Wednesday, September 28, 2016

Leitchfield passes smoking ban to take effect Jan. 1

Grayson County (Wikipedia image)
Leitchfield, the seat of Grayson County in west-central Kentucky, will become smoke-free on New Year's Day.

The Leitchfield City Council voted 4-1 on Sept. 19 for the ordinance to prohibit smoking in enclosed public places starting Jan. 1, Matt Lasley reports for the Grayson County News-Gazette.

Mayor William Thomason said the delayed start date will allow those who will be affected by the ordinance time to plan and prepare for it, Lasley reports. The ordinance does allow some exemptions.

The new law requires “No Smoking” signs to be displayed anywhere that smoking is prohibited and says local and state police will enforce the ban, with penalties for smokers up to $50 plus court costs and penalties for businesses that "willingly fail to prohibit smoking" to increase progressively up to $250 plus court costs.

A motion for a countywide smoking ban died for lack of a second reading in the Grayson County Fiscal Court in January despite strong support from local schools, the Kentucky Cancer Program and the local hospital, Twin Lakes Regional Medical Center. A hospital spokesperson said in an e-mail to Kentucky Health News that the hospital has continued to be a strong advocate for a local smoke-free law.

Smoke-free advocates in Kentucky have shifted their focus to local smoke-free policies since last fall's election of Republican Gov. Matt Bevin, who has said smoking bans should be a local issue.

Two-thirds of Kentuckians support a statewide smoking ban and have since 2013, according to the latest Kentucky Health Issues Poll. About one-third of the state is protected by comprehensive smoke-free workplace laws, according to the Kentucky Center for Smoke-free Policy.

Tuesday, September 27, 2016

Just over half of Ky. students are in schools with 100% tobacco-free policies; Warren, Russell county districts share successes

The state Department of Public Health has created videos to showcase the success of two Kentucky school districts in becoming 100 percent tobacco-free schools in hopes of encouraging other school districts to do the same. So far, 35 percent of Kentucky's school districts and 51 percent of the state's students are covered by such policies.

“School districts want to hear from their peers and hear from colleagues who have gone through the process already,” Elizabeth Anderson-Hoagland, youth policy analyst with the Kentucky Tobacco Prevention and Cessation Program, said in a news release. “By demonstrating that others have successfully adopted the policy and experienced positive results, we are able to encourage more school administrators to consider going tobacco free.”

The videos are of Russell County Public Schools, which approved its tobacco-free policy in July 2014 and Warren County Public Schools, which passed its policy in April 2015.

Warren County  Supt. Rob Clayton said in the release that a tobacco-free policy "fit perfectly into our core values, one of those being to ensure student and staff safety." Russell County Supt. Michael Ford said the decision to become tobacco-free was part of a "conscientious stance which favors better health for our youth and, I believe, readies them for the modern day workforce."

Kentucky has room for celebration and for concern when it comes to its teen smoking rates.

According to the 2015 Kentucky Youth Risk Behavior Survey, Kentucky's teen cigarette smoking rate is at a historic low, dropping nearly 10 percentage points over the past decade to 16.9 percent from 26.2 percent. However, this is still the third-highest teen-smoking rate in the nation, following West Virginia at 18.8 percent and Iowa at 18.1 percent  The national rate is 10.8 percent.

The survey also found that 23.4 percent of Kentucky's teens use electronic vapor products, near the national average of 24.1 percent.

State health officials attribute the 10-year decrease, in part, to tobacco-free school policies, which encourage districts to create campus environments where tobacco and alternative nicotine products are strictly prohibited on all school property and during school-related trips 24 hours a day, seven days a week.

Sixty Kentucky school districts, 646 schools and a little over half (51 percent) of the state's students are protected by comprehensive tobacco free policies.

Most Kentucky adults (85 percent) support 100 percent tobacco-free schools, including 89 percent of adults who have never smoked, 84 percent of former smokers and 80 percent of current smokers, according to the latest Kentucky Health Issues Poll. 

Strongly enforced 100 percent tobacco free school policies can reduce youth smoking by up to 30 percent, says the release.

“We strongly encourage every school district to adopt 100 percent tobacco-free school policies,” Senior Deputy Health Commissioner Connie White said in the release. “Smoking, which is the leading cause of lung cancer, heart disease and a host of other chronic diseases, is one of the biggest public health challenges facing our state. We owe it to our young people to create healthy environments where they won’t be exposed to tobacco and its detrimental health effects. Not only will it create a healthier, safer learning environment, it will further decrease the chances of them becoming smokers.”

For more information call (502) 564-9358. The Russell County School District video can be found here: https://youtu.be/imkcxDXiugI The Warren County School District video can be found here: https://youtu.be/xQ6-kucZUVs.

Monday, September 26, 2016

Health-insurance premiums for 2017 will be more expensive

By Trudy Lieberman, Rural Health News Service

Recently I got a note from a reader of these columns who lives in Warren, Ohio. He had seen conflicting reports about next year’s insurance premiums. The man was skeptical of an article he had read, which reported that insurance premiums are cheaper than they were in 2010, and that the Patient Protection and Affordable Care Act will cost $2.6 trillion less than estimated. Somehow that didn’t compute with what he had read about premiums going up.

He was right to be skeptical, and his comments are important because they zoom right in on the spin that’s been circulated by various interest groups that want to portray Obamacare’s upcoming fourth-year enrollment season as a gloom-and-doom disaster in the making or the federal government’s not-to-worry scenario insisting health insurance really is affordable.

There’s been much media speculation about high premium rates, and for the most part, the press has favored the not-to-worry scenario. Media have passed that message along with comments such as this from Anne Filipic, the head of Enroll America, a group that signs up people for Obamacare, who argued high premiums are a predictable course correction and a “one-time resetting.” Or this from Kathryn Martin, acting assistant secretary for the U.S. Department of Health and Human Services, who told reporters, “Headline rate increases do not reflect what consumers actually pay. The vast majority would continue to have affordable options.”

Insurance premiums are going up for the 24 million Americans who buy their coverage in what’s known as the “individual” insurance market, and in many states and counties rates are going up a lot. In Colorado, for instance, the insurance commissioner just approved increases of 20 percent or more on average for Coloradans who buy their coverage in the individual market, and in rural areas of the state some increases will top 40 percent.

About half the people in the individual market will buy Obamacare policies through their state’s shopping exchange and most will get a tax subsidy to defray some of the premium cost. The other half who buy in the individual market are not eligible for subsidies. Double-digit increases will matter a lot to them since rates must be the same for identical coverage sold on or off the state exchange.

Yet, too many media stories have omitted the fact that the unsubsidized group will get no help. Instead they’ve planted the notion that premiums are affordable. In its messaging effort, the government has said that about three-quarters of those buying on the exchanges should be able to pay $75 or less a month for a policy after taking subsidies into account. The government used the same pitch used last year when officials said 70 percent of shoppers could get insurance for $75 or less per month after subsidies.

Statements like those, however, are misleading because they overlook the total costs of care that includes the high deductibles, co-pays, co-insurance and high out-of-pocket spending limits. That expense is usually not part of anyone’s talking points.

We don’t know if rates will remain high or whether this year is an aberration, as the government and others claim. We do know that for those who have to pay the premiums, they may be unaffordable.

Affordability, of course, depends on your budget. What’s affordable to a policy analyst in Washington D.C., may not be to someone in rural Indiana. Since the subsidies are larger and most helpful to families with lower incomes, around $30,000 or $40,000, those with even slightly higher incomes may have a tougher time.

A major reason for the high rates this year is that a lot of sick people with heavy medical needs signed up for policies, and their claims have hit insurers’ bottom lines pretty hard, so hard that many have decided not to sell polices. Blue Cross Blue Shield of Nebraska just announced it was not selling Obamacare policies next year on the state exchange even after the state had approved increases of more than 30 percent. Big insurers like UnitedHealth Group and Aetna have left the exchange market in Kentucky and many other states, reducing choices and increasing costs.

As for Obamacare costing $2.6 trillion less than expected, that’s true, according to the Congressional Budget Office. There are many reasons – the recession, less Medicaid spending because 19 states did not expand their programs as the ACA intended, and shifting more of the cost of care to patients themselves through high deductibles.

No one knows whether lower spending growth will continue. One thing, though, is certain. Families will continue to pay one way or another.

What has been your family’s experience with high insurance premiums? Write to Trudy at trudy.lieberman@gmail.com.

Sunday, September 25, 2016

American Medical Association says Humana takeover by Aetna would reduce health-insurance competition in Kentucky

Humana Inc.'s proposed takeover by Aetna Inc. would hurt health-insurance competition in 57 metropolitan areas in 15 states, especially Kentucky and Georgia, says an analysis by the American Medical Association. It cites Louisville-based Humana's large share of the Kentucky market and said the threat is mainly to policyholders in preferred provider organizations (PPOs).

"The AMA, no friend of the insurance industry to begin with, is stepping up the already mounting pressure on Aetna as it attempts to buy Humana, and [on] Anthem, which is trying to take over Cigna," Bruce Japsen reports for Forbes magazine. "The U.S. Justice Department in July sued to block both deals, saying they would hurt competition and raise prices for consumers. . . . The insurers deny the AMA’s contention and are challenging the government’s lawsuits."

Across the various forms of insurance, the AMA analysis saw a threat to overall competition in the Louisville, Lexington and Elizabethtown markets. It saw a threat to the HMO market in the Clarksville, Tenn., market, which includes the Hopkinsville area. It saw lesser threats in the Evansville, Ind., and Huntington, W.Va., markets, which include parts of Kentucky.

Saturday, September 24, 2016

U.S. attorney general hears from Central Ky. families of overdose victims, who offer suggestions on what needs to be done

U.S. Attorney General Loretta Lynch attended events in Lexington and Richmond this week as part of the first national Prescription Opioid and Heroin Epidemic Awareness Week, Bill Estep reports for the Lexington Herald-Leader.

In Lexingon, families who have lost loved ones to drug overdoses shared their stories with Lynch: stories about lying awake at night wondering if their addicted son would make it home, stories of desperation in the search for treatment, stories about the difficulties in paying for treatment and stories about the death of their loved ones.

“We cry every day,” said David Greene of Lexington, whose son Domonique, 23, died of a heroin overdose last October, leaving behind a baby daughter.

Drug overdose deaths in Kentucky rose to a record 1,248 in 2015, compared with 1,088 in 2014, according to the latest annual report from the Kentucky Office of Drug Control Policy.

Members of the group USA HEAT, which stands for U.S. Attorney's Heroin Education Action Team, met Lynch in Lexington at the office of U.S. Attorney Kerry Harvey, whose office helped to set up the group.

The group was created to help members share their stories to increase understanding of heroin and painkiller abuse, and have since presented "to more than 2,500 people at schools, churches and other locations, including the federal prison in Manchester," Estep reports.

In addition to their personal stories, members of the group told Lynch what they thought was needed to fix the problem, including more efforts to educate parents about the issue; "more effective prevention education for young people; better ways for families to find treatment resources; treatment that lasts long enough; quick access to treatment in the moments of clarity when addicts reach for help; and more affordable treatment options," Estep writes.

Harvey told Estep that he was not aware of a similar program in any other U.S. attorney’s office, and his office told Estep that Lynch mentioned trying to replicate it.

“Their stories were devastating, but their resolve to spare other parents the same fate is inspiring,” Lynch said at the University of Kentucky.

Before meeting with the USA HEAT members, Lynch was part of a discussion about heroin and opioid abuse at Madison Central High School, where about 500 students from Madison Central, Madison Southern and Richmond Model Laboratory high schools attended.

"Dozens raised their hands when Lynch asked how many knew someone who had overdosed. Far fewer raised their hands when she asked how many people had survived," Estep writes.

Alex Elswick, who is in long-term recovery from addiction to heroin and pain pills, told the students he got hooked after he had his wisdom teeth removed and received pain pills, Estep reports. “You don’t know what you’re in for” when using drugs, he warned them.

Kayla Greene told students to not use any drugs, even marijuana, saying that her son used marijuana but eventually moved to pills and heroin.

Lynch told one student who asked what to do if they had a friend with a drug problem to tell a trusted adult about it. “You’ve gotta get in between your friend and that problem,” she said.

At UK, Lynch announced $8.8 million to improve state prescription monitoring systems, including Kentucky's system.

President Barack Obama has called for $1.1 billion in new federal spending to fight opioid abuse, with a large part of it going to make medication-assisted treatment more widely available. "The administration estimated in June that Kentucky would get up to $18 million over two years to boost access to treatment for opioid abuse if Congress approves Obama’s budget request."

Friday, September 23, 2016

Lung transplant recipient who battled bureaucracy to get coverage, dies five days after being widowed; funeral Sunday

"Katie Prager, the Kentucky lung transplant recipient whose story with her late husband, Dalton, touched millions, has died," reports Cheryl Truman of The Lexington Herald-Leader. Katie and Dalton met online and married in 2011. "Both had cystic fibrosis, and both had lung transplants that failed."
(Lexington Herald-Leader photo.)

Katie, 26, died in her Flemingsburg home early Thursday, a family member said.

Debra Donovan, Katie's mother, said it was Katie's wish to be surrounded by loved ones in her final moments. “Early this morning she gained her wish of being at home, in her bed, surrounded by her mom, dad, brother and her dogs, dying peacefully away from the hospital, tubes, IVs,” Donovan, wrote Thursday morning on Facebook.

"By the time Katie's close-knit Fleming County family gave her a Christmas-in-September party on Saturday, she was underweight, her once-abundant blonde hair sparse, her color waxen." Truman writes. "She had made a decision to discontinue all life-extending measures except for dialysis and had entered hospice care. She was sleeping a great deal, using an oxygen tank and getting weaker by the day."

Hours before the start of the family gathering, Dalton died in his hometown of St. Louis. "He had been trying to get to Kentucky to see his wife, who was in Hospice care after her own failed lung transplant, one last time," Truman writes.

Read more here: http://www.kentucky.com/news/local/counties/fayette-county/article102599882.html#storylink=cpy


Read more here: http://www.kentucky.com/news/state/article103380187.html#emlnl=Afternoon_Newsletter#storylink=cpy
Katie and Dalton received national attention because they both had "the Burkholderia cepacia infection, which limited the number of surgery centers specializing in their conditions," Truman writes. "Dalton received his lung transplant in November 2014. Katie, after a lengthy bureaucratic snafu over insurance coverage, received her new lungs at the University of Pittsburgh medical center in July 2015." Both transplants were unsuccessful.

"During the Saturday Christmas party, Katie said that she believed in an afterlife and would see her husband again," Truman writes. "At the family gathering in Ewing after Dalton’s death, Katie said, 'I’ll see him soon.'”

Read more here: http://www.kentucky.com/news/state/article103380187.html#emlnl=Afternoon_Newsletter#storylink=cpy

Visitation for Katie will be 4 to 9 p.m. Sunday at Elizaville Christian Church in Flemingsburg. Funeral services will be at 10 a.m. Monday at the church.

Read more here: http://www.kentucky.com/news/state/article103380187.html#emlnl=Afternoon_Newsletter#storylink=cpy

Read more here: http://www.kentucky.com/news/state/article103380187.html#emlnl=Afternoon_Newsletter#storylink=cpy

Thursday, September 22, 2016

Annual health forum looked at connections between health and the economy

The relationship between health and the economy in creating healthy communities was the focus of the 14th annual Howard L. Bost Memorial Health Policy Forum in Lexington Sept. 19. The theme of the Foundation for a Healthy Kentucky conference was "Health as an Economic Driver."

Through a series of TED-style talks, breakout sessions and a keynote address, the forum explored the relationship between health and the economy, offering insights on how anchor institutions can contribute to local economies; the high cost of health care and the lack of price transparency for consumers; and how racial inequities affect the cost of health care.

Health systems as employer and purchaser

Health systems can work as economic drivers in communities through buying local, hiring local and helping employees to live local.

Robert Eckardt
That's what three anchor institutions in Cleveland, Ohio, have done with the help of The Cleveland Foundation, Robert Eckardt, executive vice president of the foundation, said during his TED-style talk. The institutions are Case Western Reserve University and its School of Medicine, University Hospitals of Cleveland and the Cleveland Clinic.

The neighborhoods around the highly profitable anchor institutions are among the poorest in the state, Eckardt noted. His foundation asked the institutions to become stronger partners with the communites through a three part strategy: "Buy local, hire local and live local." The institutions have changed their hiring protocols to hire locally, adding a six-month training program to make it possible, and have agreed to work with three worker owned co-operatives.

Eckardt said foundations can be a "safe space" to help institutions think about their role in the community, noting that many of them have never even considered this an option or a responsibility. "I encourage you to think about how anchor institutions can change their perspective from an internal one to an external one," he said. 

Health care costs

High-deductible, consumer-driven health plans are designed to encourage patients to become more active consumers of their health care by seeking out best price and value, but often this information isn't readily available, said AJcScheitler, manager of stakeholder relations at the UCLA Center for Health Policy Research.

AJ Scheitler
Scheitler said an analysis of health-care costs in Los Angeles found the cost of a circumcision varied between $175 at a reputable clinic that does 20 to 30 circumcisions a day and $3,000 at a local hospital.

She said the cost of care in the U.S. is much higher than in other countries, citing an article by David Lazarus of the Los Angeles Times that told the story of a woman's experience getting a four-shot treatment for rabies in four different facilities that costs less than $20 overseas, and ran more than $5,000 in the U.S.

She mentioned a Reuters analysis of drug prices that found Americans pay seven and a half times more for their insulin than people in Great Britain, and a study published in the Journal of the American Medical Association that found the average cost of insulin in the U.S. more than tripled between 2002 and 2013, jumping to $736.09 from $231.48.

"We have no idea what we are paying for," she said, and though there is beginning to be some price transparency, it is not enough to be effective yet. 

Social justice, health and the economy

Adewale Troutman
Dr. Adewale Troutman, who identifies himself as a social justice and human rights activist, pointed out during his TED-style talk that poor communities with no employment or educational opportunities have poor health outcomes.

"It has been proven quite clearly that the most important number in your (health) profile is not your blood pressure, not your blood sugar or any of that," he said. "The most important number is your zip code. Where you live is the most important factor in your health outcomes."

Among other things, Troutman is the former president of the American Public Health Association with ties to Kentucky as a former associate professor in the University of Louisville School of Public Health and Information Sciences and former director of the Metro Louisville Department of Public Health and Wellness.

Troutman also noted how health inequities increase the cost of care, citing a study by Thomas A. LaVeist of John Hopkins University that examined the direct and indirect costs of providing health care to a sicker and more disadvantaged population.

The report says, "More than 30 percent of direct medical costs faced by African Americans, Hispanics and Asian Americans were excess costs due to health inequities, more than $230 billion over a four year period. And when you add the indirect costs of these inequities,the tab comes to almost $1.3 trillion."

"When you look at the issue of economics and health, it is quite clear that the relationship is very, very strong," he said.

Gail Christopher
Dr. Gail Christopher, a national expert in holistic health and diversity, also emphasized the importance of improving racial inequities as a way to improve health outcomes and to create savings in health care.

"The lions share of the cost savings that this country would experience if we were to achieve racial equity . . . are health care cost," she said in her keynote speech.

Christopher, vice president for program strategy at the W.K. Kellogg Foundation, said that the unifying factor that connects racial inequity to poor health outcomes is exposure to adversity and to stress.

"People who have access to education, people who have access to income, people who are not subjected to discrimination and adversity have better health outcomes," she said. "And when they have better health outcomes, they have fewer interactions with the health care system and therefore they spend less."

The forum is held in memory of Dr. Howard L. Bost, who helped create Medicare and Medicaid, developed the Appalachian Regional Hospital system, improved mental-health services in Kentucky and created the vision for the foundation.
Co-sponsoring partners with the Foundation for a Healthy Kentucky were Kentucky Educational Television, Health Enterprises Network, Kentuckiana Health Collaborative, Kentucky Center for Economic Policy, Kentucky Chamber of Commerce, Kentucky Hospital Association and the Federal Reserve Bank of Cleveland.

Wednesday, September 21, 2016

Nov. 11 Health Coverage Workshop offers something for all journalists, even their bosses

Kentucky faces many unique health challenges, but they don't get enough news coverage, which hamstrings the state and its communities from fully addressing their health problems. These challenges and how to tackle them from a news perspective will be addressed at the Health Coverage Workshop on Nov. 11 at Natural Bridge State Resort Park in Slade.

The workshop is open to any Kentucky journalist, from those who are just starting to cover health issues to those with years of experience in the subject matter, and it offers something for everyone: reporters, editors, news directors, publishers, photojournalists and everyone in between. The workshop is free, thanks to the Foundation for a Healthy Kentucky.

Specific health topics will include oral health, smoking, obesity and cancer, where to find information on these issues and how to localize it for your audience. Revenue building through special health sections will also be addressed.

Several guest speakers will discuss their areas of specialization. Van Ingram, of the Kentucky Office of Drug Control Policy, and Kentucky Health News Senior Reporter Melissa Patrick will talk about how to cover one of Kentucky’s biggest, most complicated problems: opioid dependency and the consequences that follow.

Al Cross, director of the Institute for Rural Journalism and Community Issues, will discuss several topics, including proposed Medicaid changes and their implications for your readers, as well as the basics of managed care organizations that handle Medicaid for the state.

Jennifer P. Brown of the Kentucky New Era in Hopkinsville and Sharon Burton of the Adair County Community Voice in Columbia will discuss, respectively, how a small newspaper can cover health and how newspapers can use health sections to gain revenue and serve readers who need more health information. Finally, Cynthia Lamberth of the Kentucky Population Health Institute will talk about how to look for health policy in all stories.

Natural Bridge has made available a small block of rooms for those participants who would like to arrive the night before. Call the park at 800-325-1710 to make a reservation.

To register for the workshop, complete this registration form as soon as possible.

Direct questions to Danielle Ray at dnray2@g.uky.edu.

Tuesday, September 20, 2016

Genetic testing is an option if you have a family history of breast cancer; regardless, if over 40 get an annual mammogram

October is Breast Cancer Awareness month, making it a good time to consider talking to your primary-care provider about genetic testing if you have a family history of breast cancer.

“Genetic testing is not recommended for all women, but can be helpful for those with a family history of breast cancer to determine if they are at risk,” said Dr. Mridula Vinjamuri of the James Graham Brown Cancer Center at KentuckyOne Health in a news release. “There is only a small chance that your family carries gene mutations that cause breast cancer. However, gene mutations account for about five to 10 percent of all breast cancers, so it is beneficial for women with a family history to be tested for these genes.”

Genetic testing helps determine if you carry certain genes that are known to cause breast cancer, such as BRCA1, BRCA2 and PALB2. Testing involves your physicians sending either a blood or saliva sample to the lab.

KentuckyOne Health notes that about 12 percent of women get breast cancer, but about 55 to 60 percent of women with the BRCA1 gene mutation will get breast cancer by age 70 and an estimated 45 percent of those with the BRCA2 gene mutation will by age 70. Breastcancer.org says that those with the PALB2 gene mutation have a 14 percent risk of developing breast cancer by age 50 and a 35 percent increased chance by age 70.

These gene mutations are inherited from a person’s mother or father. The release recommends that the first family member who has breast cancer get the gene test first, because if they don't have the gene mutations, then other family members won't either. Men with these mutations also have an increased risk of breast cancer.

KentuckyHealth One also notes the importance of seeing a genetic counselor before having any genetic testing to discuss the potential risks, limitations and benefits of the testing.

While there is no medical risks associated with genetic testing other than the slight risks associated with having your blood drawn, there are some psychological risks. The release notes that some who are tested become anxious, angry, sad or depressed because of the uncertainty related to finding out they carry the abnormal genes; others feel a sense of inevitability, though this may not be the case; and others struggle over what they should do next.

“Being aware of how to reduce your risk for a breast cancer diagnosis is very important," said Dr. Mounika Mandadi of the KentuckyOne Health cancer center, which provides breast cancer genetic counseling and testing. “Our goal at the clinic is to raise awareness of breast cancer, decrease risk of diagnosis, and provide chemoprevention.”

The release added that as you weigh the risks and rewards of testing to remember: "All women older than 40 should receive an annual mammogram, regardless of genetic testing results, as aging women are at risk for developing breast cancer." And remember, men can also get breast cancer.

Several Kentucky hospitals are now certified as 'Sexual Assault Nurse Examiner' ready facilities

Three Kentucky hospital systems have become the first in the state to obtain certification that demonstrates their ability to provide 24 hour response for sexual assault victims.

The newly certified "Sexual Assault Nurse Examiner" facilities include all of the St. Elizabeth Hospitals in Northern Kentucky, Fleming County Hospital in Flemingsburg and Meadowview Regional Medical Center in Maysville. They have a SANE nurse on call 24 hours a day, seven days a week.

"This designation demonstrates a commitment to providing a higher standard of care for sexual assault victims by ensuring they will be examined and treated by someone with skills and expertise necessary when dealing with this type of crime. This is certainly step forward for victims' rights in Kentucky," Health Secretary Vickie Yates Brown Glisson said in a news release.

SANE nurses have advanced training in the forensic examination of sexual assault victims and are credentialed by the Kentucky Board of Nursing. The certification was made possible by the "Sexual Assault Forensic Evidence Act," which passed the 2016 General Assembly with bipartisan support. The SAFE Act also addressed the backlog of untested sexual assault evidence kits in the state. Following its passage, Gov. Matt Bevin proposed an additional $4.5 million for the state crime lab to help it meet new testing deadlines set by the bill.

"Making sure sexual assault victims receive quality, compassionate care in the immediate hours following an assault can help them begin the long journey toward healing," Eileen Recktenwald, executive director of the Kentucky Association of Sexual Assault Programs, said in the release. "KASAP commends these hospitals for recognizing the importance of SANE readiness and seeking the certification, and we hope others follow suit."

The state Cabinet for Health and Family Services is required to certify SANE-ready hospitals annually and to post the list on its website. This list is also provided to the Kentucky Board of Emergency Medical Services, which then shares it with local EMS providers.

Health advocacy group that opposes new Medicaid proposal to hold eight community forums across the state to discuss it

This story was updated on 9/23/16.

Kentucky Voices for Health will host eight community forums across the state to discuss Gov. Matt Bevin's proposed changes to the state's Medicaid program during the 30-day federal comment period, which ends Oct. 8.

Each event will feature a brief presentation about the proposed changes, allow time for questions and will provide an opportunity for attendees to discuss how the proposed changes will impact them, their families and their communities, according to the website.

KVH opposes the governor's new proposal, saying on its website blog that it is "costly, complex and greatly reduces access to care."

The governor's new Medicaid proposal was submitted to the federal government in the form of a waiver from federal rules, under a section of law allowing for demonstration programs. It mainly targets able-bodied adults who now qualify for Medicaid under the expansion of this program to those who earn up to 138 percent of the federal poverty level. It does not affect children, pregnant women, the medically frail and adults who were eligible for Medicaid before the expansion.

The proposal is designed to encourage participants to have a higher level of involvement in their health care, through premiums and "community engagement" requirements, and to save taxpayers money by reducing enrollment by about 86,000 people. All of these conditions are controversial and could be denied by the federal government. To date, no proposal with work requirements has been approved.

Bevin has said that if this new plan is not approved, "there will be no expanded Medicaid in Kentucky," a decision that would take away Medicaid coverage from 430,000 Kentuckians who now qualify under the expansion, but he has also said he is willing to negotiate with federal officials.

Six of Kentucky's congressional delegation have sent a letter to  the U.S. Department of Health and Human Services Secretary Sylvia Burwell in support of the governor's new Medicaid plan, asking that it be afforded "a fair and timely review and allow the Commonwealth the opportunity to demonstrate that the Kentucky HEALTH waiver proposal can improve health outcomes while also protecting the long-term viability of the Medicaid program."

Kentucky HEALTH is the official name of the governor's plan and stands for Helping to Engage and Achieve Long Term Health.

The letter was signed by Senate Majority Leader Mitch McConnell, Sen. Rand Paul, Rep. Brett Guthrie, Rep. Hal Rogers, Rep. Andy Barr and Rep. Thomas Massie, all Republicans.

Here's the schedule for the forums:

Sept. 26 - Morehead: Morehead Conference Center, 111 E 1st Street, 6-8 p.m.
Sept. 27 - Paducah: McCracken County Public Library, 555 Washington St., 6:30-8:30 p.m.
Sept. 27 - Lexington: Mary Queen of the Holy Rosary, 601 Hill N Dale Dr., 6:30-8:30 p.m.
Sept. 29 - Elizabethtown: Pritchard Community Center, 404 S. Mulberry St., 6-8 p.m.
Oct. 3 - Prestonsburg: Jenny Wiley State Resort Park, 75 Theatre Ct., 6-8 p.m.
Oct. 4 - London: First Baptist Church, 804 W. 5th St., 6-8 p.m.
Oct. 5 - Louisville: First Unitarian Church, 809 S. Fourth St., 6-8 p.m.
Oct. 6 - Covington: Kenton County Public Library, 502 Scott Blvd., 6:30-8:30 p.m.

Click here to submit your comments. Click here to see the full report.

Monday, September 19, 2016

KentuckyOne Health lays off several top executives

KentuckyOne Health laid off several top executives Sept. 16, the latest sign of trouble at the hospital company created by mergers four years ago.

Andrew Wolfson of The Courier-Journal called the firings "a bloodbath" and wrote: "In an internal announcement that wasn’t shared publicly, the Kentucky division of financially troubled Catholic Health Initiatives said it was axing leaders to “improve operational efficiency and ensure continued focus on patient care.”

The fired executives included Dr. Damian "Pat" Alagia, senior vice president and chief physician executive; Randy Napier, president of Frazier Rehab Institute and Southern Indiana Rehab Hospital, and Michael Spine, senior vice president of strategy and business development. "Velinda Block, system chief nursing officer, who had previously shared her decision to leave the company, decided to resign and her position will not be filled," just as Napier and Spine's will not, Wolfson reports.

The company's announcement said “These decisions were made to strengthen our resources and support the physicians, clinicians and team members who are delivering on the needs of patients and families every day.”

Wolfson notes, "KentuckyOne was formed in 2012 by the merger of Jewish Hospital & St. Mary's HealthCare and St. Joseph Health System of Lexington, but it has had financial troubles ever since, and in February 2014 announced it was laying off 500 employees in Kentucky. Its Denver-based parent lost $125.9 million in the last quarter of 2015 and has run up billions of dollars of debt." Alagia told Wolfson that the moves made sense for the company.

KentuckyOne and its partner, the University of Louisville Hospital, have "come under attack on several fronts over the past few months," Wolfson notes. "Last month a jury returned a $21.2 million verdict against the company and its St. Joseph Hospital in London for conspiring with cardiologists to perform unnecessary heart procedures. . . .

"In June, triggered by a surgeon's complaint that U of L Hospital was so understaffed that it endangered patients, a state inspection last month found that deficiencies in nursing services specifically endangered three patients. A dozen nurses and doctors also told state inspectors that nursing and other staff shortages put patients at risk, according to the state's 30-page report released by the company, which said the hospital is safe and has made numerous improvements. A state inspection team concluded after a follow-up visit in August that the issues had been addressed. U of L Hospital also received the lowest possible score from the U.S. Centers for Medicare & Medicaid Services in a new rating system for hospitals.

"And in May, the Kentucky Supreme Court upheld a $1.45 million punitive damages verdict against KentuckyOne’s St. Joseph Hospital in London for patient dumping in a case in which it twice kicked out an indigent, paraplegic patient in agonizing pain – the second time wheeling him across the street to a motel, leaving him there without a wheelchair and telling him if he came back again the hospital would have him arrested. He died instead."