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Senate approves one medical marijuana bill

A pleasant surprise.

Rep. Stephanie Klick

Marijuana advocates were handed an unlikely victory Wednesday after the Texas Senate advanced a bill greatly expanding the list of debilitating medical conditions that can legally be treated by cannabis oil in the state.

Although the upper chamber’s leadership once opposed bills that would relax the state’s pot policies, the Senate unanimously voted in favor of a bill by state Rep. Stephanie Klick, R-Fort Worth, that expands the state’s Compassionate Use Program, which currently allows the sale of cannabis oil only to people with intractable epilepsy who meet certain requirements.

The bill now heads back to the Texas House, where lawmakers can either approve the Senate changes or opt to iron out their differences in a conference committee before lawmakers adjourn in five days. Klick did not immediately respond to a request for comment on whether she’d accept the Senate changes to her bill.

The version of the bill approved by the Senate would expand the list of conditions that qualify for the medicine to include all forms of epilepsy; seizure disorders; multiple sclerosis; spasticity; amyotrophic lateral sclerosis, or ALS; terminal cancer; autism and incurable neurodegenerative diseases. The bill also axes a requirement in current statute that says those wanting access to the medicine need the approval of two licensed neurologists, rather than one.

“This bill is about compassion,” said state Sen. Donna Campbell, R-New Braunfels, the Senate sponsor of the bill. “For patients participating in the [Compassionate Use Program], they have had a remarkable and life-altering change because of this. That’s compassion.”

Under Campbell’s version of the bill, the Texas Department on Public Safety would still have oversight of the Compassionate Use Program. Her revised bill also keeps intact the 0.5% cap on the amount of the psychoactive element in marijuana, known as THC, that medical cannabis products are legally allowed to contain. Campbell’s version also axes a provision in Klick’s bill that calls for a research program to assess how effective cannabis is as a medical treatment option for various conditions.

See here for the background. For whatever the reason, Dan Patrick decided to cooperate and play nice, and so here we are. It’s not much, and it brings us no closer to the criminal justice reform part of this, but it’s a step forward, and the more of those the better. The House still needs to approve the Senate changes, and Greg Abbott still needs to sign it, but I feel good about this one going the distance.

Amazon has a strange idea of what constitutes “erotica”

In last week’s Texas blog roundup, we saluted Amy Valentine for successfully turning her blog about surviving breast cancer into a book about surviving breast cancer. Amy is a friend of mine from my class at Trinity University, and I’ve been following her blog since its inception, partly because I’ve cared about what’s happening with her, and partly because she’s dealt with this awful situation with great humor and courage. It turns out that the joke is on her, as her book – a Kindle download – has been classified by Amazon as something it is not.

Breast cancer is not erotic

Amazon’s Kindle has categorized my digital breast cancer memoir as Erotica. The funniest part is that I notified Amazon of the error. After all, there is nothing erotic about breast cancer. Yet, Amazon refused to recategorize my book! They pointed out the book’s “adult content” and told me it would never be placed in a “general public listing.” I felt like I was a 12-year-old girl getting a scolding from her Sunday School teacher. I know my book’s title, Killer Boobs, can be a bit risque and the cover art, which was in the stock photos that Amazon provided, is of a naked woman’s torso, but when partnered with the overall book topic, it all works. After all, my breasts did try to kill me. And the skinny model’s torso on the cover looks more like a cancer patient in my eyes than a sexy playboy model. I don’t know who I feel most sorry for: folks hoping for Erotic literature who mistakenly buy my book, or my 77-year-old mother’s friends who purchase the digital book and then find out that other buyers purchased “Bondage Babes” and “Whips, Chains, and Lipstick.” Amazon Kindle editors will really be upset when I publish my memoir’s sequel on my harrowing and sometimes funny trip through breast cancer world: “Cleavage to Die For.”

I joked to Amy on her Facebook page that the title and art would work equally well for a Mickey Spillane novel, but there is a bit of serious business underneath all the boob jokes. Every book has a potential audience, and no book can find its audience if it’s off in the wrong section of the bookstore, whether virtual or not. If you are sent a link to Amy’s book, and see that the webpage its on contains recommendations like the ones listed above or the books that were recommended for me, you’re probably not going to have an accurate picture of what it is you’re looking at. I don’t know what Amazon’s algorithms are, but surely they ought to have some capacity for taking a writer’s word for the fact that her book is about chemo and healing and not whips and handcuffs when she tries to tell them that. A book about breasts is not necessarily a book about sex.

The HPV vaccine

This story about HPV and its vaccine is from a couple of weeks ago, but it needs to be read.

The vaccine that blocks a sexually transmitted infection that causes cervical, oral and other cancers was hailed as a home run when it was approved seven years ago, but, given usage rates, doctors still aren’t sure if it’ll ever live up to the promise and render any of the diseases a shadow of their current lethality.

Instead, doctors are huddling to determine how to improve inoculation rates that hover at 33 percent, a figure attributed to controversy that beset the vaccine from the beginning. The controversy included concerns that the vaccine would encourage premarital sex and Gov. Rick Perry’s 2007 attempt to require it of Texas school girls.

“It’s just wrong that politics should play a role in this,” says Dr. Lois Ramondetta, a University of Texas M.D. Anderson Cancer Center gynecologic oncologist who treats cervical cancer, the cancer for which the vaccine initially was approved. “This is the only cancer for which we know an infection is the cause and have a vaccine that prevents it. Getting vaccinated should be a no-brainer.”

The virus also is associated with a number of other cancers that researchers have begun finding are spiking – oral cancers that involve the back of the throat, tonsils and base of the tongue, and cancers of the vagina, vulva, penis and anus. Dr. Otis Brawley, chief medical officer of the American Cancer Society, recently referred to the increase as “one of the epidemics of the 21st century.”

[…]

Two vaccines – Gardasil and Cervarix – have been shown to protect against the strains of the virus that cause cervical cancer. Because neither provides any therapeutic benefit once an infection takes hold, the Centers for Disease Control recommends a series of three shots to girls at 11 to 12 years of age.

But it was that recommendation that roiled the waters. A Yale study found parental concern the vaccine could make adolescents less wary of casual sex was the biggest single factor in the decision not to vaccinate.

When Perry issued his order – overturned by the Texas Legislature later that session – making the vaccine mandatory for public school girls, the outcry included not just members of the religious right, but the leadership of the Texas Medical Association, who argued that it should stay voluntary until safety and liability issues were vetted.

“Education needs to come first,” said Dr. Joseph Bocchini at the time, then the chairman of the American Academy of Pediatrics chairman of infectious diseases. “Much of the public doesn’t know about HPV and its link to cervical cancer and other diseases. You can’t put a mandate ahead of that.”

The whole controversy over Perry’s order – you can see my blogging about it here was bizarre to me. It’s always strange to see Rick Perry do the right thing, though of course in this case he was motivated in large part by helping one of his cronies, who had a large piece of the company that was going to provide the vaccine. I suppose the backlash was predictable, and Lord knows it would probably be even worse today, but it was still depressing to watch. I remain grateful to Rep. Jessica Farrar for being a voice of reason and compassion throughout the debacle. I wonder how many lives might have been saved if sanity had prevailed. I can only hope the next time this comes up, the needs of the kids will come first.

Bye-bye, WHP

Thanks, Rick!

Federal health officials announced Thursday what state leaders have predicted for weeks: that they are halting funding for Texas’ Women’s Health Program.

Cindy Mann, director of the federal Center for Medicaid and CHIP Services, said Texas left her agency no other choice by forging ahead with a rule designed to force Planned Parenthood clinics out of the program

“We have no choice but to not renew their program,” Mann said. “… We very much regret that the state of Texas has taken this course.”

[…]

Mann said under federal law, Medicaid beneficiaries must be able to choose their own providers. “Neither the federal government nor the state government is permitted to stop people from getting services from their trusted source of care,” she said.

She said CMS will begin a gradual phase-out of the program, so funds won’t be cut off immediately. If Texas takes over the program and no women lose services within the next three months, she said, federal support will be terminated. If not, they might extend the support longer. Mann said the state must submit a transition plan to the federal government for approval by April 16.

Here’s the letter, and here’s a letter signed by State Reps. Garnet Coleman, Carol Alvarado, and Sylvester Turner thanking Director Mann for not cutting us off completely right away. Unfortunately, there’s also this:

Asked if local governments could skip the state level and coordinate directly with the federal government to continue to get support, Mann said no. She said money for Medicaid programs flows through the state.

Which means that the workaround Coleman and others proposed the other day won’t work. Which means we’re stuck with Perry’s phony promise, which he intends to pay for by cutting other HHS programs. If he’s going to be forced to do something for a bunch of people he couldn’t care less about, then by God someone’s gonna get hurt for it. Remember when Rick Perry pretended to care about cervical cancer?

A few years ago, in the name of fighting cervical cancer, Gov. Perry signed an executive order mandating HPV vaccinations for Texan girls. In a September 2011 presidential debate, Perry stated that “Cervical cancer is a horrible way to die” – yet he is moving to end cervical cancer screenings covered by WHP for over 130,000 Texan women. We are asking him why. The women of Texas are waiting for your response, Rick. And no, we aren’t talking about abortion – don’t change the subject – we are talking about cancer. We are talking about women’s lives.

Of course, he only pretended to care about it because it was a means to help one of his cronies, but it would be nice if some other people asked him about that. Or, if that’s too serious for you, you could head over to Facebook and ask him some questions about lady parts, since he’s such an expert about that. When you get bored with that, mosey on over to the page of Rep. Sid “Patrick” Miller, the “arthur” of the sonogram bill, and poke him with a stick, too. In the grand scheme of things it won’t really accomplish anything, but it’ll make you feel better, and Lord knows these idiots deserve it. Postcards has more.

What Planned Parenthood actually does

Since the only thing apparently holding up a deal to prevent a government shutdown is the GOP’s mulish insistence on de-funding Planned Parenthood, perhaps it’s time we all understood what Planned Parenthood actually does. Ezra Klein gives the explanation, with a chart.

[A]bortion services account for about 3 percent of Planned Parenthood’s activities. That’s less than cancer screening and prevention (16 percent), STD testing for both men and women (35 percent), and contraception (also 35 percent). About 80 percent of Planned Parenthood’s users are over age 20, and 75 percent have incomes below 150 percent of the poverty line. Planned Parenthood itself estimates it prevents more than 620,000 unintended pregnancies each year, and 220,000 abortions. It’s also worth noting that federal law already forbids Planned Parenthood from using the funds it receives from the government for abortions.

So though the fight over Planned Parenthood might be about abortion, Planned Parenthood itself isn’t about abortion. It’s primarily about contraception and reproductive health. And if Planned Parenthood loses funding, what will mainly happen is that cancer screenings and contraception and STD testing will become less available to poorer people. Folks with more money, of course, have many other ways to receive all these services, and tend to get them elsewhere already.

The fight also isn’t about cutting spending. The services Planned Parenthood provides save the federal government a lot of money. It’s somewhat cold to put it in these terms, but taxpayers end up bearing a lot of the expense for unintended pregnancies among people without the means to care for their children. The same goes for preventable cancers and sexually transmitted diseases such as HIV/AIDS.

That saves the state of Texas money, too. Not that any of the misogynists who are making these demands yet call themselves “fiscally conservative” care about that, of course. Over this wingnut wish list item they are willing to shut down the government – which, by the way, will also cost a ton of money. Among them are freshman CD27 Congressman Blake Farenthold. Makes you proud, doesn’t it? For more on what Planned Parenthood does, read this. A statement from Peter J. Durkin, President and CEO of Planned Parenthood Gulf Coast, on the subject of the shutdown is beneath the fold. Steve Benen, Matt Yglesias, RH Reality Check, and Feministing have more.

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Get well soon, Rep. McClendon!

I was shocked to read that State Rep. Ruth Jones McClendon was diagnosed a few months ago with stage 4 lung cancer, but I am very glad to see that she has responded well to treatment of it.

“It just felt like I was laid out on the floor, and somebody just dropped a bowling ball in the middle of my stomach,” said McClendon, D-San Antonio, who had quit smoking in 1998. “It was just like — just everything went out of me.”

Then she got busy figuring out what to do.

“You are in shock for a day at least, but then you’ve got to pull yourself together,” McClendon said.

Surgery wasn’t an option, so she embarked on a course of radiation and chemotherapy that drove the cancer into remission.

McClendon plans to start “maintenance” chemotherapy in December. In the meantime, she has gone public with her story because she wants to share her good fortune by urging people to get potentially lifesaving screening and checkups — and not let fear hold them back.

“I wanted people to know if they get detected for it early, if they get treatment, then there is life,” she said. “It’s not a death sentence.”

I’ve corresponded with Rep. McClendon’s staff over the past year – they’ve been very good at sending me information and responding to questions about legislative matters. My very best wishes go to Rep. McClendon, her family, and her staff as she works through this.

Funding the state cancer research initiative

Very interesting.

In 2007, Texans voted to give their scientists as much as $3 billion over 10 years to conduct groundbreaking cancer research. The money is supposed to start flowing to researchers this fall.

But scientists say the cancer research initiative may face a major roadblock: Not one penny can be distributed unless researchers can also come up with large sums from a different source.

For every dollar granted by the state, the Texas Constitution requires researchers to come up with 50 cents on their own – as much as $1.5 billion over the next decade. With the economy in recession and federal funding tight, researchers say it could be hard to find those matching funds.

“In this economy … where is this $1.5 billion going to come from?” said Dr. Daniel Foster, professor of internal medicine at UT Southwestern Medical Center in Dallas and past president of The Academy of Medicine, Engineering and Science of Texas.

Scientists also say the state may be trying to award money too quickly in its first year, operating on a schedule that could result in hastily written research proposals that don’t meet the highest scientific standards.

[…]

The state is now getting down to the nuts-and-bolts of distributing the funds. The Legislature is still debating how much money will be granted.

The Senate has asked to fund the maximum amount allowed – $300 million per year for the next two years. The House is requesting only half that. The cancer institute’s executive director, Bill Gimson, came on the job last month and said his first priority is to hire a chief scientific officer to get grant applications moving through the review process. He said he hopes to solicit applications in August.

But the big unanswered question is where to come up with money to supplement the state awards. The provision for 50 percent matching funds was inserted late in the 2007 legislative process to get the bill through the House.

Read the whole thing, it’s worth your time. I honestly don’t remember that provision from 2007 – there may be something about it in my archives somewhere, but if so, I’d forgotten about it. The lesson, as usual, is that things are never as simple as they sound in the Lege. Thanks to Vince for the link.

RIP, Terry Hayes

Terry Hayes, an employee of the Houston Chronicle who wrote an award-winning blog that detailed her fight against terminal cancer, has died at the age of 42.

Hayes spent five years as one of the newspaper’s essential support staffers, handling unseen but critical behind-the-scenes tasks, deflecting and distributing calls and complaints, and encouraging — on occasion, demanding — that co-workers live up to her fierce sense of duty and hard work.

“Terry was the voice of the sports department, the first point of contact for readers who called to complain or compliment, and the liaison between the department and the teams we covered,” said Carlton Thompson, the Chronicle’s sports editor.

“Terry’s loss will be felt not only by those of us who had the pleasure to work with her, but also by the many who knew her only as the caring voice on the other end of the line.”

In April 2006, she was diagnosed with terminal colon cancer and was told she had about two years to live. Ten months later, she began “blogging the adventure” as CancerDiva, a name that she said reflected the “mix of darkness and light” that accompanied her battle for survival.

For the next several months, CancerDiva offered readers her thoughts on topics ranging from European travel to the painful tedium of chemotherapy to thoughts about death to the adventures of her beloved cat, Sasha. She was cited as the state’s best newspaper blogger in 2008 by the Texas Associated Press Managing Editors Association.

“She was hesitant at first about blogging, but she wanted so much to share her experience with others,” said Scott Clark, Chron.com’s editor. “She not only became a good writer but one who touched the lives of hundreds of people who followed her posts – and her struggle.”

You can read the CancerDiva blog here. She was truly a remarkable person. My sincere condolences to her family and friends. Rest in peace, Terry Hayes.

UPDATE: The Bloggess eulogizes her friend.

Armstrong versus secondhand smoke

The Chron had an interview earlier this week with Lance Armstrong, in which they discussed his current focus on getting a statewide ban on smoking in public places passed.

Q: What made you want to join the Smoke-Free Texas initiative?

A: Smoke-Free Texas is a logical extension of what we’ve done with Proposition 15. Polls overwhelmingly show that the people of Texas want smoking banned from public places. The science on secondhand smoke is overwhelming. I don’t want to infringe on the rights of what people do on their own time, but you shouldn’t smoke in public places. You can’t risk others’ lives.

Q: There’s so much positive news about Americans beating cancer. Yet the news recently was that, worldwide, cancer is expected to overtake heart disease as the world’s top killer by 2010, which isn’t far away. They cite increased tobacco use in China and India. Any chance you will take your initiatives worldwide?

A: Cities all over the world — in Ireland, France, Germany — are banning public smoking. But you’re right, smoking is increasing in China and India. I suppose big tobacco has to take its marketing efforts somewhere.

Q: As you’ve worked on behalf of cancer research funding, you’ve gone into meetings with physicians, scientists and economists — yet you’re the guy everyone wants to hear from. Does that surprise you?

A: You mean that they want to talk to a guy from Plano on a bike? (laughs). People know I take this very seriously. I can talk about it at great length without being a physician or economist or scientist. I understand the disease and am comfortable talking with anyone.

Q: Is there anything else you’d like to tell Texans?

A: This is an important measure for this session. It ties in real well with the cancer initiative it created. The headline should be that Texas is leading the way. In Texas, with M.D. Anderson, UT, Baylor and all the other great hospitals, we’re suited to truly change lives.

I’ve noted Armstrong’s involvement in this effort before. Whether you agree with him or not, having Armstrong on board with this is going to be a big plus for the proponents of this legislation. Anyone who can get a proposal for three billion dollars in cancer research funds through the Lege and approved by the voters, all on their first try, is a force to be reckoned with.