT-18-248-E-000031 !(b)(6) l(b)(6) l(b)(6) www.successfu lsurvivors.org TODAY SHOW Interview Here are tips for having tough conversations with kids. Let's connect! Skype : l._ (b_)(6_>___ __. Facebook/successfulsurvivorsfoundation/ 6) Y ouTube : l Subject: Request for CONFERENCE CALL re national launch of LOVE IS ACTION COMMUNITY INITIATIVE Date: April 18, 2018 at 10:16:10 AM PDT To: "Wagner , Steven (ACF)" , Deb Augustine , Katherine Chon , /\MERICAi\ pVERSIGHT EXT-18-248-E-000033 Cc: "Pilato, Anna (ACF)" , "Lloyd, Scott (ACF)" , "Milner, Jerry (ACF)" , "Wubbenhor st, William (ACF)" , carolyn.hightower@acf.hhs .gov, wan-en.negri@acf.h hs.gov, _ Angela.Se llers@ACF. hhs.gov, l~(b_)(6_) ---~ 1(b)(6) @tavpro.com> Greeting s! If th ere is a tim e in the next two weeks that you could invest 10-15 minutes in a call regarding the national launch of th e LOVE IS ACTION COMMUNITY INITIATIVE to engage faith, business, and other community stakeholders in the fight against domestic violence, traffi cking , substan ce abuse, etc., please select dates below. http s:// doodle.com/ polll~ (b_)(6_) ____ /\MERICAi\ pVERSIGHT ~ EXT-18-248-E-000034 Thank you for all you do for kids and families. l(b)( 6) !(b)(6) l(b)(6) www.success fulsurvivors.org www.loveisact ioncommu nityin itiative.org www.yourrea lsuccess.o rg Possibly imperfect. Sent from /\MERICAi\ pVERSIGHT ~l ! ~(b)(6) [Qlsuccessfulsurvivors.org > "; "Wubbenhorst, William (ACF) "; "Lloyd, Scott (ACF) "; "Negri, Warren A. (ACF) "; "Dukes, Amanda (ACF) " i(bl(6l Sent Date: 2018/04/23 13:04:43 Delivered Date: 2018/04/23 13:04:44 /\MERICAi\ pVERSIGHT EXT-18-248-E-000036 Wubbenhorst, William (ACF) !lb\/6\ I,~ successfulsurvivors.org>"; "Milner, Jerry (ACF) < o= xchangeLabs/ou=Exchange Administrat ive Group 1 To: (FYDIBOHF23SPDLT)/cn =Recipients/cn =b184ed67b2b841389adlb8 0080916823-Milner, Jer> "; "Lloyd, Scott (ACF) " "Negri, Warren A. (ACF) "; CC: " Dukes, Amanda (ACF) " Subject: Re: CONFERENCECALL TUESDAY, APRIL 24TH 3 p.m. Dial lwrote : Good morning! Would you please advise if you can join the 15 minute conference call tomorrow at 3 p.m. to discuss the national launch of the LOVE IS ACTION COMMUNITY INITIATIVE? We greatly value your input , and so hope that you can make it. If this timing doesn't work for you , would you please provide alternative times? /\MERICAi\ pVERSIGHT EXT-18-248-E-000037 Thank you! l(b)(6) l(b )(6) l(b)(6) www.successfulsurvivors.org TODAY SHOW Interview Here are tips for having tough conversations with kids. /\MERICAi\ pVERSIGHT EXT-18-248-E-000038 Let's connect! Skype: ,_l (b_ l(6_l ___ ___. Facebook/successfu lsu rvivorsfou ndation/ YouTube : l(bl(6l lnstagram : Successfulsurvivor Linked In l(bl(5 > Twitter: l(b)(5 > Possibly imperfect. Please excuse brevity and any errors. Apr 19, 2018, at 1:33 PM , l(bl(6l l(bl<6> 1(bl(6 l ~successfulsurvivors.org>wrote: On /\MERICAi\ pVERSIGHT EXT-18-248-E-000039 Greetings , the OTIP folks have scheduled a call for Tue , Apr 24 - 3pm eastern . Can we make that work for you? l(b )(6 ) l(b )(6) l(b )(6) www .successfulsu rvivors.org TODAY SHOW Interview Here are tips for having tough conversations with kids . /\MERICAi\ pVERSIGHT EXT-18-248-E-000040 Let's connect! > ___ Skype: l,__ _<5_ ____, Facebook/successfu lsurvivorsfoundation/ YouTube: rb )(5) lnstagram : Successfulsurvivor 6> Linkedln l< 5> Twitter : l< Possibly imperfect. Please excuse brevity and any errors. Begin forwarded message: /\MERICAi\ pVERSIGHT EXT-18-248-E-000041 From: b)( 6 l successfulsurvivors.or > Subject: Request for CONFERENCE CALL re national launch of LOVE IS ACTION COMMUNITY INITIATIVE Date: April 18, 2018 at 10:16:10 AM PDT b)(6) b)(6) b)(6) (b)(6) b)(6) (b)(6) (b)(6) van uard.edu>, ==....:....=....:= > , !(b)(6) ~l (b_l(6_l ____ ~ ! cafo.or >, @fostercarecloset.org>, conniec lendenan.com, Congressman Dana Rohrabacher , ~,-------____, /\MERICAi\ pVERSIGHT f bl(6l EXT-18-248-E-000042 Rachel Green@Heller.Senate.gov Cc : "Pilato , Anna (ACF)" , "Lloyd , Scott (ACF)" , "Milner, Jerry (ACF)" , "Wubbenhorst, William (ACF)" , caro lyn.hiqhtower@ac f .hhs.gov , warren.negri@acf.hhs.gov, _ 6> An ela.Sellers ACF.hhs. ov, l(bl( (b)(6) ...__ ___ ___, Greetings ! If there is a time in the next two weeks that you could invest 10-15 minutes in a call regarding the national launch of the LOVE IS ACTION COMMUNITY INITIATIVE to engage faith , business , and other community stakeholders in the fight against domestic violence, trafficking , substance abuse, etc., please select dates below. 5 https://doodle.com/poll f~ b-(l _> ------~ Thank you for all you do for kids and families . l(b)(6) i(b)(6) /\MERICAi\ pVERSIGHT EXT-18-248-E-000043 l< >_ __._l < _6>__ ...., Wubbenhorst, William (ACF) I ~(b)(5) @successfulsurvivors.org>"; kbH6l Recipient: "Milner, Jerry (ACF) "; /\MERICAi\ pVERSIGHT EXT-18-248-E-000044 " Lloyd, Scott (ACF) "; "Neg ri, Warren A. (ACF) "; " Dukes, Amanda (ACF) " Sent Date: 20 18/04/23 18:4 7:02 Delivered Date: 2018/04/23 18:47 :03 /\MERICAi\ pVERSIGHT EXT-18-248-E-000045 ll(b)(6) From: i(b}(6} k!'lsuccessfulsurvivors.org> "Chon, Katherine (ACF) "; "11Phnr;,hc: 11... n,u,tine "; b)(6) l:wnealfamilyfoundation.com>"; wsafefamilies.net>"; ''"'" b\/6\ I n'lnmail.com>"; fh\/n\ I !J)gmail.com>"; b)(6) La>abchomes.org>"; I (b)(6) lglcompactfamilyservices.org>"; bl/6\ ICllblackmountainhome.org>"; (b)(6) ~obhc .org>"; l"\IIUO<:C Ud [ [ ,c .. u1c;c. l .Ud11 <=" ...,t-'.yvV> 11 ; 19Jroyalfamilykids.org>"; To: fh\/R\ I l!)usc.eau>"; I b\/6\ twaliainnovations.org>"; l(Qlvanguard .edu> "; In\/nl bl/6\ I l§lcafo.org>"; 11b\/6\ I trucafo.org>"; b)(6) fostercarecloset.org> "; fQlgmail.com"; (b)(6) ··congressmanuana Rohrabacher"; "Green, Rachel(Heller) "; "Wubbenhorst, William (ACF) "; "Hightower, Carolyn (ACF) " n ll lil " Pilato, Anna (ACF) "; " Lloyd, Scott (ACF) "; "Wagner, Steven (ACF) "; "Milner, Jerry (ACF) "; " Negri, Warren A. (ACF) "; "Sellers, Angela (ACF) " Subject: TODAY'SCONFERENCE CALLre national launch of LOVEIS ACTIONCOMMUNITY I NITIATIVE Date: 2018/04/24 09:03:08 Priority : Normal Type: Note Good morning, for those who are able to join in this 15-min conference call today at noon pacific/3 eastern the call-in information is: Dial b)(B) PC (b)(6) • • The topic of this ca ll is HOW BEST TO LAUNCH THE LOVE IS ACTION COMMUNITY INITIAT IVE so that it is sustainable in the long term and doesn' t live or die depending on who lives in the White House. /\MERICAi\ pVERSIGHT EXT-18-248-E-000046 o • Is a White House Summit on Children And Families the best way to encourage communities to launch OR is there a different, less political alternative? Given the time constraints on this call, if there are specific points or questions you would like to raise, please email me prior to the call so that I can be sure to call on you as time permits. Many thank s to the OTIP team for facilitating this call. l(b)(6) l(b)(6) l(b)(6) www.successfulsurvivors.org TODAYSHOW Interview Here are tips for having tough conversations with kids. Let's connect! Skype: .-I Cb -)(6_)___ __ F acebook/successfulsurvivorsfoundation/ 6) YouTube: ICb)( I Instagram: Successfulsurvivor Linkedln ICb)( 6) I 6 Twitter: ICb)C l Po ssibly imperfect. Please excuse brevity and any errors . On Apr 18, 2018, at 10:16 AMfbl(5l jillsuccessfulsurvivors.org wrote: Greetings! If there is a time in the next two weeks that you could invest 10-15 minutes in a call regarding th e nat ional launch of the LOVE IS ACTION COMMUNITY INITIATIVE to engage faith, business, and other community stakeholders in the fight against domestic violence, trafficking, substanc e abuse, etc., please select dates below. https://doodle.com/poll/ ~I Cb _l<5_>_____ ~ Thank you for all you do for kids and families. l(b)(6) /\MERICAi\ pVERSIGHT EXT-18-248-E-000047 l(b)(6) l(b)(6) www.successfulsurvivors.org www.loveisactioncommunityinitiative.org www.yourre alsuccess.org Possibly imperfect. Sent from I Sender : !rb}/6} "'-! (b""") (..... 6)_____ .....,I phone. successfulsurvivors.org> b)(6) "Pilato, Anna (ACF) "; "Lloyd, Scott (ACF) "i "Wagner, Steven (ACF) 11 ; "Milner, Jerry (ACF) "; "Negri, Warren A. (ACF) "; "Sellers, Angela (ACF) "; "Chon, Katherine (ACF) "; "Deborah S. Au ustine "; b)(6) @nealfamilyfoundation.com>"; ''".:cii;;;-,~....1-=l /b= \= /6:;;; \ ;::::::::;;'l@safefamilies.net> "; 111 mail.com>"; lf.:-~ ----.----,::--:--:--..-gmail.com> "; ,__ __ ......__ -r-abchomes .org> "; n...~-----__,-----. IF.",'.;;,:,. ------- mpactfamilyserv ices.org>"; =Wll..J>.Ws.JPntainhome.org> "; obhc.org> "; _-g'o-v>"; - ~,,,,,.. --------,;:,---- @royalfamilykids.org>"; u-s-c._e_.,u>"; ,....,~ ------~~ ..,,_,~ _____ _,__ __ ...c..: a..:.:lia innovations.org>" i ~ --,, __,_ vanguard.edu> "; cafo .org>"; lt'::-':~-------r.:,..,..,., ~~ ~~ -"""'C~-,----'---,__ Cl.@ 1~cafo.org>"; _J!! fostercarecloset.org > "; -----~ gmail.com"; "Congressman Dana Rohrabacher "; "Green, Rachel (Heller) "; "Wubbenhorst, William (ACF) "; "Hightower, Carolyn (ACF) " Sent Date: 2018/04/24 09 :00: 11 Delivered Date: 2018/04/24 09:03:08 /\MERICAi\ pVERSIGHT EXT-18-248-E-000048 ~.,.~~su1.v,<,.r DEPARTMENT OF HEALTH & HUMAN SERVICES ADMINISTRATION FOR CHILDREN AND FAMILIES Mary E. Switzer Building 330 C ST, S.W. Washington, D.C. 20201 "'",ou Case No: 18-F-0029 Civil Action 18-cv-0248 January 22, 2019 Ms. Katie O'Connor Legal Counsel Campaign for Accountability 611 Pennsylvania Avenue, SE, #337 Washington, D.C. 20003 Dear Ms. O'Connor: This is the sixth interim response of the Administration for Children and Families to Ms. Katie O'Connor's October 27, 2017, Freedom of Information Act (FOIA) request for records related to services for pregnant unaccompanied immigrant minors. Specifically, Ms. O'Connor sought the following items: 1. All records related to Office of Refugee Resettlement ("ORR") policy regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. This request includes memoranda, directives, policy statements, policy interpretations, policy guidance, talking points, and other similar documents reflecting ORR policy. 2. All records related to ORR Director Scott Lloyd's visits to ORR grantee shelters that house unaccompanied immigrant minors. This request includes calendar entries, travel and accommodation requests and approvals, itineraries, briefing memoranda, and meeting notes. 3. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and representatives of the Susan B. Anthony List, Concerned Women for America, the Heritage Foundation, the Center for Family and Human Rights ("C-Fam"), National Right to Life, Alliance Defending Freedom, Legal Works Apostolate, or the Knights of Columbus regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. This request includes communications to or from anyone using email addresses from the following domains: a. @sba-list.org b. @cwfa.org c. @heritage.org d. @c-fam.org e. @nrlc.org f. @adflegal.org g. @legalworks.com h. @kofc.org 4. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and representatives of the White House regarding Case No. 18-F-0029 Civil Action 18-cv-0248 Page 2 of 2 services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. 5. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and members and staff of the U.S. Congress regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. Your request was sent to the Office of Refugee Resettlement (ORR) and the Office of the Chief Information Officer for a search for responsive records. Please find enclosed 31 pages of responsive records responsive in part to Items 1, 4, and 5 above. Five-hundred and twenty pages are being sent to other HHS components and other agencies for consultation. Portions of the information on the enclosed pages has been withheld under the FOIA exemption (b)(6). The FOIA exemption (b)(6) permits the withholding of records which, if released, would constitute a clearly unwarranted invasion of personal privacy. In this case, the withheld information consists of the names, identities, email addresses, phone number, and/or other private information of private individuals and the cell phone numbers of federal employees. Public disclosure of this information would constitute an invasion of privacy of those individuals whose identifying information was disclosed. In withholding the information, the individual's privacy interest was balanced against any public interest in disclosure. In each instance where information was withheld, it was determined that the individual's privacy interests outweighed any public interest in disclosure of the withheld information. Disclosure of the withheld information would invade the privacy of the subject individuals but would reveal nothing about the operations or activities of the government. Sincerely yours, Carla C. Smith -S Digitally signed by Carla C. Smith -S DN: c=US, o=U.S. Government, ou=HHS, ou=ACF, ou=People, cn=Carla C. Smith -S, 0.9.2342.19200300.100.1.1=20013802 47 Date: 2019.01.22 11:22:28 -05'00' Celeste Smith Director, Freedom of Information Office Office of Communications Administration for Children and Families Department of Health and Human Services Lloyd, Scott (ACF) To: "Zadrozny, John A. EOP/WHO ;:;.. w _h _o_.e _o..;. p...; .g::... o_v_>_" _________ ---1 "Miller, Stephen EOP/WHO "; "Wagner, Steven (ACF) "; "Marriott, Brian (ACF) " Subject : ORR press event mid-May Date: 2018/04/27 09:45:00 Priority: Norma l Type: Note John, Thank you , Scott Lloyd, Scott (ACF) "Zadrozny, John A. EOP/WHO "; "Miller, Stephen EOP/WHO "; "Wagner, Steven (ACF) "; "Marriott, Brian (ACF) " Sent Date: 2018/04/27 09:46:06 Delivered Date: 2018/04/27 09:45:00 EXT-18-248-F-000001 Date: 20 18/05/06 18:04:08 Priority: Normal Type: Contact Display Name: Joyce, Shannon M. EOP/OMB Email Address: @omb.eop.gov I Sent Date: !2018/05/06 18:04:08 EXT-18-248-F-000002 Date: 20 18/05/06 18:04:08 Priority: Normal Type: Contact Display Name: Aguilar, Brenda L. EOP/OMB Email Display Name: Aguilar, Brenda L. EOP/OMB Email Address: omb.eop.gov I Sent Date: !2018/05/06 18:04:08 EXT-18-248-F-000003 Date: 20 18/05/06 18:04:08 Priority: Normal Type: Contact Display Name: Theroux, Rich P. EOP/OMB Email Display Name: Theroux, Rich P. EOP/OMB Email Address: omb.eop.gov I Sent Date: !2018/05/06 18:04:08 EXT-18-248-F-000004 Lloyd, Scott (ACF) ------_______ To _: ;... n_sc_.e_o~p..:: .g;... ov_"___________________ ----1 Subject: Waves hold-up Date : 2018/05/10 12:49:41 Priority: Urgent Type: Note Amy, Not sure what happened but I'm not waved in. I re-submitted my information just now if there ' s something you need to do on your end. Thank you, Scott ------____ Lloyd, Scott (ACF) R_e_c__ ip_ie_n_t: ;;..n_s_c._eo ..:. p....: .g::.. o_v'_' ---------------------1 Sent Date: 2018/05/10 12:49:41 EXT-18-248-F-000005 Lloyd, Scott (ACF) To: "Norris, Amy B. EOP/NSC nsc.eop.gov>" Subject : Accepted: U.S. RefugeeAdmissions Program (USRAP)PCC Date : 2018/05/24 18:18:31 Start Date: 2018/06/01 15:00:00 End Date: 2018/06/0116:20 :00 Priority: Normal Type: Schedule.Meeting.Resp.Pos Location: EEOB445 Lloyd, Scott (ACF) Recipient: "Norris, Amy B. EOP/NSC nsc.eop.gov>" Sent Date: 2018/05/24 18:18:31 EXT-18-248-F-000006 Lloyd, Scott (ACF) To: "Holm, Jim S. EOP/OMB omb.eop.gov>" Subject : Accepted: Hold: Zero Tolerance/ResourceWorking Group Date : 2018/05/25 13:17:04 Start Date: 2018/05/25 15:00:00 End Date: 2018/05/25 16:00:00 Priority: Normal Type: Schedule.Meeting.Resp.Pos I---------'--'--- ~------ Location: ~ ------------------------i (or NEOB 10209for EOPparticpants) Lloyd, Scott (ACF) Recipient: "Holm, Jim S. EOP/OMB omb.eop.gov>" Sent Date: 2018/05/25 13:17:04 EXT-18-248-F-000007 From: Mitchell Keenan ~ :;..; g::.. m _a_i_ l.c_o_m_>_______________ T . "Lloyd, Scott (ACF) " CC. "degette@mail.house .gov"; o "Michael Bennet, US Senator for Colorado " Subject : Where are the missing children Date: 20 18/05/28 01:11:01 Priority: Norma l Type: Note Dear Mr . Lloyd, Where are the missing children? Thank.you. Denver, Colorado 80220 Sender: Mitchell Keenan ;..:;.. __________________ ~ gmail.com> "Lloyd, Scott (ACF) "; ecipien . "degette @mail.house.gov"; "Michael Bennet, US Senator for Colorado " Sent Date: 2018/05/28 01:10:50 Delivered Date: 2018/05/28 01:11:01 EXT-18-248-F-000008 Lloyd, Scott (ACF) To: "Bristow, Justin A. EOP/NSC ::.,_ ns_c_.e_o:_ P..go ::._v_>_"_________ ----1 Subject : Accepted: Border Security PCCrecurring meeting Date : 2018/05/29 19:03:00 Start Date: 2018/05/31 11:00:00 End Date: 2018/05/3112:30 :00 Priority: Normal Type: Schedule.Meeting.Resp.Pos Location: EEOB476 Lloyd, Scott (ACF) Recipient: "Bristow, Justin A. EOP/NSC nsc.eop.gov>" Sent Date: 2018/05/29 19:03:32 Delivered Date: 2018/05/29 19:03:00 EXT-18-248-F-000009 Lloyd, Scott (ACF) Edwards,Lauren (ACF) To: " Lloyd, Scott (ACF) " Subject: HOLD: Congressional Briefing - UAC Date: 2018/05/30 15:45:07 Start Date: 2018/06/06 14:00:00 End Date: 2018/06/06 16:00:00 Priority: Normal Type: Appointment Wait ing for confi rm at ion from OLAB / Anna Marie Wait ing fo r confi rmat ion from OLAB/Anna M arie . Briefing Request #1 : From: Logan, Scott (ACF) Sent: Tuesday, May 29, 2018 1:21 PM To: Bena, Ann a Marie (HHS/O GC) (ACF) ; Kurkj y, Brian (ACF) (CTR) Subject: FW: Briefi ng Request Hi Anna Marie and Brian, Would you please send me some dates/times that Scott Lloyd could do a briefing for Energy and Commerce majority staff on the 1,500 kids? Next week, June 4 wou ld be better but if he on ly has t imes this week, that's fine. An interesting note, one of the House staff members requesting the briefing is Josh Trent. He was ORR's Deputy Director during t he second Bush Administration when Martha Newton was the Director. Thank you, Scott Scott Logan Director Division of Legislative and Regulatory Affairs Office of Legislative Affairs and Budget Administration for Children and Families U.S. Department of Health and Human Services EXT-18-248-F-000010 330 CST, SW Suite 5020D Washington, D.C. 20201 202.401.4 529 From : Barbian, Jennifer Sent : Friday, May 25, 2018 11:57 AM To: Hayes, Sean (HHS/ASL) Cc: Trent, Josh; Havens, Brittany Subject: Briefing Request Hi Sean Sorry to bombard you with requests before the long weekend. We're getting some questions on last month's testimony that HHS had lost track of nearly 1,500 migrant children placed with U.S. sponsors. Steven Wagner (Administration for Children and Families) testified about it before Senate. Can we set up a staff briefing to get an update on this? Next week or early the week of June 4 would be ideal so we can brief the membe rs when they return. https://mobi le.nyt imes.com/2018/04/26/us/po missing.html#cl ick=https://t.co/ac tJjumDNz litics/migrant-chi ldren - Thanks, Jen Jennifer Barbian Chief Counsel, Overs ight & Investigations Committee on Energy & Commerce Hon. Greg Walden, Chairman Briefing Reque st #2 : From : Logan, Scott (ACF) Sent: Tuesday, May 29, 2018 1:49 PM To: Bena, Anna Marie (HHS/OGC) (ACF); Kurkjy, Brian (ACF) (CTR) Subje ct: FW: Rep. Burgess mtg request: Next week Briefing #2, this one for Dr. Burgess. Would you please send me another set of dates/times Scott Lloyd could do this one next week? ASL w ill see if they would agree to do a jo int briefing with the Energy and Commerce staff but it's doubtful since th is is a personal briefing for Dr. Burgess (he's on Energy and Commerce) . From: Huggins, Rachel fmailto:Rachel.Huggins@mail.house.gov] Sent: Tuesday, May 29, 2018 1:34 PM To : Logan, Scott (ACF) EXT-18-248-F-000011 Cc: Baldwin, Amanda Subject : Rep. Burgess mtg request: Next week Hi Scott, Dr. Burgess would like to meet with someone from ORR or ACF to discuss illegal arrivals along the Southwest border . Previously, Dr. Burgess did a lot of work with ORRon how UACswere treated and has been to the border and ORRfacilities numerous times . Our most recent concern was what happened to UACswhen released to sponsors since many of them could not be tracked. I believe part of the problem was that it was outside of HHSjurisdiction to do so. Given recent reporting on the separation of children from their parents, Dr. Burgess would like to get an update on the situation and current detention policies. Please let me know what you need from me to facilitate this meeting. As I mentioned, Dr. Burgess has requested that this meeting take place next week and is willing to come to HHS offices if need be. He can also be available to fly in Monday . Thank you, Rachel Huggins Legislative Director Rep. M ichael Burgess (TX-26) 2336 Rayburn HOB Washingt on, D.C. 205 15 (202) 225-7772 Lloyd, Scott (ACF) ; Edwards, Lauren (ACF) Recipient : "Lloyd, Scott (ACF) " Sent Date: 2018/05/30 15:45:07 EXT-18-248-F-000012 From: Andrew-P ike centurylink .net > To: "hist ory@mail.house.gov" CC. "art@ma il.house.gov"; o "archives@mail.hou se.gov" Subject: Bond Docket & Original Process Date: 20 18/05/30 16:07:38 Priority: Normal Type: Not e Dear Honorable Clerk of Archives ; I am emailing you on our governments' historical form , being a Judiciary, and letters of settlement as perscribed Supreme Court of the United States Rule Seventeen award and private property unlawfully witheld BOND 7/14/17 AB U.S.C .A. 7th to be set on Congressional depository for monetary Bank post outcome, askew. Currently , Clerk Karen Haas late preparation of the Bond, where it now works House ownership ejectment , is requested in her back tracking all she did as a type of preparation the Bond at the time she recieved the Bond up till now. This to include each task Congressman Grijalva subsequently did where now the Bond docket he slung keeps it in bypassing House Appropriations Committee in Congress, where it can be, as why it was obtained, perscribed to Congress, and served, paid once set House Appropriations. Sincerely, Robert T. Keefe Sender: Andrew-Pike centurylink .net> "history@mail .house.gov"; Recipient: "art@mai l.house.gov "; "archives@mail.house .gov" Sent Date: 2018/05/30 16:07:16 Delivered Date: 2018/05/30 16:07:38 EXT-18-248-F-000013 Lloyd, Scott (ACF) To: "Bristow, Justin A. EOP/NSC nsc.eop.gov>" Subject : Maggie isn't waved in ... Date : 2018/05/31 ll:09 :49 Priority: Normal Type: Note Lloyd, Scott (ACF) Recipient: "Bristow, Justin A. EOP/NSC nsc.eop.gov>" Sent Date: 2018/05/31 11:09:48 Delivered Date: 2018/ 05/31 11:09:49 EXT-18-248-F-000014 From: postmaster@p itc .gov To: "Wetmore, David H. EOP/WHO " Subject: Undeliverable: Fwd: Sponsor Declaration (highlighted) Date : 2018/06/04 14:48:20 Priority: Normal Type: REPORT .IPM.Note.NDR Delivery has failed to these recipients or groups: Wetmore David H. EOP WHO This user is no longer able to receive mail Your message wasn't delivered because the email admin for the organization 'pitc.gov' created an email rule restriction . Please contact the email admin for that organization and ask them to remove or update the rule restriction. For more information about this error, see DSN code 5.7 .1 in Exchange Online Office 365 . 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EOP/WHO" Subject (52.135 . com (52 . 135.242.157) ([fe80 :: c8cl : 6983 : ee82 : 59b5]) by BN7PR09MB2788 . namprd09 .p rod.outlook 18:46:26 . prod.outlook.com : Fwd : Sponsor Declaration (highlighted) Declaration (highlighted) Thread-Topic : Sponsor Thread-Index : AdP8MlrbmyvKgkpgSjKmh2uxIHCRQAAAPgri Date : Mon, 4 Jun 2018 . gov> 18 : 46 : 26 +0000 Message - ID : EXT-18-248-F-000021 References: In-Reply-To : Accept - Language: Content-Language: X- MS- Has - Attach: en-US en-US yes X-MS-TNEF-Correlator: x-originating-ip: [2600:1003:b008:dbd8:d90d:2c0c:2a13:901] x-ms - publictraffictype: Email x - microsoft-exchange-diagnostics: l;BN7PR09MB2788;7:xDRy5xBzD1Z97Dvq+SuVqdl3pFO8VHi0LW4LiN8ngUdblPGWbob0S fku36APtejy7PLEVo8A3y/lLXbkR/x2QTv/blOaBtBXoCjXyKDToX9iXfeJkTsqdaYDf33R 3gesXaUSF18pv3xmT5MTW6KeDbWipGpfaNJhfQqcbgDxq72WKqd9BvPCuypNZFWPOiiBoTO v3ULXFWPKad5Irn6GmJfZ37/hjAToO+6zYaXuWPuRK3yQmpEkwrmnCIT1FlGU SOS; x-ms-exchange-a~tispa~-srfa-diagnostics: x-microsoft - antispam : UriScan:;BCL:0;PCL:0;RULEID: (7020095) (4652020) (5600026) (4534165) (462722 1) (201 703031133081 ) (201702281549075) (201 7052603328 ) (7153060) (49563074) ( 7193020) ;SRVR:BN7PR09MB2788; x - ms- traffictypediagnostic : BN7PR09MB2788: x - microsoft-antispam - prvs: x-exchange-antispam-report-test: x-ms-exchange-senderadcheck: UriScan: .p rod.out (197117283949776); 1 x - exchange - antispam - report - cfa-test: BCL:0;PCL:0;RULEID: (102415395) (6040522) (2401047) (5005006) (8121501046) (3 231254) (944501410) (52105095) (10201501046) (93006095) (93001095) (3002001) ( 149027) (150027) (6041310) (20161123562045) (20161123560045) (20161123564045 ) (20161123558120) (201703131423095) (201702281528075) (20161123555045) (201 703061421075 ) (201703061406153) (6072148) (201708071742011) (7699016) ;S~VR: BN7PR09MB2788;BCL:0;PCL:0;RULEID:;SRVR:BN7PR09MB2788; x-forefront-prvs: 069373DFB6 x - forefront-antispam - report : SFV: NSPM; SFS: ( 10 00 9020) ( 7 916004) (37 6002) ( 34 6002) (36 6004) ( 398 604 0 00 02) ( 3 9380400002) (396003) (189003) (199004) (7736002) (102836004) (8936002) (648600 2) (229853002) (33896004) (8676002) (81166006) (811 56014) (33656002) (6506007) EXT-18-248-F-000022 (2900100001) (2920100001) (14454004) (72206003) (33716001) (6116002) (46003) ( 478600001) (99936001) (476003) (446003) (25786009) (54896002) (2473003) (65120 07) (9686003) (236005) (186003) (486006) (11346002) (5250100002) (3660700001) ( 3280700002) ( 99286004) ( 68736007) ( 6916009) (53936002) (106356001) (105586002 ) (2906002) (97736004) (86362001) (316002) (76176011) (6436002) (5660300001) (5 5846006) (82676001) ;DIR : OUT;SFP:110l;SCL:l;SRVR : BN7PR09MB2788;H : BN7PR09M B2788.namprd09.prod.outlook.com;FPR:;SPF:None;LANG:en;PTR:InfoNoRecords ;MX:l;A:l; x-microsoft-antispam-message-info: 9pmdS4A2P8ag+Cei7N0tx4Onwlwz+a3StUvfVzKJN4q+Krz6SnzDISC7cjeRDQRhmAMviAx fZTmlLpPusuv04vN33DEfFgtgEPTinDxEaJoRN1JatBYFiOEv3IyOqo7JGnw5P+lERf5OOZ /3p9xcpN3C9g2IrN9oieb9L69/ALjZvU1KlCAxGzoVe0n9fve0 spamdiagnosticoutput: spamdiagnosticmetadata: Content-Type: 1:99 NSPM multipart/mixed; oboundary="_004_A67D2B3FF0A0AB446F9244AC5B423350F0C84B0Eunknown" MIME-Version: 1.0 : a9ea7e10-5412-4662-8b9a- X-MS-Office365-Filtering-Correlation-Id 08d5ca4b7a67 X- MS- Exchange 08d5ca4b7a67 - CrossTenant - Network - Message X- MS-Exchange 18:46:26.5569 - CrossTenant - originalarrivaltime: X-MS - Exchange - CrossTenant - fromentityheader: X- MS- Exchange - CrossTenant - id : d58addea - Id : a9ea7e10-5412-4662 04 Jun - 8b9a - 2018 (UTC) X-MS-Exchange-Transport-CrossTenantHeadersStamped: Return-Path: Hosted - 5053-4a80 - 8499 - ba4d944910df BN7PR09MB2788 Scott.Lloyd@acf.hhs.gov Sender : postmaster@pitc.gov Recipient: "Wetmore,DavidH. EOP/WHO who.eop.gov> " Sent Date : 2018/06/04 14:46:36 Delivered Date: 2018/06/04 14:48:20 . From: Lloyd,Scott(ACF)" Subject: Fwd:SponsorDeclaration(highlighted) EXT-18-248-F-000023 Date: ,2018/06/04 14:46:35 Type: Note Dave, This is the draft I've referenced, which is different I think from what you had in mind. If you could share with us some ideas on how to pre sent the language, that would be helpful. Thank you , Scott From: "Biswas, Toby RM (ACF)" Subject: Sponsor Declaration (highlighted) Date: 04 June 2018 14:39 To: "Lloyd , Scott (ACF)" EXT-18-248-F-000024 Cc: "Bena, Anna Marie (HHS/OGC) (ACF)" Sender: Lloyd, Scott (ACF) Recipient : "Wetmore, David H. EOP/WHO who.eop.gov>" Sent Date: 2018/06/0 4 14:46:26 Delivered Date : 2018/06/0 4 14:46:35 EXT-18-248-F-000025 Lloyd, Scott (ACF) Jackson, Ms. Chanel (ACF)(CTR) To: " Lloyd, Scott (ACF) " Subject: Briefing for Rep. Burgessand E&CCommittee Date: 2018/06/05 09:02:59 Start Date: 2018/06/08 09:15:00 End Date: 2018/06/08 09:45:00 Priority: Normal Type: Appointment Hi Chanel, Could you put Friday at 9:15 for Scott to do a briefing for Rep. Burgess and E&C Committee (they've agreed to combine the briefing)? Thanks, Anna Marie From: Logan, Scott (ACF) Sent: Tuesday, June 05, 2018 8:22 AM To: Bena, Anna Marie (HHS/OGC) (ACF) Cc: Kurkjy, Brian (ACF) (CTR) Subject: RE: Rep. Burgess mtg request : Next week Does Friday at 9:15 still work? In some good news, Burgess has agreed to combine his meeting request with the E&C committee staff request. Scott Logan Director Division of Legislative and Regulatory Affairs Office of Legislative Affairs and Budget Administration for Children and Families U.S. Department of Health and Human Services 330 CST, SW Suite 5020D Washington, D.C. 20201 202.401.4529 From: Bena, Anna Marie (HHS/OGC) (ACF) Sent: Wednesday, May 30, 2018 3:37 PM To: Logan, Scott (ACF) Cc: Kurkjy, Brian (ACF) (CTR) Subject: FW: Rep. Burgess mtg request: Next week Possibilities for one of the briefings. EXT-18-248-F-000026 From: Edwards, Lauren (ACF) Sent: Wednesday, May 30, 2018 3:37 PM To: Bena, Anna Marie (HHS/OGC) (ACF) ; Kurkjy, Brian (ACF) (CTR) Cc:Jackson, Chanel (ACF) (CTR); Dukes, Amanda (ACF) Subject: RE: Rep. Burgess mtg request: Next week Hi Anna Marie, It looks like Scott could make the following wo rk for this briefing and the one with the Committee on Energy and Commerce (Walden): Tuesday, June sth : 1- 3 {Chanel, Scott said it's ok to move his meeting with Maggie for later in the afternoon if needed.) th Wednesday , June 6 : 2 - 4 Friday, June 8 th : 9 - 10, after 1 pm Lauren From: Bena, Anna Marie (HHS/OGC) (ACF) Sent: Wednesday, May 30, 2018 1:12 PM To: Edwards, Lauren (ACF) ; Kurkjy, Brian (ACF) (CTR) Subject: FW: Rep. Burgess mtg request: Next week Here's the second briefing request. From: Logan, Scott (ACF) Sent: Tuesday, May 29, 2018 1:49 PM To: Bena, Anna Marie (HHS/OGC) (ACF) ; Kurkjy , Brian (ACF) (CTR) Subject: FW: Rep. Burgess mtg request: Next week Briefing #2, this one for Dr. Burgess. Would you please send me another set of dates/times Scott Lloyd could do this one next week? ASL w ill see if they would agree to do a joint briefing with the Energy and Commerce staff but it's doubtful since this is a personal br iefing for Dr. Burgess (he's on Energy and Commerce). From: Huggins, Rachel [mai lto:Rachel.Huggins@mail.house.go v] Sent: Tuesday, May 29, 2018 1:34 PM To: Logan, Scott (ACF) Cc: Baldwin, Amanda Subject: Rep. Burgess mtg request: Next week EXT-18-248-F-000027 Hi Scott, Dr. Burgess would like to meet with someone from ORR or ACFto discuss illegal arrivals along the Southwest border. Previously, Dr. Burgess did a lot of work with ORRon how UACswere treated and has been to the border and ORRfacilities numerous times. Our most recent concern was what happened to UACswhen released to sponsors since many of them could not be tracked. I believe part of the problem was that it was outside of HHSj urisdiction to do so. Given recent reporting on the separation of children from their parents, Dr. Burgess would like to get an update on the situation and current detention policies. Please let me know what you need from me to facilitate this meeting. As I mentioned, Dr. Burgess has requested that this meeting take place next week and is willing to come to HHS offices if need be. He can also be available to fly in Monday. Thank you, Rachel Huggins Legislative Director Rep. Michael Burgess (TX-26) 2336 Rayburn HOB Washingt on, D.C. 20515 (202) 225-7772 Lloyd, Scott (ACF) ; Jackson, Ms. Chanel (ACF) (CTR) Recipient: "Lloyd, Scott (ACF) " Sent Date: 2018/06/05 09:02:59 EXT-18-248-F-000028 From: Jim Guilianelli yahoo.com> "Lloyd, Scott (ACF) "; To: "ORR Director (ACF) " "kirsten_gillibrand@gi llibrand.senate.gov"; CC: "Scheduling_schume r@schumer.senate.gov"; "NY18SMIMA@mail.ho use.gov" Subject: Treatment of immigrants seeking asylum Date: 2018/06/06 10:53:00 Priority : Normal Type: Note Sir, I am appalled at how this administration is handling the influx of refugees at the US/Mexican border. Regardless of the legal issues surround ing immigration , the forced separation of children from parents and th is administration 's refusal to allow a thorough investigation of such actions are deplorable. Your whole process is suspect and requires an open review to ensure humane treatment of those detained . As an American citizen I'm ashamed that this administration can support such barbaric practices . We are certainly better than this. Sincerely , Sender: Jim Guilianelli :..: yc... a_ho _o_._co_m _>__________________ --1 "Lloyd, Scott (ACF) "; "ORR Director (ACF) "; "kirsten_gillibrand@gi llibrand.senate.gov"; "Scheduling _schumer@schumer.senate.gov"; "NY18SMIMA@mail.house.gov" Sent Date: 2018/06/06 10:52:22 Delivered Date: 2018/06/06 10:53:00 EXT-18-248-F-000029 From: Emily Blanck comcast.net> "Lloyd, Scott (ACF) "; "OORDirector@acf.hhs.gov" CC: "Sean Elsbernd " Subject : Return children to their parents and siblings Date: 2018/06/06 20:28:01 Priority: Normal Type: Note Mr. Scott Lloyd Director Office of Refugee Resettlement Admin istration for Ch ildren and Families U.S. Department of Health and Human Services 330 C Street SW Mailstop 5123 Washington, DC 20201 Dear Sir, You have seen 6 chi ldren. How would you like to have them taken fro sleeping on the floor and separated from each other? How can you as way? nd you and put into cages, Catholic treat ch ildren this What are you doing to change this situation and returning these children to their rightful families? . You should be ashamed of his your agency is treating them. Yours, Emily Blanck. Thank you Sent from my iPhone Plea se excuse the brev ity and any typos from my iPhone. comca st.ne t 925"Whi le there is a chance of the world getting through its trouble s, I hold that a reasonab le perso n has to behave as though they were sure of it. If at the end your cheerfulness is not .ustified, at an rate ou will have been cheerful. " H. G. WELLS comcast.net> "Sean Elsbernd "; R . . t . "Lloyd, Scott (ACF) "; "OORDirector@acf.hhs.gov" EXT-18-248-F-000030 Sent Date: 2013f??f?? 20:27:51 Delivered Date: 20:28:01 EXT-1 8-248-F-000031 ~.,.~~su1.v,<,.r DEPARTMENT OF HEALTH & HUMAN SERVICES ADMINISTRATION FOR CHILDREN AND FAMILIES Mary E. Switzer Building 330 C ST, S.W. Washington, D.C. 20201 "'",ou Case No: 18-F-0029 Civil Action 18-cv-0248 February 20, 2019 Ms. Katie O'Connor Legal Counsel Campaign for Accountability 611 Pennsylvania Avenue, SE, #337 Washington, D.C. 20003 Dear Ms. O'Connor: This is the sixth interim response of the Administration for Children and Families to Ms. Katie O'Connor's October 27, 2017, Freedom of Information Act (FOIA) request for records related to services for pregnant unaccompanied immigrant minors. Specifically, Ms. O'Connor sought the following items: 1. All records related to Office of Refugee Resettlement ("ORR") policy regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. This request includes memoranda, directives, policy statements, policy interpretations, policy guidance, talking points, and other similar documents reflecting ORR policy. 2. All records related to ORR Director Scott Lloyd's visits to ORR grantee shelters that house unaccompanied immigrant minors. This request includes calendar entries, travel and accommodation requests and approvals, itineraries, briefing memoranda, and meeting notes. 3. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and representatives of the Susan B. Anthony List, Concerned Women for America, the Heritage Foundation, the Center for Family and Human Rights ("C-Fam"), National Right to Life, Alliance Defending Freedom, Legal Works Apostolate, or the Knights of Columbus regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. This request includes communications to or from anyone using email addresses from the following domains: a. @sba-list.org b. @cwfa.org c. @heritage.org d. @c-fam.org e. @nrlc.org f. @adflegal.org g. @legalworks.com h. @kofc.org 4. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and representatives of the White House regarding Case No. 18-F-0029 Civil Action 18-cv-0248 Page 2 of 2 services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. 5. All communications, meeting notices, meeting agendas, informational materials, talking points, or other documents received by representatives of ORR from, sent by representatives of ORR to, or exchanged between representatives of ORR and members and staff of the U.S. Congress regarding services for pregnant unaccompanied immigrant minors in federal custody and/or housed at ORR grantee shelters. Your request was sent to the Office of Refugee Resettlement (ORR) and the Office of the Chief Information Officer for a search for responsive records. Please find enclosed 30 pages of responsive records responsive in part to Items 1, 4, and 5 above. Five-hundred and thirty four pages are being sent to other HHS components and other agencies for consultation. Portions of the information on the enclosed pages has been withheld under the FOIA exemption (b)(6). The FOIA exemption (b)(6) permits the withholding of records which, if released, would constitute a clearly unwarranted invasion of personal privacy. In this case, the withheld information consists of the names, identities, email addresses, phone number, and/or other private information of private individuals and the cell phone numbers of federal employees. Public disclosure of this information would constitute an invasion of privacy of those individuals whose identifying information was disclosed. In withholding the information, the individual's privacy interest was balanced against any public interest in disclosure. In each instance where information was withheld, it was determined that the individual's privacy interests outweighed any public interest in disclosure of the withheld information. Disclosure of the withheld information would invade the privacy of the subject individuals but would reveal nothing about the operations or activities of the government. Sincerely yours, Carla C. Smith -S Digitally signed by Carla C. Smith -S DN: c=US, o=U.S. Government, ou=HHS, ou=ACF, ou=People, cn=Carla C. Smith -S, 0.9.2342.19200300.100.1.1=200138 0247 Date: 2019.02.20 10:45:23 -05'00' Celeste Smith Director, Freedom of Information Office Office of Communications Administration for Children and Families Department of Health and Human Services Lloyd, Scott (ACF) To: "Wold, Theo J. EOP/WHO~b)(6) ~who.eop.gov>" Subject : coffee tomorrow Date: 2018/06/07 22:26:00 Priority: Normal Type: Note Theo, Let me know if you 're still interested in grabbing coffee tomorrow. Thanks! Scott *** E. Scott Lloyd Director Offic e of Refugee Resettlem ent U.S . Department of Heal th and Human Services (202) 401 -7269 I(cell) (202) !{b}(6) scott .lloyd@acf.hhs.gov Lloyd, Scott (ACF) Recipient: "Wold, Theo J. EOP/WHOf b)(6) ~who.eop.gov>" Sent Date: 2018/06/07 22:26:36 Delive red Date: 2018/06/07 22:26:00 EXT-18-248-G-000001 Consult to HHS OS Justin, Three things: 1. To answer your question below- yes .. .I received an update from the program, just need a minute to type it out. 2. I owe the group a bed capacity plan. I've not forgotten- I am just getting it through final clearance at the Department. Please standby and thank you for your patience. 3. If it is possible to move HHS' piece back toward the end of the meeting, I will be joining the PCC late from another meeting at the WH. Thank you, Scott ~on suit to HHS OS EXT-18-248-G-000003 Consultto HHS OS Consuftto HHS OS Consult t0 HHS OS Consultto HHS OS ,.,onsult to HHS OS Sender: Wynne, Maggie (HHS/IOS) "Wagner, Steven (ACF) "; Recipient: "Lloyd, Scott (ACF) " Sent Date : 2018/06/11 11:52:25 EXT-18-248-G-000008 From: Policy Coordinator Callahan, Kenneth (HHS/ IOS) "Mansdoerfer, David (HHS/OASH)"; "Wagner, Steven (ACF) "; "Lloyd, Scott (ACF) " Subject: FW: Weekly Immigration Update Call Date: 2018/ 06/1112:51 : 13 Start Date: 2018/ 06/12 16:30:00 End Date: 2018/06/ 12 17:00:00 Priority: Normal Type: Schedule.Meeting.Request Location: To be distrubuted PolicyCoordinator ; Callahan, Kenneth (HHS/IOS) "Mansdoerfer, David (HHS/OASH)"; "Wagner, Steven (ACF) "; "Lloyd, Scott (ACF) " Sent Date : 2018/06/ 11 12:51: 10 Delivered Date: 2018/06/1112:51 : 13 EXT-18-248-G-000009 Consultto HHS OS EXT-1 8-248-G-00001 Consult to HS 08 EXT-1 8-248-G-00001 1 .gov> From: Policy Coordinator "Wagner, Steven (ACF) "; " Moughalian, Jen (HHS/ASFR) "; To: "Lloyd, Scott (ACF) "; " Mansdoerfer, David (HHS/OASH)"; "Wynne, Maggie (HHS/IOS) " Subject: FW: Weekly Imm igration Update Call Date: 2018/06/11 15:19:51 Start Date: 2018/06/12 16:30:00 End Date : 2018/06/1 2 17:00:00 Priority: Normal Type: Schedule.Meeting.Request CodeJb)(6) Location: Dial in: (202) i(bl{6} Sender: I I Policy Coordinator ; Callahan, Kenneth (HHS/IOS) "Wagner, Steven (ACF) " ; " Moughalian, Jen (HHS/ASFR) "; Recipient: " Lloyd, Scott (ACF) "i " Mansdoerfer, David (HHS/OASH)"; "Wynne, Maggie (HHS/IOS) " Sent Date: 2018/06/1115:19:48 Delivered Date: 2018/06/11 15:19:51 EXT-18-248-G-000012 Lloyd, Scott (ACF) To: "Policy Coordinator " Subject : Accepted: FW: Weekly Immigration Update ca11 Dat e: 2018/06/11 15:35:00 Start Date: 2018/06/12 16:30:00 End Date: 2018/06/12 17:00:00 Priority: Normal Type: Schedule.Meeting.Resp.Pos I Codef.b)(5) Location: Dial in: (202) i(bl{6} I Lloyd, Scott (ACF) Recipient: " Policy Coordinator " Sent Date: 2018/06/11 15:35:04 Delivered Date: 2018/06/11 15:35:00 EXT-18-248-G-000013 From: Hope L. Hardaker j(b)(6) tligmail.com> " Lloyd, Scott (ACF) "; To: "ORRDirector (ACF) " CC: "Senator_Merkley@merkley.senate.gov" Subject: Responserequested-Human rights violations Date: 2018/06/13 17:58:24 Priority: Normal Type: Note Dea r M r. Lloyd , As a US citizen, Pub lic Hea lth pro fess iona l, and huma n rights advoca te, I want it to be on record that you are co mm itting hum an rights violations aga inst the thousands of adults and childr en whom yo u are keep ing under duress as they arrive to the US seeki ng asylum. Article 5 from the Un iversa l Declara tion of Human Rights No one shall be subjected to tortur e or to cruel, inhum an or degra din g trea tm ent or pun ishm ent. I since rely hope tha t you and the Tru mp administrat ion are held accountable. The worl d is wa tching and waiti ng for this . Please respond and tell me how you intend to reunit e the pare nts with their children whom you 've stolen from the m, and whom you've subje cted to crue l treatmen t. Thank yo u, Hope L. Hardake r, MPH fb)(6) I Sender: Hope L. Hardaker { b)(6) ~ gmail.com> " Lloyd, Scott (ACF) "; Recipient : "ORRDirector (ACF) "; "Senator_Merkley@merkley.senate.gov" EXT-18-248-G-000014 Sent Date: 1?:58:09 Delivered Date: 2018f??f13 17:58:24 EXT-1 8-248-G-00001 5 Lloyd, Scott (ACF) To: l(b)(6 ) ~nsc.eop.gov" Subject : Waves trouble Date: 2018/06/14 09:53:41 Priority: Urgent Type: Note They have my birthday as It is Lloyd, Scott (ACF) Recipient: (b)(6) li)nsc.eop.gov" Sent Date: 2018/06/ 14 09:53:41 EXT-18-248-G-000016 Lloyd, Scott (ACF) To: "Zadrozny, John A. EOP/WHO~(b)(6) t?lwho.eop.gov>" Subject : Could you give me a call when you get a chance? Date : 2018/06/14 18:30:00 Priority: Normal Type: Note Tomo rrow works alright, too. Cell below . Thanks! Scott *** E. Scott Lloyd Director Office of Refugee Resettlement U.S. Department of Health and Human Serv ices (202) 401- 7269 I(cell) (202) !(b)/6) scott. lloyd @acf.hhs.go v Lloyd, Scott (ACF) Recipient: "Zadrozny, John A. EOP/WHOJb)(6) l;!lwho.eop.gov>" Sent Date : 2018/06/14 18:30:58 Delivered Date: 2018/06/14 18:30:00 EXT-18-248-G-000017 From: Zadrozny, John A. EOP/WHO ~b )(6) ~who.eop.gov> "Lloyd, Scott (ACF) " Subject: Call Date: 20 18/06/14 19:38 : 12 Start Date: 20 18/06/15 08:30:00 End Date: 20 18/06/15 09:00:00 Priority: Normal Type: Schedule.Meeting.Request Location: b)(6) I Attendees: Lloyd, Scott (ACF) Sender: Zadrozny, John A. EOP/WHO j(b)(6) ~who .eop.gov> "Lloyd, Scott (ACF) " Sent Date : 2018/06/14 19:37:55 Delivered Date: 2018/06/14 19:38:12 EXT-18-248-G-000018 Lloyd, Scott (ACF) To: "Zadrozny, John A. EOP/WHOj(b)(6) i?iwho.eop.gov>" Subject : Accepted: Call Dat e: 2018/06/14 19:50:00 Start Date: 2018/06/15 08:30:00 End Date: 2018/06/15 09:00:00 Priority: Normal Type: Schedule.Meeting.Resp.Pos Location (b)(6) I Lloyd, Scott (ACF) Recipient: "Zadrozny, John A. EOP/WHOj(b)(6) ~who.eop.gov>" Sent Date: 2018/06/14 19:50:02 Delivered Date: 2018/06/14 19:50:00 EXT-18-248-G-000019 Wolfe, Kenneth (ACF) "Wynne, Maggie (HHS/IOS) "; "Wagner, Steven (ACF) " ; To: " Marriott, Brian (ACF) "; "Stecker, Judy (OS/ASPA) "i "Lloyd, Scott (ACF) " Subject: Monday event in Brownsville Date: 2018/06/15 16:55:37 Priority: Normal Type: Note FYI, on a Brownsville congre ssional event following Monday' s UAC tours. Note the bishop of the diocese will be there, among others -Ken From: Home land Security Dems Sent: Friday, June 15, 2018 1:12 PM Subject : FW: EMBARGOED: Ve la to Host Roundtable Follow ing Visit to Casa Pad re and Casa Presidente STRIC TLY EMB ARG OED UNT IL 1 PM CST JUNE 18, 2018 For Planning Purposes Day-of Press Contact: Br enda Range l (956) 564-1527 Brenda. rangel @mai 1.house. gov Democratic Members to Visit Separated Children (***STRICTLY EMBARGOED UNTIL 1 PM CST JUNE 18, 2018***) th Brownsville, TX - On Monday , June 18 at I :00 PM CST, Congressman Filemon Ve la will host a roundtab le with Members of Congress and local immigration advocates regarding the family separation crisis. EXT-18-248-G-000020 Last month, the Trump Administration instituted a "zero tolerance " immigration plan, designed to deter undocumen ted families from entering the country. The policy has had the inevitab le effec t of ripping children from their paren ts' arms wh ile they await prosecution . Children have been relocated to Office of Refugee Resettlement (ORR) facil ities, where they rema in an average of 56 days. Members of Congress will be visiting Casa Padre and Casa Presidente in Brownsville, TXfacilities where unaccompanied and separated children are being held. Followi ng the visit, Memb ers and local immigration advocates will partic ipate in a round table to discuss the impact of the family separation plan . The round table will be livestreamed here . WHO Rep . Filemon Vela (TX-34) Homeland Security Committee Ranking Member Bennie Thompson (MS-2) Rep . Sheila Jackson Lee (TX-18) Rep. Ben Ray Lujan (NM-3) Rep . Joaqu in Castro (TX-20) Rep. Vicente Gonzalez (TX-15) Mo nsignor Bert Diaz, St. Mary 's Catho lic Church Bishop Daniel Flores, Catho lic Diocese of Brownsville Jodi Goodwi n, immigration lawyer Sister Phyll is Peters, Proyecto Juan Diego Lupita Sanchez , Proyec to Jua n Diego Michael Seifert, ACLU WHEN Monday, June 18, 20 18 1:00 - 2:00 PM: Fami ly separa tion roundtable WHERE D'Ga la Eventos Recep tion 3620 Ruben M . Torres Sr. Blvd. Brownsville , TX 78526 RSVP Please RSVP to brenda.rangel@ma il.house .gov . RSVP not necessary, but appreciated. ###- Wolfe, Kenneth (ACF) Recipient : "Wynne, Maggie (HHS/IOS)"; "Wagner, Steven (ACF) "; "Marriott, Brian (ACF) "; "Stecker, Judy (OS/ASPA) "; " Lloyd, Scott (ACF) " Sent Date: 2018/06/ 15 16:55:37 EXT-18-248-G-000022 Lloyd, Scott (ACF) To: "Georges, Liza B. EOP/WHOl(b)(6) la>who.eop.gov>" Subject : Accepted: Border Security MessagingMeeting Dat e: 2018/06/15 18:57:59 Start Date: 2018/06/19 13:30:00 End Date: 2018/06/19 14:30:00 Priority: Normal Type: Schedule.Meeting.Resp.Pos Location: WHSR- JFK Conference Room Lloyd, Scott (ACF) Recipient: "Georges, Liza B. EOP/WHO" Sent Date: 2018/06/15 18:57:58 Delivered Date: 2018/06/15 18:57:59 EXT-18-248-G-000023 Logan, Scott (ACF) To: "Sualog, Jallyn (ACF) " "Arbes, Sarah (HHS/ASL) "; "Morse, Sara (HHS/ASL) "; CC: "Lloyd, Scott (ACF) "; " Hayes, Sean (HHS/ASL) " Subject: RE:Tornillo Tour Requestfor June 15 Date: 2018/06/15 23:15:35 Priority : Normal Type: Note Thank you. I'll share this now . Scott Logan Director Division of Legislative and Regulatory Affairs Office of Legislative Affairs and Budget Administration for Children and Families U.S. Department of Health and Human Services 330 CST, SW Suite 5020D Wash ington, D.C. 20201 202.401.4529 From : Sualog, Jallyn (ACF) Sent: Friday , June 15, 2018 11:15 PM To: Logan, Scott (ACF) Cc : Arbes, Sarah (HHS/ASL) ; Morse, Sara (HHS/ASL) ; Lloyd, Scott (ACF) ; Hayes, Sean (HHS/ASL) Subject: RE: Tornillo Tour Request for June 15 Status of infrastructure deployment and expected timeline -Expected capacity of facility: Current capacity of the facility is 360. -Number of children currently present at facility and number expected to arrive within the next days: Approximate ly 96, with another group scheduled to arrive tonight to bring the total to 296. -Characteristics and conditions of facilities and infrastructure: The site consists of softsided structures that are adequate and safe to house male UAC that are between 13-17 years of age . -Estimated costs: Current cost is approx imately $ 15M. -Estimated duration of the operation: There is no specified duration of the operation at this time . EXT-18-248-G-000024 Jallyn N. Sualog Act ing Deputy Director for Children's Programs Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services 330 C Sh.eet SW Wash ington, DC 20201 Jallyn. Sualog@acf.hhs.gov 0: (202) 401-4997 C: fb )(6) I From: Logan, Scott (ACF) Sent: Frida y, June 15, 2018 11:07 PM To: Sualog, Jallyn (ACF) Cc: Arbes, Sarah (HHS/ASL) ; Morse, Sara (HHS/ASL) ; Lloyd , Scott (ACF) ; Hayes, Sean (HHS/ASL) Subject: FW : Tornillo Tour Requ est for June 15 Importance: High Jallyn, What info cou ld you answer in O'Rourke's q's below? Scott From: Rodarte , Samuel Sent: Friday, June 15, 2018 3:55 PM To: Logan , Scott (ACF) Cc: Mor se, Sara (HHS/ASL) ; Clark, Barbara (HHS/ASL) ; Casterline, Rebecca (ACF) ; Acosta, Stephanie Subject: RE: Tornillo Tour Reque st for June 15 Hi ScottI know your team is very busy with all the requests but can you provide us with some basic facts about the operation at Tornillo . For example: -Status of infrastructure deployment and expected timeline -Expected capacity of facility EXT-18-248-G-000025 -Number of children currently present at facility and number expected to arrive within the next days -Characteristics and conditions of facilities and infrastructure -Estimated costs -Estimated duration of the operation Congressman O'Rourke would appreciate any even if brief information on those items. We want to make sure we have the right information. Thanks again for all your help, -Sam Rodarte Samuel Rodarte Jr. Senior Legislative Assistant Congressman Beto O'Rourke (TX-16) 1330 Longworth House Office Building (202) 225-4831 I http://orourke.house.gov / From: Acosta, Stephanie Sent: Friday , June 15, 2018 1:26 PM To: Logan , Scott (ACF) ; Rodarte, Samuel Cc: Morse, Sara (HHS/ASL) ; Clark, Barbara (HHS/ASL) ; Casterline, Reb ecca (ACF) Subject: RE: Tornillo Tour Request for June 15 Hi Scott - Please see attached and let me know if you require any additional information. I look forward to hearing from you. Thank you! Stephanie Acosta I Binational Affairs Congressman Beto O'Rourke 303 No 1th Oregon Street, Suite 210 El Paso, Texas 79901 Office: (915) 541-1400 FAX: (915) 541-1407 From: Logan, Scott (ACF) Sent: Friday , June 15, 2018 11:02 AM To: Rodar te, Samuel Cc: Acosta, Stephanie ; Mor se, Sara (HHS/ASL) ; Clark, Barbara (HH S/ASL) ; Casterline , Rebecca (ACF) Subject: RE: Tornillo Tour Request for June 15 EXT-18-248-G-000026 Hi Sam, HHS requests 2 weeks notice for tour requests ofUAC shelters. Would you please complete the attached form and return it to us? Thank you, Scott Scott Logan Director Division of Legislative and Regulatory Affairs Office of Legislative Affairs and Budget Administration for Children and Families U.S. Department of Health and Human Services 330 CST, SW Suite 5020 D Washington, D.C. 20201 202.401.4529 From: Rodarte, Samuel Sent: Friday , June 15, 2018 12:56 PM To: Logan, Scott (ACF) Cc: Acosta, Stephanie Subject: Tornillo Tour Request for June 15 ScottWe understand that HHS/ORR has selected the Port of Entry at Tornillo, Texas, for the construction of tents to temporarily house the overflow of immigrant children. We also understand that children will begin arriving in the next few days. Cong ressman O'Rourke would like to request a tour for staff member , Stephanie Acosta, of the Tornillo facility today, Friday , June 15. How can we facilitate this visit within the next few hours? If it is easier, please contact at me at 202-225-4831 at your earliest opportun ity, and let me know if you require additional infonnation. Thank you, -Sam Rodarte Samuel Rodarte Jr. Senior Legislative Assistant Cong ressman Beto O'Rourke (TX-16) 1330 Longworth House Office Building (202) 225-483 1 I http://orourke.house.go v/ EXT-18-248-G-000027 Logan, Scott (ACF) "Sualog, Jallyn (ACF) "; "Arbes, Sarah (HHS/ASL) "; "Morse, Sara (HHS/ASL) "; "Lloyd, Scott (ACF) "; "Hayes, Sean (HHS/ASL) " Sent Date: 2018/06/ 15 23:15:34 Delivered Date: 2018/06/ 15 23:15:35 EXT-18-248-G-000028 Lloyd, Scott (ACF) To: "Georges, Liza B. EOP/WHOj (b)(6) l?>who.eop.gov>" Subject : Accepted: Border Security MessagingMeeting Dat e: 2018/06/18 12:09:44 Start Date: 2018/06/19 13:00:00 End Date: 2018/06/19 14:00:00 Priority: Normal Type: Schedule.Meeting.Resp.Pos Location: WHSR- JFK Conference Room Lloyd, Scott (ACF) Recipient: "Georges, Liza B. EOP/WHOl(b)(6) ~who .eop.gov>" Sent Date: 2018/06/18 12:09:44 EXT-18-248-G-000029 Lloyd, Scott (ACF) To: "Miller, Stephen EOP/WHO.fb)(6) !iiwho.eop.gov>" Subject : clarification if needed Dat e: 2018/06/19 15:49:00 Priority: Normal Type: Note Sir, I was a little puzzled by your comments, so if there's someth ing you've heard that I can address I'd value the opportunity to do so. l(b)(6l I In any case I'll take what you 've said to heart. Thank you, Scott *** E . Scott Lloyd Director Office of Refugee Resettlement U.S. Departm ent of Health and Human Services (202) 401 -7269 I(cell) (202) !(b)(6) scott. Iloyd @acf. hhs.gov Lloyd, Scott (ACF) Recipient: "Miller, Stephen EOP/WHO-f.b)(6) ~who.eop.gov>" Sent Date: 2018/ 06/19 15:49:46 Delivered Date: 2018/06/19 15:49:00 EXT-18-248-G-000030