The Morning Roundup: N.C. Docs Under Investigation, HBCUs Under Attack | News
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Monday, May 16, 2016

The Morning Roundup: N.C. Docs Under Investigation, HBCUs Under Attack

Posted by on Mon, May 16, 2016 at 8:17 AM

Good morning, everyone. Here's some news from the weekend.

1. The North Carolina medical board is investigating sixty doctors and physician assistants for over-prescribing narcotic painkillers after their patients died of drug overdoses, as well as twelve others who have prescribed high doses or large volumes of narcotic painkillers.

From the Charlotte Observer:

In some cases, the agency says, there is no direct link between the deaths and the doctor’s prescribing. But regulators will look into whether patients received substandard care.

Doctors who over-prescribe OxyContin, Percocet and other narcotic painkillers known as opioids are widely seen as partly responsible for a dramatic rise in drug overdose deaths over the last two decades. Fatal overdoses kill more than 1,000 people a year in North Carolina and nearly half involve prescriptions written within 60 days of the victim’s death.

Regulators seeking to curb deaths are now using a statewide database to spot potentially reckless prescribing.

“The Safe Opioid Prescribing Initiative” represents a more aggressive approach for the Medical Board, which has been criticized for its slow response to the overdose crisis. Officials say they will review the state data every three months and launch investigations in addition to receiving complaints.

Spokeswoman Jean Fisher Brinkley said the change signals that the Board wants to increase the number of investigations into improper prescribing.

From 2013 through 2015, the Medical Board investigated more than 7,000 cases. But only in about 343 cases, or about 5 percent of the time, was prescribing the primary issue even though the agency itself has labeled the rising overdose death rate a public health crisis. Of those cases, 109 resulted in public sanctions.

“The Board views this as a serious problem that requires ongoing attention,” said Dr. Scott Kirby, the agency’s chief medical officer. “They have no tolerance for incorrect or substandard prescribing.”
2. Lawmakers in the House will be working on the budget this week, and Moral Monday is back. Also the General Assembly is working to reconstitute the coal ash commission, wh
lady-w-mud-bottle.jpg
ich Gov. McCrory disbanded after winning a lawsuit against the General Assembly, earlier this year. 

Speaking of coal ash, the News and Observer reports that Dr. Megan Davies, the states's epidemiologist, said in a deposition taken by the Southern Environmental Law Center that she had concerns about rescinding "do-not-drink" advisories that had been issued to households with wells located near Duke Energy coal ash ponds. 

Duke says its ash isn’t the source of two contaminants found in neighboring wells, cancer-causing hexavalent chromium and vanadium, but the state has not confirmed that. Davies’ deposition was taken for state lawsuits against Duke over ash contamination.

Her sworn testimony shows that the conflicting advice given residents over the safety of their water reflects not only disagreements between health and environmental officials but within the health department itself.

That debate included the governor’s office, Davies said in the May 4 deposition.

Gov. Pat McCrory’s office intervened, she said, on the wording of warning letters sent to well owners in the spring of 2015. Duke, Davies said, later met twice last year with top state officials, including two department secretaries, to challenge the advisories.

The state abruptly reversed course in March, revoking the advisories and telling residents their water is safe. Many neighbors, distrustful of Duke and regulators, continue to use bottled water.

Danny Staley, director of the department’s Division of Public Health, also objected to revoking the advisories before it is known whether the contaminants came from coal ash, Davies said in her deposition. Neither could be reached Friday.

“We both felt it made more sense to wait on source determination, because once a source was determined, we would have a sense of if this – the hexavalent chromium was a contaminant versus naturally occurring,” she said. “That is relevant because if it were a contaminant, there might be ongoing contamination of wells with the increase in levels.”

Frank Holleman, the Southern Environmental Law Center attorney who deposed Davies, said Davies “thought that giving the do-drink advice was not consistent with the department’s mission of protecting public health and welfare. That’s a very serious thing.”

Dr. Randall Williams, the state health director who rescinded the advisories, is scheduled to also be deposed by the law center. So is state toxicologist Kenneth Rudo, who has publicly defended the advisories.

3. There's a bill in the Senate that would offer semesters of college tuition at several of the state's historically minority colleges and universities—Elizabeth City State, Fayetteville State, UNC Pembroke, Winston-Salem State and Western Carolina—for $500 a pop.

Bill sponsors and proponents say the bill would attract more students to colleges that have seen declining enrollment, as well as make college affordable. 

The sponsor of the bill, Hendersonville Republican Sen. Tom Apodaca, said the low tuition proposal would cost $60 million to $80 million a year and would come from the state’s general fund.

Supporters of the plan say it would help North Carolina live up to a mandate in the state constitution for the benefits of public higher education to be free, “as far as practicable.” They cite an average increase of 72 percent in tuition and fees at UNC schools in the past decade and an average cumulative debt of $23,440 per student.

Apodaca said rising costs and debt are threatening the value of a student’s investment. “That’s why we are committed to making college more accessible and affordable, strengthening our universities to make them more competitive and encouraging our students to complete their degrees in four years,” he said in the announcement about the bill.

Others sense different motives among Republican legislators, who have in recent years discussed closing Elizabeth City State or merging HBCUs.

BlueNC, a left-of-center blog, was direct in its assessment: “This proposed bill looks like a ‘back door’ way to simply erase the historical identity of these institutions and effectively end their unique service to minority communities.”

The low-tuition plan was discussed quietly in the Senate early this year, as reported in The N&O in February. That was before the arrival of UNC President Margaret Spellings, who started in March. Also, chancellors at the affected institutions knew little or nothing about it when closed-door meetings were happening at the legislature.
But critics, like Yale professor Glenda Gilmore, call the bill "a wolf in sheep's clothing" designed to bankrupt five of the state's universities and end their historic services to minority students, which sounds about right. 

But Bill 873 also has another purpose, which is to rename four of the five campuses. That goal is presumptive, ignorant, and, frankly, racist. The bill calls for a study of “the impact of each university’s name on the institution’s academic strength, enrollment, and diversity. The Board of Governors may make recommendations on any potential changes to the legislature.”

Three of the campuses named in the bill are Historically Black Universities; one, Pembroke, served primarily Native Americans and African Americans. Two other HBUs, North Carolina Central and A&T, have been spared, and Western Carolina, a historically white university, is thrown in to disguise the bill’s racist intentions. The state’s HBUs began as Jim Crow schools, funded by the state to train black citizens. They educated women alongside men and, despite the shame of segregation, became the best state-funded system of black education in the nation.

What would the Board of Governors find wrong with the current names of our HBUs, and how might it correct them? At first glance, they seem, well, too geographical. Like Appalachian State University and East Carolina University, the names of Winston-Salem State, Elizabeth City State, Fayetteville State, and UNC-Pembroke convey their locations. They also represent a source of pride to the state’s minority populations who attended them. On the face of it, there is nothing wrong with the names of the state’s HBUs. So, why change?

The only possible reason to rename historically black universities is to sever them from their African American heritage to attract more white students.
4. More HB2. This story posits that the debate over transgender rights boils down to how we define what a person's sex is, an issue the U.S. Supreme Court has not yet addressed, while lower courts have split on it. 

The Obama Justice Department contends that sexual orientation is not a personal decision, but is based on an array of factors affecting an individual’s sense of gender and is protected by civil rights laws enacted 40 and 50 years ago. In slapping the state of North Carolina with a suit charging HB2 violates sex discrimination provisions in the Civil Rights Act of 1964, a 1972 education law and the 2013 Violence Against Women Act, Attorney General Loretta Lynch accused North Carolina officials of “state-sponsored discrimination against transgender individuals.”

N.C. Gov. Pat McCrory and legislative leaders filed separate suits asking that a judge determine the law is not discriminatory.

The 1964 law barring employment discrimination on the basis of “race, color, religion, sex and national origin” says it’s illegal to “discriminate against people based on their sex,” Karlan, who was a senior official of the Civil Rights Division in 2014 and 2015, said in a phone interview. “It doesn’t say you can’t discriminate against people based on the sex on their birth certificate.”

But Ed Whelan, president of the conservative-leaning Ethics and Public Policy Center and head of its program on the Constitution, the Courts and the Culture, says laws like North Carolina’s “do not involve by any conceivable measure discrimination on the basis of gender identity.”

North Carolina’s law disregards gender identity by defining gender as a person’s biological sex at birth, Whelan, a former law clerk to the late conservative Supreme Court Justice Antonin Scalia, said in a phone interview.

Proponents of both sides say cringe-worthy bathroom scenarios will occur if they lose the argument.
5. In case you missed it, North Carolina is no longer 42nd for average teacher pay in the nation. It is now 41st, according to a report from the National Education Association. 

NEA released its annual rankings Friday in a 130-page report that details everything from teacher pay to school enrollment and funding by state.

The report shows North Carolina teachers make an average of $47,985 this school year, about $10,000 less than the average U.S. teacher, who makes $58,064. The figures represent the average gross salary before deductions for things such as Social Security, retirement and insurance and do not take into account cost of living by state.

Last year, the average North Carolina teacher made $47,819, about $9,600 less than the national average of $57,420, according to NEA's newly revised numbers.
That's it! Have a good week everyone. 

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