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President Trump, after failing to repeal the Affordable Care Act in Congress, will act on his own to relax health care standards on small businesses that band together to buy health insurance and may take steps to allow the sale of other health plans that skirt the health law’s requirements. The president plans to sign an executive order “to promote health care choice and competition” on Thursday at a White House event attended by small-business owners and others. (Pear and Abelson, 10/11)

President Donald Trump is planning to sign an executive order Thursday to initiate the unwinding of the Affordable Care Act, paving the way for sweeping changes to health-insurance regulations by instructing agencies to allow the sale of less-comprehensive health plans to expand. Mr. Trump, using his authority to accomplish some of what Republicans failed to achieve with their stalled congressional health-care overhaul, will direct federal agencies to take actions aimed at providing lower-cost options and fostering competition in the individual insurance markets, according to a Wall Street Journal interview with two senior White House officials. (Radnofsky, Armour and Wilde Mathews, 10/11)

The order will ease rules on small businesses banding together to buy health insurance, through what are known as association health plans, and lift Obama administration limits on short-term health insurance plans, according to a source on a call with administration officials Wednesday night. The order will direct the Department of Labor to "modernize" rules to allow small employers to create association health plans, the source said. Small businesses will be able to band together if they are within the same state, in the same "line of business," or are in the same trade association. (Sullivan, 10/11)

It's not yet clear how far the administration will go, or how quickly it can implement the president's order. But if successful, the new rules could upend the way businesses and individuals buy coverage — lowering premiums for the healthiest Americans at the expense of key consumer protections and potentially tipping the Obamacare markets into a tailspin. "Within a year, this would kill the market," said Karen Pollitz, a senior fellow at the Kaiser Family Foundation who previously worked at former President Barack Obama’s HHS Department. (Cancryn, 10/12)

U.S. President Donald Trump's expected plan to let Americans buy insurance across state lines could violate federal law governing employee benefit plans and will almost certainly be challenged in court, several legal experts said. Trump said on Tuesday he would likely sign an executive order this week allowing people to cross state lines to obtain "great, competitive healthcare" that would cost the United States "nothing." (Pierson and Raymond, 10/12)

Local and state groups that help with ObamaCare enrollment say they will likely have to reduce their services following funding cuts from the Trump administration. Funding for the "navigator" groups, which provide outreach, education and enrollment assistance, was cut in half this year for being "ineffective," Trump officials have said. (Hellmann, 10/11)

[Glen] Gardner and tens of thousands of other Iowans are anxiously awaiting the outcome of last-minute negotiations over state regulators’ “stopgap” proposal to shore up Iowa’s health-insurance market. Iowans heard last week that President Donald Trump allegedly demanded his administrators reject the proposal, which would rewrite key rules of the Affordable Care Act. The president wants to repeal the law, also known as Obamacare. He has said Republican politicians should let Obamacare collapse in order to build support for the repeal effort. Just one carrier, Medica, plans to sell individual health-insurance policies in Iowa under current rules, which will remain in place if the state’s stopgap plan is rejected. Medica plans to raise its premiums by an average of nearly 58 percent. (Leys, 10/11)

The state Democratic Party filed a Freedom of Information Act request days after The Washington Post reported that Trump in August personally asked top health officials to turn down the plan after reading about it in The Wall Street Journal. Iowa officials have said their plan, which would rewrite major parts of Obamacare, is needed to prevent its individual insurance market from collapsing. (Pradhan, 10/11)

Vanderbilt University Medical Center has worked out a contract with Cigna to be covered under individual health insurance plans in 2018. The contract means people in Davidson and eight surrounding counties will be able to see VUMC doctors in-network via the Cigna Connect plans. And, unlike in 2017, the plans covering the health system are eligible for tax credits for those who financially qualify. (Fletcher, 10/11)

California’s health exchange said Wednesday it has ordered insurers to add a surcharge to certain policies next year because the Trump administration has yet to commit to paying a key set of consumer subsidies under the Affordable Care Act. The decision to impose a 12.4 percent surcharge on silver-level health plans in 2018 means the total premium increase for them will average nearly 25 percent, according to Covered California. Taxpayers, not consumers, will bear the brunt of the extra rate hike because federal premium assistance for policyholders, which is pegged to the cost of coverage, will also increase. (Terhune, 10/11)

Liberal groups 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. Organizations such as Planned Parenthood Action Fund and Emily’s List believe the Trump administration handed them a potent political issue Friday when it carved out wide exceptions to the Affordable Care Act’s promise of no-cost contraception. Activists plan to link this action to congressional Republicans’ repeated attempts to undercut the ACA in ways that could have caused millions to lose health insurance, as part of a broader strategy focused on defeating moderate GOP members and buttressing vulnerable Democrats. (Viebeck, 10/11)

The Trump administration's new birth control rule is raising questions among some women's health experts, who say it overlooks known benefits of contraception while selectively citing data that raise doubts about effectiveness and safety. "This rule is listing things that are not scientifically validated, and in some cases things that are wrong, to try to justify a decision that is not in the best interests of women and society," said Dr. Hal Lawrence, CEO of the American Congress of Obstetricians and Gynecologists, which represents women's health specialists. (Alonso-Zaldivar, 10/11)

Pennsylvania Attorney General Josh Shapiro on Wednesday became the latest official to sue the Trump administration over its move to roll back the Affordable Care Act’s birth control coverage mandate. ... On Friday, the Department of Health and Human Services issued a directive that would let many more employers, including colleges, universities, and health insurance companies, deny birth control coverage on moral grounds. (McCullough, 10/11)

In other women's health news —

Planned Parenthood and the American Civil Liberties Union (ACLU) of Missouri sued the state of Missouri on Tuesday over new abortion regulations. The groups argue a recently passed law "severely restricts access to safe, legal abortion" by requiring the same physician performing an abortion to be the one giving state-mandated information to a patient 72 hours before the procedure. (Hellmann, 10/11)

Twitter reversed its decision to block a GOP congresswoman from promoting her campaign video on its website. In a video announcing her campaign for the Senate, Rep. Marsha Blackburn (R-Tenn.) referenced "baby body parts," which Twitter called a violation of its guidelines. (Hellmann, 10/11)

New York will have to convene a special legislative session to address a nearly $1 billion shortfall if Congress doesn’t quickly renew funding for the Children’s Health Insurance Program (CHIP), the state’s health department said Wednesday. In a letter to Acting Health and Human Services Secretary Eric Hargan, the state’s health commissioner warned about the consequences if CHIP funding is not renewed “in the next few weeks.” (Weixel, 10/11)

In other news from Capitol Hill —

Senate Democrats are calling on the National Institutes of Health to renew recently-lapsed funding for gun violence research following the Las Vegas concert shooting. In a letter to NIH Director Dr. Francis Collins, Democratic Sens. Elizabeth Warren (Mass.), Chris Murphy (Conn.), and 21 others joined Sen. Bernie Sanders (I-Vt.) in saying that continuing the program is urgent. (Weixel, 10/11)

The bodies turn up in public restrooms, in parks and under bridges, skin tone ashen or shades of blue. The deceased can go undiscovered, sometimes for hours, or days if they were alone when they injected heroin and overdosed. Terrell Jones, a longtime resident of the Bronx, was pointing to the locations where overdoses occurred as he drove through the East Tremont neighborhood, the car passing small convenience stores, rowhouses and schools. (DelReal, 10/12)

More than 50 lawmakers testified Wednesday at a House committee hearing on the nation’s opioid epidemic, describing how the crisis has devastated their communities and proposing solutions. While many applauded bipartisan legislation passed last year that included hundreds of millions of dollars targeting opioid abuse, they emphasized that more needs to be done. More than 90 Americans die from opioid overdoses each day, said House Energy and Commerce Committee Chairman Greg Walden, R-Ore. (Williams, 10/11)

Brandi Wagner thought she had survived Hurricane Katrina. She hung tough while the storm’s 170-mph winds pummeled her home, and powered through two months of sleeping in a sweltering camper outside the city with her boyfriend’s mother. It was later, after the storm waters had receded and Wagner went back to New Orleans to rebuild her home and her life that she fell apart. “I didn’t think it was the storm at first. I didn’t really know what was happening to me,” Wagner, now 48, recalls. “We could see the waterline on houses, and rooftop signs with ‘please help us,’ and that big X where dead bodies were found. I started sobbing and couldn’t stop. I was crying all the time, just really losing it.” (Vestal, 10/12)

Many have criticized the federal government for being slow in its response to Puerto Rico compared to its efforts in Texas after Hurricane Harvey or Florida after Hurricane Irma. The immediacy of the need for relief has prompted healthcare providers to take a lead role in providing support. ... Along with Florida Hospital, providers based in New York have been among the leaders in the relief effort. New York City has the largest Puerto Rican population in the mainland U.S. (Johnson, 10/10)

Kaiser Health News: Video: Health After A Hurricane
If a hurricane strikes where you live, how does it affect your health and well-being? In this Kaiser Health News video, senior correspondent Julie Appleby and Georges Benjamin, the executive director of the American Public Health Association, discuss the ongoing public and environmental health concerns resulting from Hurricanes Harvey, Irma and Maria — and the latest natural disaster of wildfires in California. (10/11)

New research from the University of South Florida suggests evacuating nursing home patients before a storm increases the chance of both hospitalization and death. The study -- which looks at hurricanes -- recommends nursing homes "shelter in place," or not evacuate unless a facility gets flooded or severely damaged. (Miller, 10/11)

When the clouds darken and rain starts pouring down, many Houston-area elementary school students get nervous and start to sob — a sign of the long-lasting effects of watching the water levels rise during and after Hurricane Harvey. ...To address such challenges, the Texas Education Agency on Wednesday announced a task force — in conjunction with the Texas Higher Education Coordinating Board and the Texas Health and Human Services Commission — that will connect Harvey-affected schools, universities and their communities with counselors, training, and funding opportunities as they continue to deal with the after-effects of the destructive storm. (Swaby, 10/11)

Ophelia became a hurricane late Wednesday, the tenth in a row and tying a record set more than a century ago. Located in the central Atlantic about 760 miles southwest of the Azores, the hurricane poses no threat to land and would probably be unremarkable if not for its place in the record books. (Staletovich, 10/11)

One of the most promising new cancer treatments involves altering patients' own immune cells to attack blood cancers. But it comes with a big downside: It can cause serious side effects, including high fevers and sharp drops in blood pressure as well as potentially fatal brain swelling. Now researchers at two major cancer centers — Fred Hutchinson Cancer Research Center in Seattle and MD Anderson Cancer Center in Houston — are homing in on these toxic complications to better understand why they occur, which patients are most vulnerable to the side effects and how to prevent them. (McGinley, 10/12)

A proposal to simplify cervical cancer screening could end up missing some cancers, researchers and patient advocates say. And that could be especially true for minority women. Latina and black women already have the highest rates of cervical cancer in the U.S., and more than half of women with the disease were not screened in the five years before their diagnosis, according to the Centers for Disease Control and Prevention. (Haelle, 10/11)

It is a medical puzzle: Why are death rates for black men with prostate cancer almost 2.5 times the rate of white men in the United States? ... Understanding those biological differences is difficult, however, because many ethnic and racial groups are underrepresented in genomic studies and in the cell lines and clinical trials used to test new drugs, said Franklin Huang, an oncologist at Dana-Farber Cancer Institute. (Levenson, 10/11)

This year’s crop of MacArthur “geniuses” included artists, writers, computer scientists — and one biomedical researcher: Gabriel Victora, an immunologist who’s studying how our bodies respond to foreign invaders. Victora — who runs an immunology research lab at Rockefeller University in New York City — didn’t pick up the phone the first time the folks at MacArthur tried to call to notify him he’d won the award. Nor did he pick up the second time his phone rang, or the third. He was sitting in on a seminar. (Thielking, 10/12)

For years, doctors have been warning us that high cholesterol, cigarette smoking, illegal drug use and diabetes increase our chances of having a potentially fatal stroke. And yet, most of the stroke patients showing up at hospitals from 2004 to 2014 had one or more of these risk factors. And the numbers of people at risk in this way tended to grow among all age groups and ethnicities in that time period. (Fulton, 10/11)

Women with high blood pressure in their 40s are at increased risk for dementia in later years, researchers report. But the finding does not hold for men. Beginning in 1964, investigators collected health and lifestyle information on 5,646 men and women when they were 30 to 35 years old, and again when they were in their 40s. From 1996 to 2015, 532 of them were found to have Alzheimer’s or other forms of dementia. The study is in Neurology. (Bakalar, 10/11)

Abstinence may have found its most impressive poster child yet: Diploscapter pachys. The tiny worm is transparent, smaller than a poppy seed and hasn't had sex in 18 million years. It's basically just been cloning itself this whole time. Usually, that's a solid strategy for going extinct, fast. What's its secret? (Bichell, 10/12)

A115-year-old vaccine vial has provided an important clue in the search for an answer to one of medicine’s enduring mysteries: What went into the world’s first vaccine?  Medical legend has it that Edward Jenner — the father of vaccination — used cowpox virus to protect against the dreaded smallpox. But a new report, published Wednesday, shows a virus closely related to the horsepox virus was used in a 1902 smallpox vaccine, providing fresh ammunition to those who believe the history books have it wrong. (Branswell, 10/11)

The first placebo-controlled study of two vaccines against the Ebola virus found they both successfully created a powerful antibody response for a year, suggesting they both could be tools to save lives in a future epidemic of the deadly disease. The research, by doctors from the U.S. and Liberian governments and elsewhere, was published Wednesday in the New England Journal of Medicine. The study looked at 1,500 patients in Liberia, and took place amid and after the outbreak of Ebola in Liberia from 2014 into 2015. (Burton, 10/11)

In just over four decades, obesity levels in children and teenagers have risen dramatically worldwide, though that rise has been far from uniform. In a new study published online Tuesday, British researchers and the World Health Organization say those levels have plateaued lately in high-income countries, "albeit at high levels," while the rise in obesity rates has only accelerated in regions such as East Asia and Latin America. (Dwyer, 10/11)

Kaiser Permanente timed the kickoff of some efforts to broaden its reach to coincide with National Suicide Prevention Awareness Month in September. Its new campaign, “Find Your Words,” encourages people to discuss their mental illness and treatment and help remove the stigma. One of Kaiser’s public service announcements features a young black teenager walking alone around his neighborhood. He doesn’t speak, but the lyrics to rapper and songwriter Kendrick Lamar’s confessional “i” are recited. It is vastly different from the typical pharmaceutical industry commercial related to mental health. (Scoville, 10/11)

Hoffman's mission is to help those people navigate the complexities of living and dying with ALS, including getting the overwhelming amount of equipment they'll need. The work might even be Hoffman's calling, after his own brush with death long ago. (Mullins and Joliocoeur, 10/11)

Loyola Medicine has a deal to acquire MacNeal Hospital in Berwyn, Ill., a community facility owned by for-profit giant Tenet Healthcare Corp. And Dallas-based Tenet is looking to sell its other three hospitals here and exit the Chicago market entirely, just four years after it arrived, a source close to the company said. Tenet, with nearly 80 hospitals nationwide, also owns Weiss Memorial Hospital in the Uptown neighborhood, Westlake Hospital in Melrose Park and West Suburban Medical Center in Oak Park. Dallas-based Tenet has been busy shopping around its hospitals nationwide. (Schorsch, 10/11)

Loyola Medicine plans to buy MacNeal Hospital in Berwyn, further expanding its reach while adding another name to the list of suburban hospitals snapped up by Chicago-area health systems. It also marks the beginning of the end of Tenet Healthcare Corp. in Chicago. The for-profit hospital chain, which owns MacNeal, has three other Chicago-area hospitals it plans to sell: Weiss Memorial Hospital in Chicago, Westlake Hospital in Melrose Park and West Suburban Medical Center in Oak Park. Dallas-based Tenet is in discussions with potential buyers for those hospitals. (Schencker, 10/11)

In hospital news elsewhere —

Denver’s Welltok expanded big time into hospitals on Wednesday with its purchase of Tea Leaves Health, a Georgia digital-health company that uses data to help hospitals connect with patients and doctors. The acquisition gives the Denver firm access to Tea Leaves’ more than 400 hospitals, plus customers in 30 percent of the nation’s top health systems, according to Welltok. The company said it paid $83 million for Tea Leaves. By comparison, Ziff Davis paid $30 million when it purchased of Tea Leaves in 2015. Ziff Davis is now owned by j2 Global. (Chuang, 10/11)

A Portland nurse who successfully argued that she was fired for raising an alarm about hospital cutbacks that she believed jeopardized patient care has agreed to settle her case two years after a jury awarded her $3.1 million. Linda Boly had not received any of the jury award since the September 2015 verdict in Multnomah County Circuit Court because Legacy Good Samaritan Medical Center appealed the verdict to the Oregon Court of Appeals. (Green, 10/11)

The union representing Allina Health hospital nurses filed a complaint Wednesday — one year to the day after ending a 37-day strike — over the continued assigning of patients to supervisory charge nurses. Allina leaders haven't lived up to a key provision in the contract that ended the strike, said Emily Sippola, a nurse at United Hospital in St. Paul: a commitment to meet and discuss how to prevent charge nurses from being overworked by being assigned patients. (Olson, 10/11)

Michigan Gov. Rick Snyder is sticking by his congressional testimony about when he learned about a fatal outbreak of Legionnaires’ disease during the Flint water crisis, despite a senior aide’s new disclosure that he informed the Republican governor weeks earlier. Some Democrats in Congress are pouncing on the conflict and urging the U.S. House Oversight and Government Reform Committee to investigate. (White, 10/11)

The frequency of mass shootings has changed how Nashville's top trauma medicine experts think about whether it could happen here: It's no longer a theoretical scenario of "if." It's when. And with each event — the Pulse Nightclub shooting in 2016, the Las Vegas shooting, the 2011 massacre that killed 77 in Norway, the 2015 attack at the Bataclan in Paris, to name just a few — the trauma teams review what happened and modify their plans. (Fletcher, 10/11)

The newly expanded 33,000-square-foot center is a collaboration between the Beaumont Center for Exceptional Families and the University of Michigan-Dearborn's Early Childhood Education Center, and includes a preschool program where children with autism can be included with typically developing children and experience what it's like to be in a mainstreamed classroom before they start kindergarten. The demand for a center like this is huge. About 50,000 people in Michigan are on the autism spectrum. It is the fastest-growing developmental disability in the U.S., according to the Centers for Disease Control and Prevention, now affecting as many as 1 in every 68 children. (Shamus, 10/11)

Sacramento Valley and foothills residents awoke Wednesday to the heavy smell of smoke, hazy brown skies and ashes on car windshields – the result of nearly two dozen Northern California wildfires, including the Atlas Fire, which exploded overnight in the hills west of Fairfield. ...Air meters throughout the region registered unhealthy levels of particulate matter from Vacaville and Davis in the west valley to higher foothill elevations in Grass Valley and Colfax early Wednesday. (Bizjak, Anderson and Glover, 10/11)

Days before there was any sign of fire, Nicole and Ben Veum of Santa Rosa, Calif., had been waiting and waiting for their baby to arrive. Nicole’s due date came and went. Her doctor called her into the hospital — Sutter Santa Rosa Regional Hospital — to induce labor. That was Friday. “So we were very excited at that point,” she said. “And then, day after day after day with not a whole lot of progress.” (Dembosky, 10/11)

The owner of a Worcester company that provides home health care services was arrested Wednesday and charged with stealing $2.7 million from the state Medicaid program, in the latest case of alleged fraud in the home health industry. (Dayal McCluskey, 10/11)

About 8 percent of people who serve in the military go on to develop PTSD, said Heather Axtell, who oversees trauma recovery in the behavioral-health service at the Department of Veterans Affairs’ Chalmers P. Wylie Ambulatory Care Center on the Northeast Side. That means that about 700,000 veterans of the Vietnam War, which ended more than 40 years ago, have struggled with the disorder. (Viviano, 10/12)

Parents of children with disabilities and advocacy groups filed a lawsuit in federal court Wednesday alleging the state of Georgia has discriminated against students placed in “unequal and separate’’ schools for kids with behavioral disorders and problems. The Georgia Network for Educational and Therapeutic Support (GNETS) schools are “segregated programs,’’ housed in separate buildings or in separate wings of regular schools, the lawsuit says. (Miller, 10/11)

Georgia uses its unique network of psychoeducational schools as a “dumping ground” for unwanted students with disabilities, a new class-action lawsuit claims. The suit, filed Wednesday by several advocacy groups on behalf of three parents, accuses state officials of violating federal law and the U.S. Constitution by placing disabled children in segregated schools and classrooms operated by the Georgia Network for Educational and Therapeutic Support, or GNETS. (Judd, 10/11)

In a first-of-its-kind survey this year by Beech Acres Parenting Center, nearly half of Greater Cincinnati parents, 44 percent, said “understanding kids’ mental health issues” is “very or extremely concerning” to them. More than half of respondents, or 55 percent, were “very or extremely interested” in getting training or guidance to address childhood mental-health issues. (Saker, 10/11)

State officials said this week that while August saw 18 cases of West Nile, there were just six cases in September. Overall, Georgia reports 37 cases of the disease this year, with five deaths. (Miller, 10/11)

According to a recent report from the Atlanta-based Centers for Disease Control and Prevention, Georgia ranked among the top five states in America with the highest rates of chlamydia, gonorrhea and syphilis. (Pirani, 10/11)

Kaiser Health News: Dementia Patient At Center Of Spoon-Feeding Controversy Dies
An Oregon woman with Alzheimer’s disease, whose husband claimed she was kept alive with spoon-feeding against her written wishes, has died. Nora Harris, 64, died early Wednesday at the Fern Gardens senior care center in Medford, Ore. Her husband, Bill Harris, said the death marks the end of an eight-year battle with the progressive, debilitating disease, which included an unsuccessful court fight to withdraw all food and liquid. (Aleccia, 10/12)

On Twitter, President Donald Trump said he would be “using the power of the pen to give great HealthCare to many people — FAST.” He isn’t bluffing. His White House has been working on a series of executive actions on health insurance. But his tweet is misleading. The most far-reaching action under consideration would not give anyone health care. Rather, it would dramatically reduce enforcement of Obamacare’s fines on people without insurance. (Ramesh Ponnuru, 10/11)

President Donald Trump on Thursday plans to sign an order that 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. The changes represent a step toward repeal of Obamacare, something Trump and Republicans have unsuccessfully attempted to do through legislation. And the ultimate impact on small businesses and people who buy private coverage on their own ― the two groups Thursday’s order would affect directly ― is likely to resemble some of the effects that experts predicted GOP repeal bills would have if they become law. (Jonathan Cohn, 11/11)

Covered California made it official Thursday: The Trump administration’s waffling will raise health insurance premiums an additional 12.4% for many Californians not covered by large employer plans. In some cases, the Trump-induced surcharge will be 27%. Those increases are on top of an average premium increase of 12.5% due to other factors. In other words, premium increases will be twice as high next year for many Californians, simply because the Trump administration (and Congress) won’t commit to reimbursing insurers for the payments the government requires them to make. (Jon Healey, 10/11)

We know that Congress is just unimaginably busy right now, so perhaps it’s understandable that 11 days after funding for a crucial children’s healthcare program expired, the lawmakers still haven’t gotten around to restoring it. We’re talking about the Children’s Health Insurance Program, a state-federal program serving 9 million children and their mothers. (Michael Hiltzik, 10/11)

Americans are dying at the rate of 175 a day from opioid overdoses, but President Trump has yet to deliver his promised strategy to end the crisis. And so the people’s representatives, in the absence of presidential leadership, did about the only thing they could do. They had a day of opioid karaoke. There wasn’t actual music. But it was open-mic day Wednesday before the House Energy and Commerce Committee. The panel invited members of Congress to take the witness seat and, in three minutes or less, sing a sad song about how the opioid crisis is ruining the lives of their constituents. (Dana Milbank, 10/11)

Saudi women are gaining the right to drive. American women are losing the right to employer-provided birth control. The first development signifies a theocratic kingdom’s bow to the inexorable onslaught of modernity. The second is a cynical bow to the forces of reaction against modernity. (Linda Greenhouse, 10/11)

Adult day centers seem to have made it into the political debate in Washington, though not in a good way. In his nasty weekend back-and-forth with President Trump, Senator Bob Corker (R-TN) suggested the White House has become an “adult care center” and wondered if the staff had “missed a shift” when Trump launched his Sunday Twitter storm. ... Leaving aside this mature level of political discourse, the name-calling does raise an important question: What are adult day centers and how do they work? Adult day centers can be an important service to frail seniors and other people with disabilities who are living at home. (Howard Gleckman, 10/11)

Gov. Jerry Brown can take an important step in recognizing housing is health care by signing Assembly Bill 74 by Assemblyman David Chiu, D-San Francisco. Our emergency department staff at Santa Clara Valley Medical Center can do little to prevent a homeless patient from returning again and again to the hospital for preventable and manageable conditions. (Rene Santiago, 10/11)