Saturday, February 26, 2011

Board for nursing-home administrators wants a law to let it issue secret admonitions; bill is in jeopardy

A bill that was introduced late and got a fast start, but has hit speed bumps and maybe a roadblock, would allow the Kentucky Board of Licensure for Nursing Home Administrators to admonish them in secret without the action being "considered a disciplinary action against the licensee."

The chairman of the board committee that recommended the bill said the alternative already exists, though not in law, and "would only be used for situations that were not serious enough to warrant action against an administrator's license," reports Valarie Honeycutt Spears of the Lexington Herald-Leader.

House Bill 414, which would make several other changes, was introduced Feb. 9 by Rep. Tom Burch, D-Louisville. On Feb. 14, he posted the bill for consideration by the Health and Welfare Committee, which he chairs, and got the House to waive the rule that bills be posted for three days before being considered. The next day, the committee approved the bill 14-0 and put it on the consent calendar, which is used to pass non-controverial bills without debate. It was posted for passage Feb. 18, but was removed from the consent calendar that day and has languished on the regular calendar since.

On. Feb. 22, Rep. Tim Moore, R-Elizabethtown, filed an amendment to the bill that could doom it. His is one of several measures that would require abortion clinics to give women face-to-face counseling and offer them an opportunity to see an ultrasound image of their unborn child. Because of that, "Burch said this week he did not think the bill would continue to move," Sepears reports. However, the contents of the bill could be revived as an amendment to another one.

Spears, who has done much reporting about problems in nursing homes, notes that the board minutes from Februrary 2010 referred to 29 complaints, one was from 2006 and the rest were from 2007 through 2010. Among the cases was a nursing home administrator who did not contact authorities when aides abused a resident, an administrator criminally charged with stealing prescription drugs and an administrator sentenced to 10 years in prison for theft and exploiting an adult. The bill does not specify what kind of infractions would result in private criticisms." (Read more)

Friday, February 25, 2011

Kentucky is 'ground zero' in the war on drugs, Rogers says

A Kentucky congressman called "ground zero" in the war against drugs Wednesday as officials gathered in London for the regional meeting of the UNITE Coalition. In attendance was director of the White House Office of National Drug Control Policy, Gil Kerlikowke, right, who has been touring the state to investigate prescription drug abuse.

U.S. Rep. Harold "Hal" Rogers, R-5th District, was the keynote speaker, The Sentinel-Echo's Nita Johnson reports. "Our back yards have been become battlegrounds," Rogers said. "Just last week, five pharmacies in the area were robbed. Our overdose rate is twice as high as the rest of the country."

Rogers, left, repeated expressed his dismay over Florida Gov. Rick Scott's proposal to cancel his state's prescription-drug monitoring program, which has yet to really start. The lack of a monitoring system allows drug dealers to "doctor shop," obtaining prescriptions for drugs they sell in Kentucky. "There are drive-through pain clinics in Florida and 98 percent of the top 100 pain killers is oxycodone," Rogers said. "Last year, Florida alone issued 19 million units of oxycodone. This is an urgent crisis for the people I represent."

Rogers credited UNITE coalitions for fighting against the problem. "Adversity is being harnessed into hope," he said. "UNITE is reshaping future generations."

At a roundtable discussion before the gathering, Kerlikowske spoke of his goals. "I'm here to listen," he said. "The drug problem really impacts so much of our country ... It cuts across all of the social lines, all of the racial lines." (Read more)

Thursday, February 24, 2011

Meds-for-meth bill backer has last-ditch change to exempt liquids and gelcaps, which police expert calls inefficient feedstocks

Hoping to gain the few votes he needs, the sponsor of the bill that would require prescriptions for three popular decongestants said today that he will draft an amendment to exclude liquids and gelatin capsules from the bill, but doubts it will push the measure into law.

"I'm having one drafted to see if it would make a difference" to senators who might be wavering, said Sen. Tom Jensen, R-London. "But even if it passes in the Senate, the likelihood of it passing in the House before the end of the session would be very low. We're running very short on time." Only nine days remain in the session, and two of those are supposed to be reserved for consideration of any vetoes by the governor.

Senate Bill 45 would make pseudoephedrine, a key component in methamphetamine, available only by prescription. It would also apply to two other decongestants used in many cold medicines. A Senate committee approved the bill weeks ago but the full Senate has not voted on it because it lacks the votes to pass. Jensen said he thinks he is about two votes short.

Pseudoephedrine is more difficult to extract in gel or liquid forms, and less efficient in meth making, says Sgt. Stanley Salyards of the Louisville Metro Police and supervisor of its Clandestine Lab Team. "We've never seen a meth lab in Kentucky use gel caps or liquids," he said, "And it's much harder to do. I think it would definitely be worth it to get this bill passed."

The drug industry, which is still running a heavy advertising campaign against the bill, opposed the compromise when it was suggested several days ago. A spokeswoman for the Consumer Healthcare Products Association, citing information from the U.S. Drug Enforcement Administration, said pseudoephedrine is still easily extractible from gelcaps or liquids.

Salyards said the chemical can be extracted from liquids and gelcaps, but "You lose almost 60 percent of the pseudoephedrine when you're extracting it," and half the remainder is lost when the actual lab is cooking off. "It takes a heck of a lot more," he said. "Right now, you can dump [pills] in there and you're good to go."

He acknowledged that meth makers could adapt to the use of liquids and gelcaps, but "If it becomes a problem, we go back and deal with it then."

Beshear signs first bill of session; optometrists will benefit

Gov. Steve Beshear has signed legislation that will significantly increase the scope of care optometrists can provide, making it the first bill to become law in this session of the General Assembly.

"Access to quality health care is a critical issue for families across the commonwealth," he said in a press release. "After careful consideration, along with meetings with many interested parties, today I signed Senate Bill 110 to give Kentuckians greater access to necessary eye care."

The bill made an unusually speedy passage through the General Assembly after being filed Feb. 7. The Courier-Journal reported earlier this month optometrists have given a total of $400,000 in campaign contributions to legislators, the only exception being one who is a physician. Beshear's re-election campaign has also received optometrists' money.

The law will allow optometrists, who do not attend medical school, to perform more types of procedures, most notably one that uses a laser to fix complications that can arise from cataract surgery. Only optometrists in Oklahoma are likewise allowed to use lasers while treating their patients; in every other state, only opthalmologists can. The law also allows optometrists to prescribe certain drugs and lets the state Board of Optometric Examiners define what procedures optometrists can legally perform.

"In order to ensure the highest degree of oversight, I will be meeting with the Board of Optometric Examiners to make sure that providers of these services undergo extensive training," Beshear said. "I believe this new law will mean more Kentuckians can get the eye care they need." Optometrists practice in 106 counties in Kentucky. Two-thirds of the state's counties do not have an ophtalmologist, and supporters of the bill sais it will make eye care more accessible and affordable in rural areas.

Ky. officials ramp up criticism of plan to cancel Florida drug monitoring; U.S. drug czar says Fla. governor may lack facts

Kentucky officials continue to rail against Florida Gov. Rick Scott's proposal to cancel his state's prescription-drug monitoring program, a move they argue would keep the pipeline open for Kentucky dealers who head to the Sunshine State to get drugs.

"The callousness of this governor is absolutely incredible, with the number of people who are dying," said Frank Rapier, director of the Appalachia High Intensity Drug Trafficking Area program.

Democratic Gov. Steve Beshear and Republican U.S. Rep. Hal Rogers have written Scott expressing their displeasure. Kentucky "may have to take legal action," Lt. Gov. Dan Mongiardo, who lacks legal authority to do so for the state, told The Courier-Journal's Emily Hagedorn. "Rick Scott is trying to legalize prescription drugs on the street," Mongiardo said. "The last thing we need is an open spigot to illegal drugs."

Because Florida is one of few states without a drug-monitoring program, traffickers can to go from doctor to doctor, getting prescriptions for drugs at each stop. More people died from prescription drug abuse in Kentucky than traffic accidents, The C-J reported in a recent investigation. Scott has said the monitoring program is an invasion of privacy, is costly and may not be effective.

The issue was discussed in London Wednesday while R. Gil Kerlikowske, director of the White House Office National Drug Control Policy, made a stop there. Kerlikowske (right, C-J photo) is in Kentucky to investigate the prescription drug abuse in the state. "I am certainly giving (Scott) the benefit of the doubt that his decision comes from a lack of knowledge," he told Hagedorn. "So many people in his own state are dying, and others are dying, too." (Read more)

Yesterday, "Narcotics agents across South Florida descended on more than a dozen pain clinics," report Scott Hiaasen and David Ovalle of The Miami Herald. They call it "the most dramatic effort yet to curb the region’s booming business of illegal prescription narcotics." (Read more)

Most Kentuckians say they don't understand health-reform law

Though parts of the new national health-care law have started to take effect, three out of four Kentucky adults say they don't understand how the new policies will affect them, the Kentucky Health Issues Poll has found. But their lack of information hasn't kept most people from venturing an opinion to pollsters about the law. About half said they don't like it, another quarter do and another quarter didn't know how they felt.

Congress passed the law, formally called the Patient Protection and Affordable Care Act, in early 2010, after a major push by President Obama and a heated political battle that still rages and has moved to the courts. Some provisions took effect immediately; others are being phased in through 2014.

The poll showed that four of 10 Kentucky Democrats favor the legislation, while just one in 10 Republicans do. But certain components get support from more than 75 percent of Kentuckians, regardless of political affiliation. Most notably, people like the law's small business-tax credits; its guarantee of access to preventive services without having a co-payment; its guarantee of coverage for children with pre-existing conditions; and its closure the Medicare drug-coverage gap, often called the "doughnut hole," which means certain seniors will no longer have to pay the full cost of medications.

The poll was conducted Dec. 3-22 and 27-28 by the Institute for Policy Research at the University of Cincinnati. It interviewed a random sample of 1,677 adults, 1,469 by landline phones and 208 via cell phones. The poll was funded by the Foundation for a Healthy Kentucky and The Health Foundation of Greater Cincinnati. In 95 of 100 cases, the estimates are accurate within a 2.4 percent margin of error.

Respondents were asked more than 50 questions that covered a range of health-related topics, including financial stresses related to health care; characteristics of their neighborhood (examples: Is it easy to buy fresh produce or ride a bicycle?); degree of civic engagement, such as donation of blood, work on a community project or attendance at a political meeting or rally; how they felt about treatment versus incarceration for substance abusers; using cell phones while driving; health insurance coverage; and smoke-free policy, including a proposed state-wide smoking ban, which found the respondents evenly divided.

Wednesday, February 23, 2011

Kentucky teens under 18 among least likely to drink alcohol, but binge drinking among them is nearly the national average

About 6 percent (709,000 of 12 million) of U.S. children aged 12 to 14 drank alcohol in 2009, and nearly half got their drinks from their own home, according to a study by the Substance Abuse and Mental Health Services Administration.

Because the data are new, they have not been broken down by state, SAMHSA spokesman Bradford Stone said. But the 2007-08 National Survey on Drug Use and Health, which was released in June 2010, showed Kentucky teens are among the least likely in the country to drink alcohol. Numbers showed about 13.8 percent Kentucky youth ages 12 to 17 had tried alcohol in the month they were surveyed. Census estimates indicate Kentucky has about 235,000 10- to 14-year-olds.

Kentucky ranks 10th lowest in percentage of youths who drink alcohol, the 2007-08 numbers showed. Most of the states with the lowest percentages were in the South, including Alabama, Georgia, Mississippi, South Carolina and Tennessee. The lowest percentage, 7.57, was in Utah; Rhode Island, at 20.7 percent, had the highest. Nationwide, the percentage was 15.3 percent.

Nearly 9 percent of 12- to 17-year-olds in Kentucky said they had binged on alcohol in the month they were surveyed, compared to 9.25 percent nationwide.

Research shows underage drinking can lead to future problems. "People who begin drinking alcohol before the age of 15 are six times more likely than those who start at age 21 and older to develop alcohol problems," said SAMHSA Administrator Pamela Hyde.

The National Survey on Drug Use and Health is an annual, countrywide survey involving in-person, at-home interviews with about 70,000 people 12 years of age and older. Each interviewee is randomly selected. Data pertaining to the use of alcohol, tobacco, illicit drugs and mental health is collected. The survey is funded by SAMHSA. Figures are subject to error margins depending on the size of a state and its sample in the survey.

Longtime legislator gets national award for helping mentally ill

State Rep. Jimmie Lee of Elizabethtown, left, today received the national Jacob K. Javits Award, an honor given to legislators who advocate for mental health services.

"It just blows my mind that someone from Kentucky wins, and it was me," Lee told Marty Finley of his hometown paper, The News-Enterprise.

Lee, who has served as a legislator since 1993, was chosen for the honor due to his efforts to expand services for the mentally ill. His efforts include helping to replace the Eastern State Hospital in Lexington, obtaining funding for community mental health centers, and helping to open a new crisis stabilization unit in Louisville.

Lee is the first Kentucky legislator to be chosen for the award. To recognize his achievements, the Kentucky General Assembly passed resolutions that made today Jimmie Lee Day. (Read more)

Tuesday, February 22, 2011

Sponsor of meds-for-meth bill now willing to accept compromise excluding gel capsules and liquids

Legislators wanting to pass a bill that would make the key component to make methamphetamine available only by prescription are now willing to make a concession that they would not accept last week.

House Speaker Greg Stumbo, D-Prestonsburg, said "supporters of the bill are considering excluding cold medicines in gel or liquid capsule form," the Lexington Herald-Leader's Beth Musgrave reports. It is more difficult to extract pseudoephedrine in cold medicines that come in gel or liquid capsule form, though it's unclear how much more difficult.

When Kentucky Health News first broached the idea to the bill's sponsor, Sen. Tom Jensen, R-London, last week, Jensen said he was not willing to make comprises on the bill, though it lacked the votes to pass the Senate. Now he seems to have had a change of heart. "If that would get it passed, we would certainly do it," said Jensen, right. "I have not talked to enough people yet who have said that would change their minds."

Democratic Rep. Linda Belcher of Shepherdsville, who has a similar bill in the House, said the change would help, because more legislators would vote for it because there would still be some cold medicines containing pseudoephedrine, which helps combat symptoms from allergies, on the market.

Drug industry lobbyists, however, rejected the compriomise. "According to the U.S. Drug Enforcement Administration, PSE (pseudoephedrine) in gel cap or liquid formations is 'readily extractible,' meaning it can still be used illegally to make meth," said Elizabeth Funderburk, a spokeswoman for the Consumer Healthcare Products Association.

Senate Bill 45 would make ephedrine, pseudoephedrine and phenylproppanolamine available only by prescription. It is similar to legislation that has passed in Oregon and Mississippi, where there has reportedly been a radical drop in the incidence of meth labs. The bill has been repeatedly passed over since being approved 6-4 by the Senate Judiciary Committee. (Read more)

Monday, February 21, 2011

Humana reinvents itself again, to adapt to U.S. health-care reform

Humana, Kentucky's largest corporation, says it is reinventing itself in the wake of the federal health reform law, focusing on becoming a "well-being" company rather than just a provider of health insurance.

Of the notable changes, the Louisville-based corporation that started life almost 50 years ago as a nursing-home company, then ran hospitals, is now back in the business of providing medical care directly, The Courier-Journal's Patrick Howington reports. That change is due to the $790 million purchase of Concentra, which operates occupational and urgent-care clinics (photo of Dr. J. Shawn Standridge and Danny Murphy by C-J's Michael Hayman). Humana Chairman and CEO Michael McCallister said similar purchases in fields like home health and information technology are expected.

Humana is also involved with development of products such as fitness games that can be played online and a water bottle that tells its owner when it's time to rehydrate. The company is also planning to market diabetic supplies to consumers, and is selling research to health-care companies about the effectiveness of certain drugs. "It's a significant change in our strategy," McCallister said.

Part of the change is due to the new health law, which will mean a $136 billion federal cutback in Medicare Advantage, a supplemental coverage program. Humana is the program's second-largest provider with 1.9 million members, and half its revenue comes from the program.

Though Humana laid off 750 Louisville workers early last year, analysts predict the company will weather the changes. Though Medicare Advantage cuts will likely mean there will be a predicted 5 million fewer seniors enrolled in the plan by 2019, other, smaller providers will likely stop offering it. Humana will be there to pick up those lost customers, analysts contend. (Read more)

Smoking ban up for discussion, not a vote, in Jessamine County Tuesday; bars would be exempt, unlike in Fayette

UPDATE, Feb. 27: "Each branch of government will have the option of adopting or rejecting the ordinance as it stands. Each body will essentially adopt the same ordinance but has freedom in the way it’s enforced within each jurisdiction," Laura Butler of The Jessamine Journal reports.

Elected officials in Jessamine County will meet tomorrow to discuss a smoking ban that could come to a vote later this year. The proposed ordinance would prohibit smoking inside and near the entrance of most enclosed places and workplaces, including restaurants, outdoor stadiums and arenas, but bars would be exempt.

So would a cigar bar (photo by Matt Goins) in the Brannon Crossing development near the border with Fayette County, which has an ordinance banning smoking in bars. The Lexington Herald-Leader's Greg Kocher reports that smoking would be allowed in private homes, unless they are used for child care, adult day care or health care. It would also be allowed in hotel and motel rooms that are designated for smoking; in tobacco stores; in private clubs; and at private functions.

Members of the Smoke-Free Jessamine County Coalition are disappointed by the exceptions. "They've changed a stronger ordinance to exclude certain words and phrases to make it a weaker ordinance," coalition member Susanna Moberly said. "We're very upset with that as a coalition."

"We're not going to put anybody out of business," countered Terry Meckstroth, a Jessamine County Fiscal Court magistrate. "I think the committee felt, 'Let's get something that everybody can live with right now.'" Tomorrow's meeting involves the fiscal court and the city councils of Nicholasville and Wilmore. (Read more)

Three Ky. physicians and one nurse practitioner investigated for high numbers of prescriptions for antipsychotic drugs

State and federal officials are investigating three Kentucky doctors and one nurse practitioner because of the unusually high amounts of antipsychotic drug prescriptions they write for Medicaid patients.

In 2008 and 2009, the four wrote the most prescriptions in the state for Abilify, Geodon, Seroquel, Zyprexa and risperidone, antipsychotic drugs that can cost up to $10 a pill, The Courier-Journal's Laura Ungar reports.

Somerset psychiatrist Dr. Zev Zusman wrote 6,556 prescriptions in 2008 and 2009, resulting in $2.2 million in Medicaid charges.

Mount Sterling's Dr. Samuel Welch, left, wrote 5,881 prescriptions, costing taxpayers $1.9 million.

Deborah Bradford, an Owensboro-based nurse practitioner and psychologist, wrote 4,279 prescriptions, at a cost of $1.2 million.

Paducah-based Dr. Duncan Darnell, a child and adolescent psychiatrist, wrote 3,536 prescriptions, costing $1.1 million.

Welch and Darnell defended their practices. Welch, the medical director of Pathways Inc., said he sees about 20 patients a day in a 10-county area. "The biggest chunk of what I do is see patients for medications," he said, adding that other psychologists provide talk therapy.

Darnell, the medical director at Four Rivers Behavioral Health, said he prescribes for more than 1,000 of his own patients, as well as sometimes prescribing for patients cared for by another psychiatrist and a nurse practitioner. "The folks I end up seeing are often very mentally ill," he told Ungar. "For me, medicines are used as a last resort."

Tracking the prescription levels is part of "a federal review into concerns about over-prescribing, waste and health care fraud in an era of tight government budgets," Ungar reports. Sen. Chuck Grassley, R-Iowa, is leading the review, and has asked every state to list the top 10 prescribers for certain medications. (Read more)

Sunday, February 20, 2011

Kentucky's rates of leisure-time physical activity are among the lowest in the nation; Carter and Pike counties may be the worst

In three-fourths of Kentucky's counties, more than 30 percent of adults say they get no physical activity in their leisure time, according to new survey data from the Centers for Disease Control and Prevention. The statewide average is 30.1 percent. The problem is largely an Appalachian one; four Eastern Kentucky counties may have the highest percentage of physically inactive adults in the country.

CDC's telephone surveys indicate that 42.8 percent of adults in Pike and Carter counties were physically inactive in 2006-08. The only county with a higher figure, 43 percent, was McDowell County, West Virginia, which nearly borders Pike County. Magoffin and McCreary counties, also in Appalachia, rank fourth and fifth. The statewide rate for Kentucky is 30 percent; Kentucky Health Facts has this listing of county rates.

County figures are subject to error margins depending on the size of a county and its sample in the survey. Error margins are usually expressed in terms of a 95 percent confidence level, meaning that in 19 of 20 cases if the entire population were surveyed, the result would be within the error margin. For example, in Carter County, there's a 19 in 20 chance that the figure is between 36.3 and 50.4 percent. A less strict test is standard deviation, which gives the likely result if the data are distributed like the famous "bell curve." In Carter County, the standard deviation is 3.6 percentage points for each figure, meaning there's about a two-out-of-three chance that between 39.2 and 46.4 percent of adults in Carter County are physically inactive -- in any case, very high.

Because Pike County is larger and produces a larger sample for the survey, the error margin there is smaller, with a standard deviation of 2.6 percentage points. At the 95 percent confidence level, Pike County's physical-inactivity figure is between 37.9 and 48.2 percent. At the standard deviation it is between 40.2 and 45.4 percent -- again, very high in any case.

Magoffin County, with a likely rate of 42.2 percent, has a standard deviation of plus or minus 4.9 percentage points and a range of 33.4 to 52.7. McCreary County, at 41.6 percent, has a standard deviation of plus or minus 4.6 percentage points and a range of 33.4 to 51.2 percent.
Colors indicate level of inactivity for each county; legend below (click map for larger image)

Fayette County was the only Kentucky county below the 2006-08 national rate of 25.4 percent, with a rate of 25.3 percent, plus or minus a standard deviation of 1.8 percentage points. It was followed by Calloway (25.5, plus or minus 2.7 points), Oldham (27.2, plus or minus 3.3), Henderson (27.5 percent, plus or minus 2.5) and Jefferson (27.6 percent, plus or minus 1.1).

Light blue/green: 21.1 to 26 percent
Medium blue: 26.1 to 31.1 percent
Dark blue 31.2 percent and above
Activity rates were higher in the northwestern quadrant of the state, in the Louisville and Evansville metropolitan areas. More than 30 percent of adults in Eastern and Southern Kentucky were physically inactive, making Kentucky adults as a whole some of the least physically active in the country. Physical inactivity rates were 29.2 percent or higher for more than 70 percent of the counties in Alabama, Kentucky, Louisiana, Mississippi, Oklahoma and Tennessee. Mississippi had the highest percentage of counties whose adults fell in the lowest of four levels measured, followed by Tennessee.

The results are based on data collected by the CDC's Behavioral Risk Factor Surveillance System, which is an ongoing telephone survey. People were listed as physically inactive if they answered "no" to this question: "During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening or walking for exercise?" Three years of data are used to compute each year's results. (Read more)

Lack of physical activity is a risk factor for developing obesity and Type 2 diabetes. CDC numbers show the proportion of U.S. adults who are obese was 33.9 percent in 2007-2008. Obesity-related medical costs were as high as $147 billion in 2008. The average annual medical costs for an obese person are $1,429 more than for someone who weighs a normal amount. In 2010, 25.6 million people had diabetes. Kentucky's obesity and diabetes rates are among the highest in the nation.

Orange: 26.3 to 29.7 percent
Red: Above 29.8 percent
Orange: 8.5 to 10.1 percent
Red: Above 10.1 percent

Kentucky politicians of both parties object to Florida governor's plan to stop pill-monitoring program before it starts

The new Florida governor's plan to scuttle a yet-to-start program to monitor painkiller prescriptions "has sparked an uproar in Appalachian states that say they are deluged with illegally bought pills from South Florida," Arian Campo-Flores reports for The Wall Street Journal. The strongest objections come from Kentucky.

"The tracking system would include a centralized database to help identify buyers who are accumulating large numbers of pills and the doctors who are overprescribing them. In his recently released budget proposal, however, [Gov. Rick] Scott [CFNews13 photo] recommended repealing the 2009 law directing the state to set up the system," the Journal reports. "Scott has raised concerns about the database's effectiveness and its possible intrusion on patient privacy. Pointing to a $3.6 billion budget deficit for the coming fiscal year, he also worries that the state would end up paying for a program that lawmakers designed to be funded by federal grants and private donations. Most drug-monitoring programs in other states rely on both federal and state funds."

Scott's move has prompted expressions of disappointment from some of his fellow Republicans in Florida and strong objections from politicians of both parties in Kentucky and West Virginia, hotbeds of for abuse painkillers such as oxycodone. "It seems Gov. Scott wants Florida to become the oxy-tourism capital of the world," Kentucky Lt. Gov. Daniel Mongiardo, a Democrat from Hazard, told the Journal. (Read more)

Republican 5th District U.S. Rep. Hal Rogers of Somerset, the new chairman of the House Appropriations Committee, sent Scott a sharp letter on Feb. 17 expressing alarm and dismay. "Now is not the time to back down from this life or death challenge," Rogers wrote, calling Scott's move "equal to firing firefighters while your house is ablaze; it neither makes sense nor addresses an urgent crisis. Governor, your state, more than any other, must take this crisis seriously. . . . Your state's participation is paramount to the success of our nation in fighting this problem, helping addicts get treatment and prosecuting pushers." (Lexington Herald-Leader photo by David Perry)

Rogers dismissed concerns about privacy, saying Florida's program, like those in other states, has strict regulations governing access to the data. Noting his new position, "I can certainly appreciate the fiscal pressures with which you are confronted in balancing a tight state budget. However, this is a matter which warrants sacrifices elsewhere." For a story from the Herald-Leader's Bill Estep, click here.

Saturday, February 19, 2011

Optometrists, ophthalmologists debate bill on TV after its passage

The bill to let optometrists perform some procedures now done legally only by ophthalmologists has passed both houses and is on the governor's desk, but members of both professions are debating its effects on television.

Leaders of the Kentucky Optometric Association and the Kentucky Academy of Eye Physicians appeared on cn|2's "Pure Politics" with Ryan Alessi on Insight cable Friday night, and are scheduled to appear on KET's "Kentucky Tonight" with Bill Goodman Monday at 8 p.m. EST.

Ben Gaddie of Louisville, president-elect of the optometrists' group, told Alessi that while the bill was passed only 11 days after it was filed, becoming the year's first to go to Gov. Steve Beshear, “We weren’t intentionally hiding anything … There are no secrets in Frankfort.”

Woodford VanMeter of Lexington, president of the ophthalmologists' group, "took issue with the ophthalmologists receiving limited time to raise their objections during committee hearings on the bill," cn|2 reports. (Click arrow to start video)

Friday, February 18, 2011

Abortion bills die in House Health and Welfare Committee

Four bills that would have made it more difficult to have an abortion in Kentucky won't make it past the House Health and Welfare Committee.

House Bill 390 and House Bill 215 would have prohibited a woman from having abortion after 20 weeks of pregnancy except in emergency cases; House Bill 374 would have required that a woman wanting an abortion meet with a doctor in person; and House Bill 243 "would have stopped a minor from another state from petitioning a court to receive an abortion if she does not have the permission of a parent," the Lexington Herald Leader's Beth Musgrave reports.

Republican Rep. David Floyd of Bardstown, left, sponsored three of the bills, but did not attend the meeting. "He had three bills, and he didn't have the guts to show up to defend his bills," committee chairman Tom Burch, D-Louisville.

Floyd said the bills should be considered by the Judiciary Committee, not the Health and Welfare, committee. "They devise the committee specifically to kill any pro-life bill," Floyd said of the health committee. The panel includes 10 Democrats and six Republicans. They voted along party lines. (Read more)

No vote taken on bill for drug tests for recipients of public aid

Despite motions to do so Thursday, the House Health and Welfare Committee did not vote on a bill that would require Kentuckians who receive public assistance to submit to random drug testing. The bill did not receive a vote because there is no money to pay for the drug testing and rehabilitation that would be required, said committee chairman Tom Burch, D-Louisville.

Maysville native Ruth Chamblin spoke at the meeting, saying her 12-month-old great-niece might still be alive if such a bill had been made law, the Lexington Herald-Leader's Beth Musgrave reports. Chamblin's great-niece died after she was allegedly beaten by her niece's then-boyfriend. Fearing investigation, Chamblin's niece neglected to take her daughter to the doctor for four days after the alleged attack, and the baby consequently died. The family was on public assistance at the time, and the boyfriend was reportedly a drug abuser.

House Bill 208, sponsored by Republican Rep. Lonnie Napier of Lancaster, right, would require random drug testing for people who receive Medicaid, food stamps and other kinds of public assistance. Those who test positive on the drug screening would have 60 days to get treatment. They would continue to receive public assistance in the meantime, but if they repeatedly failed more tests their assistance would be cut off. The reasoning behind the bill is to stop people from selling food stamps to buy drugs, Napier said.

Napier said the drug testing would cost about $1.5 million a year. One Idaho study has concluded drug testing for state-aid recipients is inefficient. (Read more)

Optometrists' well-financed bill is first to clear General Assembly

The bill that would significantly increase the care optometrists can provide passed the House Friday morning by a 81-14 vote. The bill, which now heads to Gov. Steve Beshear's desk, is the first this session to clear both houses of the General Assembly, The Courier-Journal's Tom Loftus reports.

Since it was filed Feb. 7, Senate Bill 110 has been cause for controversy, in part because of its speedy passage. It passed the full Senate last week, passed the House Licensing and Occupations Committee Wednesday and was voted on by the full House this morning. Loftus notes that optometrists have made more than $400,000 in campaign contributions to legislators and Gov. Steve Beshear in the past two years.

The bill allows optometrists, who do not attend medical school, to perform more types of procedures, most notably one that uses a laser to fix complications that can arise from cataract surgery. Only optometrists in Oklahoma are likewise allowed to use lasers while treating their patients; in every other state, only ophthalmologists -- medical doctors trained to perform eye surgeries --  can. The bill also allows optometrists to prescribe certain drugs and lets the state Board of Optometric Examiners define what procedures optometrists can legally perform.

On Thursday, ophthalmologists voiced their displeasure, saying they believe rules were broken in passing the bill. The bill should have been heard by the Health and Welfare committees, not the licensing committees, they say. "We hope that someone in the House (which now has the bill) will appeal for this to be corrected and ... sent to the proper committee so that the facts can be heard," said Woodford Van Meter, president of the Kentucky Academy of Eye Physicians and Surgeons.

House Speaker Greg Stumbo and Senate Majority Floor Leader Robert Stivers, the bill's sponsor, disagreed, saying the bill affects the licensing of optometrists. Ophthalmologists note the Senate and House rules say the health committees have "general jurisdiction" over "matters pertaining to ... optometrists." (Read more)

Wednesday, February 16, 2011

Bill to expand optometrists' scope of care, aided by political money, continues rapid progression through General Assembly

A bill that would considerably expand optometrists' scope of care cleared the House Licensing and Occupations Committee in an hour-long meeting this afternoon, the latest move in its speedy progression through the General Assembly.

Senate Bill 110 was introduced last week and was passed 33-3 by the full Senate last Friday. It passed through the House Licensing and Occupations Committee today by a 14-2 vote. It will likely be considered by the full House Friday, The Courier-Journal's Tom Loftus reports.

Loftus reported this morning that legislators have received more than $400,000 from optometrists' political action committee and its individual members, with 137 of Kentucky's 138 legislators and Gov. Steve Beshear receiving campaign money. The Kentucky Optometric Association, which employs 18 lobbyists, has given more than $327,000 alone in the past two years through its PAC. (Read more)

"In 2010, optometrists gave $249,273 to all political candidates, including local candidates," Beth Musgrave reports for the Lexington Herald-Leader. "Ophthalmologists, in comparison, gave only $575 in 2010, according to the Kentucky Registry of Election Finance." (Read more)

Both sides are running advertising campaigns, but the ophthalmologists and their fellow medical doctors seem to be behind in that competition, too. A radio ad from the Kentucky Medical Association this week urged listeners to call their senators, though the bill had already passed the Senate.

The bill, sponsored by Republican Sen. Robert Stivers of Manchester, left, extends the scope of care optometrists can provide, most notably allowing them to conduct some laser procedures usually performed by opthamologists. "These are considered minor, non-invasive laser procedures," Dr. Joe Ellis, a spokesman for the Kentucky Optometric Association, told Kentucky Health News. "They're most commonly performed when a person has cataract surgery. There is a membrane that clouds over and they would be allowed to remove that."

Nationwide, only optometrists in Oklahoma are allowed to perform this type of laser procedure, Ellis said. They have been permitted to do so since 1998.

The bill would also allow optometrists to "remove lumps and bumps around the eye," Ellis said, which is currently only permitted in Oklahoma, Louisiana, Tennessee and North Carolina. It would also allow optometrists to do what Ellis termed "routes of administration." "Like if a person had an inflammation around the eye, you can inject a steroid to reduce inflammation," he said, adding nine states allow optometrists to do that.

The proposal would also allow optometrists to prescribe certain drugs, and would let the state Board of Optometric Examiners define what procedures optometrists could legally perform. Supporters say it would make certain types of eye care more available in rural areas, which have few ophthalmologists.

Physicians take issue with the proposal, saying optometrists are not properly trained to perform the procedures. Critics are also suspicious over the speed with which the bill is moving. An editorial in the Herald-Leader today says, "We've long known that politicians are blinded by political money," the opinon piece says. "If this bill becomes law, some of their constituents could be, too." (Read more)

Foundation for a Healthy Kentucky awarded nearly $3 million in grants in 2010

The Foundation for a Healthy Kentucky awarded nearly $3 million to community organizations, schools, government agencies and institutions in 2010. The funds, awarded in 80 grants, will support programs and policy development for health improvement and access to health care.

The grants supported health advocacy initiatives; helped civic leaders identify and address key health concerns; supported the integration of mental health and medical services; helped communities get planning assistance and funding for federally-qualified health clinics; and helped four foundations address nutrition, physical activity and environment policy issues.

The largest sums went to Burkesville-based Cumberland Family Medical Center for the Kentucky Health Futures Initiative; Home of the Innocents to improve access to dental care; Montgomery County Health Department for the Gateway Rural Health Investment Network; and Saint Joseph Health System to deliver virtual care. Each of these four organizations received $250,000.

The Foundations spends earnings on a $45 million settlement that then-Attorney General Ben Chandler reached in 1999 with Anthem Inc. as a result of the company's conversion of the charitable assets of the old Blue Cross & Blue Shield of Kentucky. For the foundation's history and other background click here.

Panel OKs bill to ban children under 14 from tanning booths

A bill that would prevent children under the age of 14 from bronzing their skin at tanning booths cleared the House's Health and Welfare Committee Tuesday. House Bill 338 will now move to the full House for consideration.

The bill is sponsored by Henderson Democratic Rep. David Watkins, who is a physician. "This is simply trying to protect our children and trying to protect our young people," Watkins, right, told WTVQ-TV. "They are utilizing tanning booths to an excess amount and I think parents need to be aware of this."

The bill is backed by the Kentucky Medical Association and the American Cancer Society. If it passes, a parent or business that allows a child under 14 would not face any penalties, though the bill's sponsors would eventually like to see penalties added. (Read more)

Tuesday, February 15, 2011

Cost is one obstacle for bill that would require coroners to look into nursing home deaths

A bill that would require coroners to be called when someone dies in a nursing home may be in jeopardy. At issue is how to pay for it.

Chief State Medical Examiner Tracey Corey estimates she would need three more doctors, more support staff and more equipment if even 10 percent of deaths needed investigation, the Lexington Herald-Leader's Valarie Honeycutt-Spears reports.

House Bill 69, sponsored by Rep. Tom Burch, D-Louisville, right, would require a nursing home or hospice staff member to alert a coroner about a death on the premises within 24 hours. If they, and they alone, suspect abuse, coroners would be required to inform law enforcement authorities or prosecutors. The aim is to determine if abuse or neglect might have occurred.

"But Burch said if Corey's financial concerns lead to the bill being sent to the committee making decisions about state spending, he think it 'means sudden death' for the legislation," Honeycutt-Spears reports.

Burch also said nursing home officials are balking at the bill's aim to increase the penalties for failing to report abuse or neglect. As of now, such a failure is considered a Class B misdemeanor, which carries a punishment of up to 90 days in jail and a $250 fine. The bill would change it to a Class A misdemeanor, which can result in up to 12 months in jail and a fine up to $500.

The bill would also mean long-term care facilities that fail to designate a staff member to report deaths to the coroner would be fined $200 a week. (Read more)

Drug czar coming to Kentucky to look at prescription pill abuse

The White House drug czar will visit Kentucky next week to investigate prescription pill abuse, a problem he called "heartbreaking." In a four-day tour, Gil Kerlikowske, President Obama's chief advisor on drug issues, will meet with law-enforcement officials, recovering addicts, drug-treatment workers, business leaders and politicians, Roger Alford of The Associated Press reports.

On Monday, U.S. Senate Republican Leader Mitch McConnell of Kentucky met with Kerlikowske, right, to discuss his visit. They discussed several of the state's drug issues, including prescription drug abuse, meth production and marijuana cultivation.

Kerlikowske's visit will focus on prescription pill abuse. Earlier this year, Kentucky's two largest newspapers published in-depth reports on the issue. In its series "Prescription for Tragedy," The Courier-Journal reported more Kentuckians die from prescription pill overdoses than car crashes. In its look at "pill mills," the Lexington Herald-Leader investigated how some counties are passing legislation to keep the faux medical clinics out of their areas.

Alford reports the problem drastically grew in 2000 upon the explosion in use of of OxyContin, which became known in Appalachia as the "Heroin of the Hills." When Kentucky started maintaining narcotic monitoring systems, drug traffickers went south to Florida, where there is no such system, to buy the drug. In one raid in South Florida in the early 2000s, authorities found more than 1,000 files from patients who lived in Eastern Kentucky, the Herald-Leader found. Most recently, Florida's Gov. Rick Scott proposed a budget that would leave a new prescription drug monitoring program unfunded. The chairman of the Health and Human Services Committee of the Florida House called the monitoring system "big brother."

Given the tight economy, Kerlikowske said it will be important to deal with the issue in "smart ways." "If we educate kids about the dangers of pills ... if we clean out medicine cabinets in a safe way, if we get physicians more information about how to recognize addiction and how to deal with this, and then we can crack down on doctor shopping and physicians who are over-prescribing, we have huge potential to really begin to bring this under control." (Read more)

Campbell County expected to repeal smoking ban

UPDATE, Feb. 17: The county Fiscal Court voted 3-1 to repeal the ban, Mike Rutledge of The Kentucky Enquirer reports.

A smoking ban in Campbell County may be repealed before it even takes effect. Campbell County commissioners will vote on the matter tomorrow.

The ordinance, which would ban smoking in workplaces and public places like bars and restaurants, originally passed in December, The Kentucky Post's Chris Reed reports. But with two new members on the four-member commission, both of whom have expressed their opposition to the ban, it may be overturned.

Opponents say a ban would hurt Newport bars and restaurants, citing studies that show businesses that go smoke free experience a 20 to 30 percent loss in revenue. Supporters are still fighting to keep the ban. "We're trying extremely hard to convince the commissioners to leave the ban in place, said Jenny Beene-Skuban, volunteer for Smoke-Free Northern Kentucky. (Read more)

New fitness program in Clay County designed to get kids moving

Every fourth- and fifth-grader in the Clay County schools will receive a pedometer as part of a new fitness program designed to combat childhood obesity.

"The goal is to motivate students to be more physically active in a county where one research project found that 47 percent of children were overweight or obese," the Lexington Herald-Leader's Bill Estep reports.

The program integrates physical activity in lesson planning in subjects like math and geography. "It does that through challenges to walk enough steps to get to Houston, for instance, with lessons about the geography or history of places along the route," Estep reports. "We want to see some changes," said Deann Allen, instructional supervisor for the school system.

The program is a venture between the system, Kosair Children's Hospital in Louisville and Manchester Memorial Hospital. Kosair is paying for the pedometers, expected to cost about $15,000. A similar program was started in Louisville last year. (Read more)

Survey shows 75 percent of Bullitt County residents favor smoking ban; measure to be considered tomorrow

A survey found 75 percent of 400 Bullitt County residents would support a smoking ban in businesses. The numbers were released a day before the Bullitt County Board of Health is set to consider the ban, The Courier-Journal's Emily Hagedorn reports.

"There were a lot of people who said Bullitt County wasn't ready (for a smoking ban)," said Health Department Director Swannie Jett. "I think we've gotten to the root of who wants change in Bullitt County."

The survey showed people who most supported the measure are between the ages 18 and 34 and over 65 and have college degrees.

Critics who oppose a ban weren't impressed. "No survey that's paid for by an interest group is worth anything," said Harlen Compson, spokesman for Bullitt County Choice.

A statewide survey released in January by activists in favor of a statewide smoking ban showed 59 percent of Kentucky voters favor a ban in public places. (Read more)

Monday, February 14, 2011

Kentucky companies adjust to new federal rules requiring accommodations for breast-feeding mothers

Rules in the federal health-care refom law are resulting in Kentucky companies making room and time for mothers breast-feeding their children, the Lexington Herald-Leader's Mary Meehan reports.

Louisville Metro Government and four Louisville hospitals have announced programs that encourage breast feeding. Thirteen government work sites in Louisville will add lactation stations funded by a $7.9 million federal grant. The University of Kentucky started providing a program for breast-feeding mothers in 2009.

"It's not easy being a working mom when you are trying to breast-feed," said mother Lauren Goodpaster, right (H-L photo by Mark Cornelison). "Just having the support, having people say that's a great thing you are doing, that was kind of a boost to keep me going on days when it is such a pain."

The rules, which took effect when the Patient Protection and Affordable Care Act was signed March 23, 2010, require employers to provide reasonable break time and a private, non-bathroom place for nursing mothers to express breast milk during the work day. For more information about the regulations, click here. The U.S. Department of Labor has not yet released specific accommodation requirements or penalties if companies don't comply.

As of now, accommodations can be anything from providing a clean room with a locked door to allowing a fast food worker time to pump breast milk while in her car, Meehan reports.

Studies show breast-fed children are sick less often than those given formula, resulting in mothers missing less work time to care for their kids. In Kentucky, just 59 percent of new mothers breast-feed, compared to 75 percent nationwide. (Read more)

As meds-for-meth bill languishes, some seek compromise, but bill's sponsor says proposals would render it ineffective

By Al Cross and Tara Kaprowy
Institute for Rural Journalism and Community Issues

As the bill to require prescriptions for three widely used decongestants remains short of votes to pass the Senate, there is talk of a compromise measure to thwart the use of the medicines for making methamphetamine. But the bill's sponsor says he is not open to the compromises he's heard.

"We want to go with something that works," said Sen. Tom Jensen, R-London. "What has worked is what they've done in Oregon and Mississippi. What they have done is make a controlled substance out of pseudoephedrine, ephedrine and phenylpropanolamine," and greatly reduced the number of meth labs.

Lobbyists for drug manufacturers are circulating alternative proposals, such as applying the prescription rule only to the estimated 5,500 people convicted of a drug-related crime. Another industry proposal would cut the annual non-prescription purchase limit by more than half, from 108 grams per year to 50.

Jensen dismissed those proposals, saying they would do nothing to curtail "smurfing," meth makers' use of people who are paid to buy ingredients. "Some of them are homeless, some of them are college kids, some of them come from poor backgrounds," Jensen said of the buyers. "They've got fake IDs, they've got GPS systems showing all the pharmacies in the area, and they'll hit them very quickly." He added, "Even trying to limit (per-month consumption) has created a whole other problem. We have a whole lot of people who are getting involved in criminal activity who probably don't even know it."

The current monitoring system keeps the decongestants behind the counter and requires buyers to register. Under federal law, individuals may not buy more than 9 grams of pseudoephedrine in a 30-day period.

Last week on the Jack Pattie Show on Lexington's WVLK-AM, Louisville drug officer Stanley Salyards said he would accept a bill that would require prescriptions only for pills containing the three decongestants, since making meth from gelcaps and liquid preparations is very difficult. Two other police officers on the program indicated agreement.

Jensen rejected that idea today, saying his Senate Bill 45 would apply to only 15 products, and "All the other cold and flu medicines are still out there."

A Senate committee approved the bill on a 6-4 bipartsan vote last week, but the full Senate has passed over it for more than a week, and Jensen acknowledged in today's interview that it lacks the votes to pass.

He said manufacturers of the 15 cold remedies "have spent a tremendous amount of money opposing it and getting a lot of misinformation out there ... We, unfortunately, don't have the funds to get out and make full-page ads and radio statements and TV commercials that say 'That's just not true.'" For example, the ads say the registration and tracking system is effective, but the law-enforcement officers on the radio show last week said it is not.

Opponents of the bill say having to get prescriptions would increase costs for cold and allergy sufferers, and meth makers would simply cross state lines to get their supplies. The opponents are backed not only by heavy spending, but by the Kentucky Chamber of Commerce. The Chamber has suggested "banning all online retail sales, distribution and shipment of products containing ephedrine and/or pseudoephedrine from non-Kentucky licensed pharmacies to individuals in Kentucky."

Rep. David Floyd, R-Bardstown, filed a bill last week to make the pill forms of the three substances “legend” drugs, those that are "available through the determination of a pharmacist or by prescription," reports The Kentucky Standard of Bardstown. "It would not be classified as a controlled substance." The bill would also prohibit purchases of any of the three medicines by anyone under 18 without a prescription.

“While many of us are sympathetic to those who have been adversely affected by the meth trade in Kentucky, I don’t believe making pseudoephedrine only available via a doctor’s prescription will curtail the meth problem in our commonwealth,” Floyd said in a press release. “By placing more responsibility on pharmacists who already have a monitoring system for pseudoephedrine sales, we can gain better control on those who are purchasing the product to make meth while not punishing those who need pseudoephedrine for legitimate health purposes.”

Floyd's House Bill 376, which he said he wrote after consulting with Bardstown pharmacists, would allow pharmacists to dispense the drugs to "a person evidencing physical symptoms treatable by those products," according to the bill summary, and "would require pharmacists to ask a series of questions to those trying to purchase a pseudoephedrine product," the Standard reports. It would also require thrm to put the information into the state's electronic tracking system for prescriptions.

"Local pharmacist Leon Claywell already uses a screening system to determine why a customer is buying medicine containing pseudoephedrine, Floyd said. If he thinks it is not for a legitimate purpose, he refuses to sell it," the Standard reports.

Idaho study: Drug testing for state-aid recipients inefficient

As discussion continues among Kentucky lawmakers over whether public-assistance recipients should undergo mandatory drug testing, an Idaho study has concluded such an undertaking is not cost-effective.

"The costs of legal action alone during the first year could exceed the costs of the drug testing and treatment program," says the study, as reported by The Associated Press. "To fund the costs of the program, (Idaho) would need to either appropriate additional funding for a drug-testing program, or divert funds from current programs for the screening, testing and treatment activities."

The study was conducted by Idaho's Department of Health and Welfare. It found that testing for federal welfare programs like Medicaid and food stamps is forbidden. For child-care assistance and temporary cash assistance for families, programs that cover about 10,500 Idahoans, the study showed the "costs of testing and related treatment would wipe out prospective savings achieved by removing offenders."

On Jan. 7, state Rep. Lonnie Napier, R-Lancaster, filed House Bill 208, which would requie random drug and urine testing for any Kentucky resident over 17 who gets Medicaid, food stamps or welfare benefits. Those failing the test would lose their benefits until they passed drug testing at a later date. The cost of the proposal was unknown, though Napier, right, said there are more than 600,000 Kentucky adults on welfare, and a drug test costs about $30. Those numbers result in a $18 million price tag, plus the costs of expanding drug treatment programs.

The House's Health and Welfare Committee has had the bill since Feb. 1 and does not appear likely to approve it.

Missouri, Virginia and Nebraska legislators are considering similar proposals. New Mexico lawmakers are debating whether to test for drugs as a condition to receive unemployment benefits. Minnesota and Wisconsin test convicted felons who receive some form of public assistance. Arizona "requires about 12,500 people in one federal program to complete a drug-screening questionnaire, with some then undergoing drug screens," AP reports.

The proposals have not been met without controversy. In 1999, Michigan's effort to drug test members of needy families who received temporary federal assistance lasted just five weeks before it was ruled unconstitutional, AP reports. (Read more)

Red wine, dark chocolate make for heart-healthy Valentine's

Those seeking to stay heart healthy even on the most romantic day of the year won't have to look much farther than the wine rack, scientific research source Newswise reports. Experts from the Loyola University Health System have found red wines like Pinots and merlots all contain a healthy amount of catechins, which help improve "good" HDL cholesterol.

Dark chocolate with a 70 percent-plus cocoa content is likewise heart friendly, thanks to its resveratrol, which helps lower blood sugar. "You are not even choosing between the lesser of two evils, red wine and dark chocolate have positive components that are actually good for your heart," said Susan Ofria, clinical nutrition manager at Gottlieb Memorial Hospital.

In honor of National Heart-Healthy Month, which is being celebrated this month, Ofria also recommends eating: salmon or tuna; flax seeds; oatmeal; black or kidney beans; walnuts and almonds; and blueberries, cranberries, raspberries and strawberries. (Read more)

Sunday, February 13, 2011

Legislators expected to ban products containing addictive, powerful ingredient marketed as 'bath salts'

Kentucky is one of an increasing number of states proposing an emergency ban on products marketed as "bath salts," which can cause paranoia, hallucinations and even violent behavior.

The product, which is sold legally in stores and online under names like Cloud Nine, Red Dove, Blue Silk, Zoom and Ivory Wave, contains the ingredient methylenedioxypyrovalerone, commonly known as MDPV. The drug, which is also in products labeled as plant food, has been compared to cocaine and methamphetamine because of its addictive nature, the Lexington Herald-Leader's Beth Musgrave reports.

State Sen. Walter Blevins, D-Morehead, left, sponsored Senate Bill 129, and state Rep. John Tilley, D-Hopkinsville, right, sponsored House Bill 121, both of which ban methylenedioxypyrovalerone. Their bills simply refer to the drug with the street name "dove," and, in an emergency capacity, ban possession, trafficking or manufacture of MDPV and two related chemicals. The emergency ban is expected to pass.

Musgrave reported in December more than 100 cases of MDPV overdose were reported to poison centers in the last quarter of 2010, more than 75 percent of which were in Louisiana and Kentucky. The Louisiana Poison Center has been studying the abuse of the drug, which is most commonly snorted, but can be injected, smoked and eaten. Nationwide, the center has received 360 calls about the drug this year, Director Mark Ryan said. Earlier this month, White House drug czar Gil Kerilikowske issued a warning against abusing the product. Emergency bans have been issued in Louisiana, North Dakota and Florida, and legislative bans are also pending in Hawaii and Mississippi. (Read more)

Two bills aim to establish registry for abusers of adults

Identical bills have been filed in the House and Senate to establish a state registry of people who have abused or neglected adults.

Senate Bill 38, sponsored by Sen. Julie Denton, R-Louisville, left, and House Bill 101, filed by Rep. Ruth Ann Palumbo, D-Lexington, right, have advance in their respective committees.

The Courier-Journal's Deborah Yetter, who wrote a series of stories that examined elder abuse in December, reports that advocates including the Council on Developmental Disabilities are working to advance the bill. Council officials feel "a registry would help protect disabled or elderly adults by giving potential employers a place to check the backgrounds of people they hire to provide personal care at home such as housekeeping or bathing or grooming," Yetter reports.

Some state officials have expressed concerns about the cost of such a registry. (Read more)

Saturday, February 12, 2011

Senate quickly passes bill to allow optometrists to perform minor surgical procedures; ophthalmologists say that would be risky

"The Senate approved a bill Friday to allow optometrists to perform some surgical procedures on the eye and eyelid, brushing aside warnings from medical doctors who said optometrists are not qualified and could harm surgical patients," John Cheves reports for the Lexington Herald-Leader. Supporters of the bill said it would improve eye services in rural areas.

Prospects for Senate Bill 110 in the House are uncertain, but it passed the Senate 33-3 and optometrists have long been major financiers of legislators' campaigns. They have given almost $740,000 to state candidates since the Registry of Election Finance began keeping computerized records in 1997, and have won several legislative battles against ophthalmologists, medical doctors who specialize in eye matters.

The bill was filed Monday night and approved by the Senate Licensing and Occupations Committee the next day. "After ophthalmologists started calling, the Senate granted them a brief hearing Friday morning to air their complaints, although it did not stop the Senate vote," Cheves reports. Sen. Julie Denton, R-Louisville, chair of the Health and Welfare Committee, called the process a "kangaroo court" and said, "Just because we have a squeaky wheel doesn't mean we have to oil it immediately."

If the bill becomes law, optometrists could "remove lumps and bumps and use lasers to treat a few specified conditions, although they could not perform Lasik corrective surgery or any other procedure requiring general anesthesia," Cheves reports. "Optometrists told the committee that about two-thirds of Kentucky's counties don't have an ophthalmologist, especially in rural areas. . . . Oklahoma passed a similar law in 1998 with no serious problems, they added."

Oklahoma's law is the only one like it in the U.S., according to a commenter on the story, identified as "uk1234." Noting the bill language that would give the state Board of Optometric Examiners "sole authority to determine what constitutes the practice of optometry," the commenter wrote, "The fox will be in charge of the hen house." But a commenter named "taxus" replied, "If the training is adequate (long enough to be proficient) and the practitioner trainee is certified by a panel of peers in the licensing body, then it could prove to be a good idea for folks the 2/3 of the counties where these particular procedures are not now available." (Read more)

Friday, February 11, 2011

State's Tobacco Quit Line is now available to users aged 15-17

The state Tobacco Quit Line will now offer counseling services to Kentuckians aged 15 to 17 to help them give up cigarettes or other tobacco products. The line had been available only to people 18 and older.

Public Health Commissioner William Hacker, a pediatrician by trade, said “Studies show that people have more success quitting smoking when they have access to resources like counseling and peer support. We hope this change will encourage young people who are interested in quitting to take action and start leading healthier, tobacco-free lives.”

Data from the 2010 Kentucky Youth Tobacco Survey show that almost 25 percent of the state's high-school students are smokers and almost 70 percent of teenage smokers want to quit. Although the prevalence of smoking among youth has declined in the past few years, the smoking prevalence among teenagers and young adults is higher than among other adult populations.

“Addressing the prevalence of teen smoking in Kentucky is a critical issue because statistics show that more than 80 percent of adult smokers became regular smokers before age 18,” said Irene Centers, coordinator OF the tobacco prevention and cessation program in the Department of Public Health. “It’s imperative that we not only prevent young people from ever using cigarettes and tobacco products, but also that we offer assistance to help them give up tobacco.”

Kentucky’s Tobacco Quit Line is a free, telephone-based tobacco cessation service that offers:
· One-on-one proactive counseling for tobacco users who are ready to quit.
· Support for people who want to stop smoking or using other tobacco products.
· Information on tobacco dependence for health care professionals.
· Information about local resources to help tobacco users quit.

Callers to the line speak with coaches trained to assist them with quitting. Coaches have a minimum of a bachelor’s degree or equivalent and are trained in behavioral modification and motivational interviewing. Services are available in English and Spanish at the time of the call. Counseling in other languages is available free through a third-party translation service. For the deaf or hard of hearing, TDY/TDD is available at (800) 969-1393. If employers want to help their employees quit, information is available through the Quit Line and local health departments. Group sessions and cessation materials can be made available at the worksite.

Beshear backs bills to protect seniors from abuse but doesn't endorse minimum staffing for nursing homes

Gov. Steve Beshear today endorsed a package of previously introduced bills that he said would give the elderly and other adults more protection against abuse and exploitation, but it did not include a bill to set minimum staffing standards for nursing homes, the major measure sought by reformers. The legislation would:
  • Prevent people who abuse or neglect vulnerable or elderly adults from benefiting from their deaths (House Bill 52)
  • Keep a person convicted of felony abuse or exploitation of an adult from serving as that victim's guardian, executor or power of attorney (HB 54)
  • Make it easier and more efficient for adults and seniors needing a guardian when more than one state is involved. (HB 164)
  • Require annual criminal background checks of staff at personal care agencies, a step beyond the pre-hiring check. (Senate Bill 23)
  • Require criminal background checks for all employees of nursing homes and assisted living homes, including custodians and food service workers (SB44)
  • Create an adult abuse registry (HB101 and SB 38)
Beshear noted that last year he implemented recommendations from a Cabinet for Health and Family Services report investigation of nursing home neglect and abuse and said “This legislation further strengthens safety standards and will make a significant difference in the lives of Kentucky’s elderly citizens and the people who care for them.” Beshear recently received the Better Life Government Involvement Award from the main nursing-home lobby, the Kentucky Association of Health Care Facilities.

Bernie Vonderheide of Kentuckians for Nursing Home Reform told Kentucky Health News, "We think Gov. Beshear is to be applauded for reacting decisively to reports by advocates and the media of abuse and neglect of our state's senior citizens. We hope he will continue giving his attention to these serious matters. For example, he should also support legislation before the General Assembly that would set minimum staffing standards for nursing homes, one of the big causes of abuse and neglect among our seniors."

Tuesday, February 8, 2011

Foundation matches Social Innovation Fund money to create grants for improving health services in seven Kentucky counties

The Foundation for a Healthy Kentucky today announced four equal Social Innovation Fund grants totaling $1 million to improve access to health services, reduce health risks and disparities, and promote health equity in Jefferson, McCreary, Wolfe, Powell, Montgomery, Bath and Menifee counties. The projects are expected to serve nearly 9,000 people in the next year.

Home of the Innocents in Louisville will establish a dental clinic at the newly opened interdisciplinary Hockensmith Pediatric Assessment Center. The program will provide dental services to children in state care, children with special health care needs, and other children and families served by the Home and its partner agencies.

St. Joseph Health System, based in Lexington, will establish primary care clinics in Powell and Wolfe counties, both rural and low-income. These satellite clinics will be staffed by nurse practitioners and will utilize telemedicine to collaborate with physicians and specialists at a central location.

Cumberland Family Medical Center, based in Burkesville, will establish a nurse-managed health center and rural training program for nurse practitioners and physician assistants. Funds will be used to expand the scope of services provided in McCreary County to include x-ray and utilize health IT to connect with other CFMC sites. This will be the county's first x-ray, reducing travel for local residents who previously had to travel ouside the county for x-ray services.

The Montgomery County Health Department in Mount Sterling will establish a health education and navigation program to serve a low-income population in Montgomery, Bath and Menifee counties. Four full-time health navigators will be employed to serve the community by assessing individual needs and linking patients with services.

Each $250,000 grtant includes $125,000 from the Foundation for a Healthy Kentucky. As an endowed public charity, the foundation was able to provide the matching funds that were required to secure the Social Innovation Fund award for Kentucky. Learn more about the grants here.