Friday, March 31, 2023

Appalachian Nursing Academy for high school juniors and seniors in Appalachian counties extends application deadline to April 15

The Appalachian Nursing Academy, for high school students in Appalachia who are wondering if they would like to pursue a career in health care, has extended its application deadline to April 15. 

The academy is a free, two-week summer program at the University of Pikeville July 10-21. It is available to rising junior or senior high school students who reside in one of Kentucky's 54 Appalachian counties. 

Those counties are Adair, Bath, Bell, Boyd, Breathitt, Carter, Casey, Clark, Clay, Clinton, Cumberland, Edmonson, Elliott, Estill, Fleming, Floyd, Garrard, Green, Greenup, Harlan, Hart, Jackson, Johnson, Knott, Knox, Laurel, Lawrence, Lee, Leslie, Letcher, Lewis, Lincoln, McCreary, Madison, Magoffin, Martin, Menifee, Metcalfe, Monroe, Montgomery, Morgan, Nicholas, Owsley, Perry, Pike, Powell, Pulaski, Robertson, Rockcastle, Rowan, Russell, Wayne, Whitley, and Wolfe. 

Participants of the academy are required to attend the entire program and participate in a year-long mentorship program following the academy. Those who complete the program will also receive a $1,500 scholarship to any college or university of their choice.

Participants will receive housing, three meals a day, interactive programming and trips to see regional attractions and activities. 

To apply, students will need to submit a permission form, a completed application, a copy of their unofficial transcript and a letter of recommendation. Click here for more information. Click here for answers to frequently asked questions. Applications will close Saturday, April 15 at 11:59 p.m. ET.

The academy is sponsored by Shaping Our Appalachian Region in partnership with the state Department for Public Health and the university. This is the second time the academy has been offered. 

Thursday, March 30, 2023

Mostly along partisan lines, legislature overrides governor's veto of bill that would ban gender-affirming care to minors in Kentucky

Nineteen protesters opposing Senate Bill 150 in the gallery were arrested as the House voted to override the veto of a bill to ban gender-affirming care for Kentucky's youth. (Photo by Melissa Patrick)
By Melissa Patrick
Kentucky Health News

Republicans in the Kentucky House and Senate voted Wednesday to override Democratic Gov. Andy Beshear's veto of Senate Bill 150, which bans gender-affirming care for trans youth and sets rules around how issues of sexuality should be addressed in schools. 

The Senate voted 29-8 to override the veto, with one Republican voting against the override and one Democrat changing her vote. Soon after, the House voted 76-23 for the override, with four Republicans voting against the measure and one Democrat voting for it. 

Protesters were chanting loudly from the halls while the Senate overrode the veto. In the House,  protesters in the gallery yelled, "Henry, Zachee -- they should be with us today." 

This chant was in reference to Sen. Karen Berg's 24-year-old transgender son, Henry, who died by suicide in December and the shooting death of a Louisville transgender woman, Zachee Imanitwitaho. 

Kentucky State Police arrested 19 of the protesters, according to the Lexington Herald-Leader

"KSP gave each individual the option to leave without any enforcement action or be placed under arrest,” Capt. Paul Blanton, a KSP spokesperson, told the Herald-Leader in a prepared statement.

Earlier that morning, hundreds of LGBTQ+ youth and their supporters rallied to ask the lawmakers to not override Beshear's veto. 

Before being removed, the protesters in the House were so loud that it was difficult to hear the lawmakers explaining their "no" votes during the veto override, even with their efforts to be heard. 

Senate Bill 150, sponsored by Sen. Max Wise, R-Campbellsville, would ban gender-affirming treatment for Kentuckians under 18, including surgeries and puberty-blocking hormones, even if parents want the treatment for their children.

It would bar schools from requiring teachers to use a transgender student's preferred pronouns, keep trans students from using bathrooms that fit their gender identity, and bans instruction that explores "gender identity, gender expression or sexual orientation," among other sex-education requirements.

Wise focused his comments on the school-related requirements, with little said about the bans on gender-affirming care for trans youth. 

"The goal is to strengthen parental engagement and communication in children's education while protecting the safety of our children," he said while explaining the bill on the Senate floor. 

“I’ve had countless number of people coming up to me from both sides of the aisle to say, ‘Thank you for standing up for common sense. Thank you for standing up and being willing to stand in that gap, to be willing to take whatever it is thrown our way,’’ Wise said on the Senate floor while explaining the bill. “If it’s hit jobs from newspaper activists, if it is for standing up for parents, for those that do not show up here in committee meetings to testify because they’re working and because they are also dependent upon us in a representative democracy, that we can make common sense decisions here that protect our children.”

Berg opened her remarks by reading the words her son, Henry Berg-Brousseau, wrote for the Human Rights Campaign that was published the day before he took his life.  

"To say this is a bill protecting children is completely disingenuous. And to call this a parent rights bill is an absolute despicable affront to me personally," she said. "We are denying families their physicians and their therapists the right to make medically informed decisions for their families. Not a single reputable society, National Medical Society in this country, supports what we are doing today. The data at this point is unequivocal.  The misinformation is appalling. Appalling that you allow this information to stand." 

Sen. Danny Carroll of Benton was the only Republican to vote against the measure. He said it was an "uncomfortable place to be" to go against his entire caucus, but he was convinced it was the right thing to do, later adding that if having access to puberty-blocking hormones saved just one child's life, they should be available to them. 

"My fear and my no vote is for those kids that are being left you Those kids that may be contemplating suicide, that may need to delay puberty, that that could have a huge impact on them. We're taking away an option that a family that a doctor would have -- we're not doctors, with the exception of a couple of us, we're not doctors, I trust them to make the right decisions when they are dealing with those kids in those specific instances." 

Sen. Robin Webb, D-Grayson,  initially voted in favor of the bill but said after further "reflection and evaluation" she voted against voting to override Beshear's veto of SB 150. Over and again, she called the bill a "bad product." She said there were parts of the bill that she could support and that the amendment offered by Carroll that was not called up for a vote was " a rational solution and a much better product." Further, she said the bill had "legitimate constitutional issues" and contradictions. 

"This discussion is not over," she said. "We will get to revisit this I'm sure once it gets through the courts. And I'm going to serve with the senator from McCracken in making sure that we achieve what the intention of this legislation is and to better perfect the provisions of it that I personally support." 

While explaining his "yes" vote, Sen. Chris McDaniel, R- Ryland Heights, said, "The bill is intended to balance the needs and desires of families with children who are following a conventional path of human sexuality, while making reasonable accommodations for those who have a different path." Later adding that the bill strives for a balance for all citizens "while protecting the rights of the minority, while respecting the will of the majority." 

It is unclear what majority McDaniel is referring to. A Mason-Dixon poll by the Fairness Campaign, a pro-LGBTQ+ rights advocacy group that paid for the poll question, showed 71 percent of respondents oppose laws letting state leaders overrule parents' wishes for gender-affirming care for their child.

In the House, 16  of the 20 Democrats stood to passionately explain their "no" votes, as there was no discussion allowed on the measure before the vote because of the protesters. No one stood to explain their yes vote. 

"This is dangerous policy, passed by poor process, supported by junk science," said Josie Raymond, D-Louisville, "We should not override this veto." 

Minority Leader Derrick Graham of Frankfort said, "Over my 21 years, this is the worst bill I've had to vote for on this floor. . . .  For over 40 years, you want limited government, you want local control, you believe in individual responsibilities, and government intervention is not the real answer to solving our problems. Well, all of those four things that I just went off and talked about, you've done. You've invaded on the rights of the parents, you've invaded on the rights of the individuals who were here today." 

The four House Republicans who voted against the veto override were Reps. Killian Timoney, Kim Moser, Kim Banta and Stephanie Dietz. Rep. Ashley Tackett Laferty was the only Democrat to support the measure.

The bill is expected to face a legal challenge. 

"To all the trans youth who may be affected by this legislation: we stand by you, and we will not stop fighting. You are cherished. You are loved. You belong," the American Civil Liberties Union of Kentucky said in a statement. "To the commonwealth: we will see you in court."

The ACLU has called this bill the most extreme anti-trans bill in the United States.

The Family Foundation of Kentucky praised the override. 

"SB 150 will protect the lives of Kentucky children by setting policy in alignment with the truth that every child is created as a male or female and deserves to be loved, treated with dignity, and accepted for who they really are," Family Foundation executive director David Walls said in a statement.

Monday, March 27, 2023

Coronavirus cases up 8.7% over prior week; Covid-19 deaths fall, but remain above month's average; state attributed 49 last week

Kentucky Department for Public Health graph, adapted by Kentucky Health News
By Melissa Patrick
Kentucky Health News

New coronavirus cases in Kentucky rose last week and deaths attributed to Covid-19 went down, but remained above the recent average as Kentuckians continued to die from the disease.

The state Department for Public Health's latest report showed there were 2,222 new cases of the coronavirus last week, or 317 cases per day. That's 8.7% more than the prior week, when the state reported 2,044 new cases, 292 per day.

The state attributed 49 more deaths to Covid-19 last week, down from 66 the week before. The state's Covid-19 dashboard indicates that the attribution of deaths is running about a month behind the dates of death.

Over the last four weeks, the state has reported an average of nearly 44 Covid-related deaths each week. The state's death toll from Covid-19 is now 18,292.

The best way to protect yourself from the virus is to get vaccinated and there's still plenty of Kentuckians who need to do so. State data show that only 58% of Kentucky's total population is "fully vaccinated" and only 39% have been boosted.

The weekly new case rate was 6.91 cases per 100,000 residents, up from 6.17 the week before. The top 10 counties were Fleming, 32.33 cases per 100,000; Clinton, 20.97; Elliott, 19; Wayne, 17.56; Powell, 17.34; Rowan, 16.35; Russell, 15.14; Rockcastle, 14.55; Green, 14.36; and Martin, 14.04.

Friday, March 24, 2023

Almost all of Kentucky has a low risk of Covid-19, CDC says; N.Y. Times ends daily data updates, citing states' less frequent reports

Centers for Disease Control and Prevention map
By Melissa Patrick
Kentucky Health News

All but five of Kentucky's 120 counties have a low risk of Covid-19 transmission, according to the latest federal risk map. 

The Centers for Disease Control and Prevention map, which is based on new corinavirus cases and Covid-19 hospital numbers, shows that the only Kentucky counties with a medium level of Covid-19 risk are Rowan, Elliott, Menifee, Morgan and Pike, shown in yellow on the map.

The CDC advises those in medium-risk counties, and those anywhere who are at high risk of getting very sick, to wear a well-fitting mask when indoors and in public; and to consider getting tested before having social contact with someone at high risk for getting very sick, and consider wearing a mask when indoors when you are with them.

In the week of March 16-22,  The New York Times ranked Kentucky's new-case rate 24th among the states, with a 10 percent drop in the last two weeks. 

Earlier in the week, the Times announced that after more than three years of daily reporting on the number of Covid-19 cases and deaths in every county in the U.S., it will be ending its daily Covid data-gathering operation. The Times will continue to report virus data from the CDC weekly on a new set of tracking pages. 

"This change was spurred by the declining availability of virus data from state and local health officials," the Times said. "Since few states report more than once a week (and some no longer report data to the public at all), the weekly data reports from the CDC have become the most reliable source of information on the virus’s spread." 

Centers for Disease Control and Prevention map
The CDC also provides a community level transmission map, largely used by health-care facilities and researchers, that shows the level of virus in each county, at one of four levels. The latest map shows five counties with a low level of transmission and 57 with a medium level; the rest are either substantial or high. The state says residents should take their guidance from the other map.

Beshear vetoes bill that would ban gender-affirming care for Kentuckians under 18; Republicans are expected to override it

Gov. Andy Beshear (State photos)
By Melissa Patrick
Kentucky Health News

Gov. Andy Beshear has vetoed a far-reaching bill that would ban transgender minors' access to gender-affirming care and sets strict rules for teaching in Kentucky's schools about sexuality. 

Senate Bill 150 would ban gender-affirming treatment for Kentuckians under 18, including surgeries and puberty-blocking hormones, even if parents want the treatment for their children.

It would bar schools from requiring teachers to use a transgender student's preferred pronouns, keep trans students from using bathrooms that fit their gender identity, and bans instruction that explores "gender identity, gender expression or sexual orientation," among other sex-education requirements. 

State Sen. Max Wise
The veto came as no surprise. Beshear, a Democrat running for re-election, has been consistent in his disapproval of the bill, sponsored by Sen. Max Wise, R-Campbellsville, who is running for lieutenant governor on a slate headed by Kelly Craft of Lexington.

"I think I've been clear on how I feel about it," Beshear said the day before he vetoed the bill. "I believe Senate Bill 150 tears away the freedom of parents to make important and difficult medical decisions for their kids. It tears away the freedom of parents to do what those parents believe is best for their kids, and instead has big government making those decisions for everyone -- even if the parents disagree."

Beshear's veto message says SB 150 "allows too much government interference in personal healthcare issues and rips away the freedom of parents to make personal family decisions." He wrote that it turns educators and administrators into investigators who must report to parents about how students behave and/or refer to themselves or others. 

He also wrote, "My faith teaches me that all children are children of God and Senate Bill 150 will endanger the children of Kentucky," citing data to support his concerns.

"In a 2022 National Survey on LGBTQ youth mental health, 45% of LGBTQ youth seriously considered suicide in the past year and nearly one in five transgender youth attempted suicide," he wrote. "The American Medical Association reports that receipt of care dramatically reduces the rates of suicide attempts, decreases feelings of depression and anxiety, and reduces substance abuse. Improving access to gender-affirming care is an important means of improving health outcomes for the transgender population. Senate Bill 150 will cause an increase in suicide among Kentucky's youth." 

Lawmakers will reconvene March 29 and 30, when the majorities of Republicans in the House and Senate are expected to easily override the veto. Republicans were quick to criticize it. 

Wise's statement said Beshear "puts party over Kentuckians' wish to eliminate woke ideologies in our children's schools." He said the goal of the bill "is to strengthen parental engagement and communication in their children’s education."

He added, "Parents should look at this veto as a slap in the face. . . . I look forward to the legislature overriding this veto, and protecting children from the irreparable harm of gender-transition surgeries by making SB 150 law.”

Wise also issued a joint statement with Craft, saying “Time and time again, Gov. Beshear has proven he is out of step with what Kentuckians are talking about at their kitchen tables: communication and engagement with their children’s schools. A Craft-Wise administration will ensure our children are protected, make sure parents are heard, and empower teachers to focus on providing a world-class education that teaches our children how to think, not what to think.”

Republican Party of Kentucky spokesman Sean Southard also criticized the veto and looked ahead to the election.

“Is Andy Beshear the governor of Kentucky or California?” Southard asked. “Kentucky voters will have an opportunity this fall to rid our state of this far-left governor and replace him with a Republican who will work to protect children. Once this campaign is over, today may very well be remembered as the day Andy Beshear lost his bid for re-election.”

Attorney General Daniel Cameron, the apparent front-runner in the May 16 Republican primary, criticized news-media coverage of the bill and said “chemical castration and genital mutilation . . . is the exact opposite of how we should support children experiencing gender dysphoria or mental-health struggles. My administration will protect our youth from dangerous ideologies and defend Kentucky’s values.”

Others issued statements praising the veto. 

"By vetoing this hateful legislation, Gov. Beshear has demonstrated his commitments to protect Kentucky parents’ rights to raise their children as they see fit, and to keep medical decisions where they belong: between providers and patients," said Angela Cooper, communications director for American Civil Liberties Union of Kentucky.   

Chris Hartman, executive director of the Fairness Campaign, said "SB 150 will only lead to disaster and despair for transgender Kentucky kids and their families. . . . We urge state lawmakers to read the governor's veto message, listen to medical professionals and sustain Gov. Beshear's veto." 

Kentucky Voices For Health said in its newsletter that it joined more than 500 organizations, providers and individuals in signing a letter of opposition to SB 150, and urged citizens to call their legislators' offices at 502-564-8100.

Thursday, March 23, 2023

Legislature takes away Medicaid dental, vision and hearing benefits Beshear granted; he indicates he will do it another way

By Melissa Patrick
Kentucky Health News

In October, Democratic Gov. Andy Beshear announced the expansion of dental, vision and hearing benefits for 900,000 Kentucky adults on Medicaid. On March 16, 2023, the Republican-controlled General Assembly took a final vote to take those benefits away, calling the regulation used to install them deficient. Beshear said Thursday that he will find a way to keep them in place.

Sen. Stephen West, R-Paris
In presenting Senate Bill 65, Sen. Stephen West, R-Paris, said the regulation Beshear issued to expand these services was deficient because the funding came from the $38 million in savings that came when the state moved to a single pharmacy benefit manager, a middleman between drug manufacturers and companies that manage Medicaid.

West said using these savings amounted to the governor "appropriating money" and that lawmakers should have been involved in how it was spent.  

"It was a huge change, really that should have been done through, we felt, through statute through involving the legislature," West said at the Feb. 15 Senate State and Local Government Committee meeting.

In October, Cabinet for Health and Family Services spokeswoman Susan Dunlap told the Courier Journal that federal funds would cover 90% of the expansion's cost. She said the state's move to one pharmacy-benefits manager last year "has resulted in significant ongoing savings to the Medicaid program that will provide enough funding for this program moving forward."

As SB 65 went through the legislature, it was amended to extend dental, vision and hearing services through June 30 to allow people already getting the services to receive them and allow providers to be paid. 

The amendment also says nothing in the bill should be construed to prohibit the state Medicaid department from increasing reimbursement rates, long a goal of health-care providers. The Kentucky Oral Health Coalition says Medicaid's dental provider rates have been stagnant for more than 20 years.

Sen. Stephen Meredith, R-Leitchfield, said a rate hike is especially needed in medically disadvantaged areas. In explaining his vote for SB 65, he also said the money could have been used to help the 5,000 children who are waiting for services from one of the state's special Medicaid waiver programs. 

"I just want to remind folks that what we're asking here is for some involvement from the legislature," Meredith said. "Talk to us. Let us have some input in this." 

What's next? 

Before the expansion of these services, they were offered on a limited basis. 

Dental services for adults were limited to an annual cleaning and extractions linked to certain medical conditions. Adult fillings were not covered. The expansion allowed coverage for fillings, dentures, implants, root canals, extractions, restorations, periodontics and an additional cleaning each year.

Also, under the old rules, a Medicaid enrollee could be evaluated for hearing loss only on referral from their primary-care doctor; and glasses and contact lenses were not covered, though exams were. Some managed-care firms offered some of these services as an incentive to get people to enroll with them.

Asked at his weekly news conference Thursday if there is a way to maintain the benefits, Beshear said, "I believe a new regulation will allow for the continuation of vision, dental and hearing benefits. The expansion of those benefits, the funding coming from the federal government is an executive branch function. But even at the hearing, I believe . . .  one of the legislators said it looks like you'll need a new regulation."

SB 65 requires any new regulation to be substantially different from the original. If Beshear vetoes the bill, the legislature could easily override the veto.

Beshear called the need for dental, vision and hearing benefits for people on Medicaid a "no-brainer" because "This is what gets people back to work." He elaborated:

"There's a study that talks about over 100 million work hours lost due to dental, emergency dental procedures that if you have coverage you avoid. Now there are studies out there about the number of people that can't go to work because we don't cover getting them a pair of glasses. And then think about safety on the job site. You know a ton of Americans . . . suffer from hearing loss. And to be able to get to the job and to do it correctly, you need to have that type of coverage. Again, if we care about the workforce, right, let's take the basic steps to get more people healthy [and] back to work." 

Access to providers

West also argued that health-care providers tell lawmakers that even if these services are permitted in Medicaid, the program's reimbursements are so low that it will be hard for the patients to find providers. 

That said, the health cabinet says thousands of Kentuckians on Medicaid have already taken advantage of these services since they became available Jan. 1.

"As of Feb. 22, more than 8,000 Kentuckians – across all 120 counties – have already received dental, vision, and hearing services they need under these regulations," the cabinet said. "More than 1,000 Kentuckians received nearly 3,330 dental services under these regulations – in all 120 Kentucky counties – including from a dentist in Clay County who since Jan. 1, 2023, had provided four sets of dentures for patients and has 44 more sets of dentures in progress."

Clay County is the home of Senate President Robert Stivers, R-Manchester.

The cabinet added, "Nearly 7,000 Kentuckians have received vision services under these regulations, with nearly 43,000 services provided. And 40 Kentuckians have received hearing services with these regulations in place. . . . Providers have received over $1 million in reimbursement for the services."

Health advocates push back 

Health advocates were disappointed in the bill's passage and called for legislators to reinstate thes services. 

"The genesis of this unfortunate piece of legislation is a raw partisan battle between the General Assembly and the governor," said Terry Brooks, executive director of Kentucky Youth Advocates. "Both branches of our government should be holding each other accountable when one thinks the other overstepped its bounds. Yet, there should also be no doubt that neither providers nor Kentucky families should pay the price for a political food fight. SB 65 has providers left holding the bag with more Kentuckians losing dental benefits than the total population of Alaska. It's as unwise as it is unfair." 

In a statement about the passage of SB 65, the Oral Health Coalition cited the great need for comprehensive dental services in Kentucky, noting that the state ranks among the bottom five states on several oral-health indicators and has more seniors with no natural teeth than any other state. 

"While it was a worthy debate about the process to expand services, the reality now is that 900,000 low-income, disabled, and other vulnerable Kentucky adults must once again go without critical dental care," the coalition said. "By no means is this expansion the answer to the growing oral health crisis in Kentucky, but it can offer a first step toward providing comprehensive dental care for Kentuckians. The Department for Medicaid Services and the General Assembly must reach an agreement in the immediate aftermath of the legislative session so our Commonwealth can be back on track to providing folks with the health care they need to be healthy, work, and thrive." 

Emily Beauregard, executive director of Kentucky Voices for Health, an advocacy group, told Kentucky Health News in an e-mail, "Regardless of the politics, it's clear that Kentuckians don't have enough access to the dental, vision, and hearing care they need to be healthy. We've made progress in recognizing that mental health is health and we need to do the same for our mouths, eyes, and ears."  

She added, "Whether it's through regulation or legislation, we need policymakers to increase access to these services to improve population health and build a stronger workforce," she added. With the passage of SB 65, "I hope legislators will take action to increase services through legislation instead."

Opinion: Gender dysphoria may have a basis in human biology

By Kimberly Kennedy

Most of us witnessed with horror the passage of anti-transgender bill SB150 by legislators who ignored overwhelming opposition. Since Gov. Andy Beshear is expected to veto it, our only recourse is to convince legislators not to override that veto.

If you’re dubious, hear me out: We’ve left critical information out of the conversation, namely the growing evidence that gender dysphoria (GD) has a basis in biology. Skeptical that would work? Well, research shows that when people understand this, their support for trans people increases.

Kimberly Kennedy
Many in the trans community bristle at the idea of discussing GD as if it were a defect. But I believe we can be sensitive; and I take inspiration from researcher Dr. J. Graham Theisen of Augusta University, who describes it as a “variant,” like blue eyes or brown hair, that doesn’t cause disease but makes us individuals.

Plus, we must meet the opposition where they are, if we hope to bridge the gap. I’ve heard awful comments about trans people; but I look for common threads, like the belief it’s a choice or lifestyle, or that it ignores what God intended. Evidence of a biological basis discounts these arguments and might persuade more legislators to push the pause button on anti-trans legislation.

So here’s a sample: First, research has confirmed that male and female brains are different. Second, during fetal development, hormones influence the gender of the external and internal sex organs during the first trimester; hormones program gender development in the brain, where gender identity is experienced, later in the pregnancy.

Research in the Netherlands from 2014 found that in some cases, physical development in utero was subject to a hormonal mismatch from brain development, “so that the body was masculinized and the brain was feminized, or the other way around.” This corresponds with transgender people’s reported experience of their gender identity, which occurs before age seven for three-fourths of the population.

In 2018, an Australian study comparing transgender women and cisgender men (both born male) found statistically different variations in four genes. In 2020, a U.S. and a U.K. meta-analysis (compilation of multiple studies) found that “people with gender dysphoria have a brain structure more comparable to the gender to which they identify” rather than to the sex assigned at birth. Yet a 2020 German study found that the brain structure of trans women was different from both cisgender males and females. In view of this, researchers suggest that we view gender as a “spectrum” rather than a binary construct.

Theisen clarifies that “once someone has a male or female brain, they have it and you are not going to change it. The goal of treatments like hormone therapy and surgery is to help their body more closely match where their brain already is.”

Proof of transgender biology indicates that SB 150 will invite a civil-rights lawsuit. Thus Kentucky taxpayers will pay to defend legislation that 71% of Kentuckians don’t want — potentially costing hundreds of thousands or even millions of dollars; just ask Floridians about the price tag for defending controversial legislation.

Contact all legislators who voted "yes" in the House and Senate. Write to your own representative or senator, or call the Legislative Research Commission comment line at 1-800-372-7181. We have until Tuesday, March 28, to make a difference for our families and friends.

Kimberly Kennedy of Villa Hills is a freelance writer, former educator and parenting-magazine editor, and parent of an LGBTQ+ young adult. Her degrees are a BFA in art education and a BA in art history from the University of Cincinnati. This article was originally published in Forward Kentucky.

Beshear bans sale of products with tianeptine, unapproved drug with opioid-like effects that has caused overdoses and deaths

Some of the products that contain tianeptine
(Photo from Center for Science in the Public Interest)
Gov. Andy Beshear has signed an emergency regulation that bans the sale of products containing tianeptine, an unregulated drug known as “gas station heroin” that produces opioid-like effects, his office announced. The order classifies tianeptine as a Schedule I controlled substance, with no known medical use. 

Tianeptine, which is available online and at retail locations, sometimes in dietary supplements, has been linked to serious harm, overdoses and death, according to the Food and Drug Administration. It is not approved in the U.S. In nations where it is approved, it is marketed as Coaxil or Stablon. In the U.S., it is known as ZaZa, Tianna, TD Red and Pegasus.

"Side effects from abusing or misusing tianeptine by itself or with other drugs, like antidepressants or anti-anxiety medications, include agitation, drowsiness, confusion, sweating, rapid heartbeat, high blood pressure, nausea, vomiting, slowed or stopped breathing, coma and death," Beshear's office said in a news release.

The FDA says eports of bad reactions to tianeptine, and unwanted effects from it, are increasing. "Some companies are illegally marketing and selling products containing tianeptine to consumers," FDA says. "They are also making dangerous and unproven claims that tianeptine can improve brain function and treat anxiety, depression, pain, opioid use disorder, and other conditions." The agency also says people with a history of opioid-use disorder or dependence may be at greater risk of abusing tianeptine.

Beshear said in the release, “Until now, someone looking for a heroin-like high could walk into certain places or buy this harmful product online. We’re committed to protecting Kentuckians from this kind of harm, and if someone is struggling with abuse, we’re here to help.”

Resources for addiction and recovery include FindHelpNowKY, the Kentucky Help Call Center (833-8KY-HELP) and the Kentucky Opioid Response Effort, or KORE.

Wednesday, March 22, 2023

All 45 and older should be screened for colon cancer, earlier if you have family history of it; Ky. has made much progress against it

Colon Cancer Prevention Project graphic

Ky. Health News

March is Colorectal Cancer Awareness Month, which serves to remind everyone who is 45 and older – or is younger than 45 with a family history of colon cancer – to get screened.

That's because colorectal cancer is one of the leading causes of cancer-related deaths in Kentucky and often doesn't cause any symptoms, especially in early stages when the only way to detect it is through screening, says Dr. Avinash Bhakta, a colorectal surgeon at the University of Kentucky Markey Cancer Center. 

The Colon Cancer Prevention Project says regular screening is recommended to begin at 45 for people who do not have a family member who has had colon cancer and/or polyps. Those who have a family history of colon cancer should get a colonoscopy at age 40 or earlier. 

For those without a family history of colon cancer, two types of tests are recommended by the U.S. Preventive Services Task Force: visual exams (primarily colonoscopies) and stool-based tests that check a stool sample for signs of cancer. 

UK's Bhakta writes that while colonoscopy is the gold standard for screening that must be done in a clinic or hospital under sedation, stool-based tests offer an alternative that is less invasive and can be more accessible. 

Stool-based tests check for blood and/or abnormal DNA in the stool, and can be done in the privacy of your own home, Bhakta notes. The test is then returned to a doctor or mailed to a laboratory for testing. All at-home tests need to be repeated every year, and any positive findings will require a follow-up colonoscopy.

Colonoscopies involve finding pre-cancerous lesions and removing them before they turn into cancer, and that means that most cases of colorectal cancer are considered preventable. Screenings also allow physicians to find cancer at an earlier stage when it is more treatable.

And as Bhakta wrote in her headline,  "The best screening test is the one you take." 

Colorectal screening in Kentucky

Kentucky has made great progress when it comes to getting Kentuckians screened for colon cancer.

"Twenty years ago, Kentucky had the highest colorectal cancer incidence and mortality rates in the U.S., as well as the second-lowest colorectal cancer screening rate," Elizabeth Chapin reports for UK. "Today, thanks to the coordinated efforts of state agencies and organizations, these dire statistics have turned around. Since 2002, colorectal cancer screenings have doubled in Kentucky, which has led to a more than 30% decrease in incidence and mortality rates."

Much of this success is due to efforts made by the Kentucky Cancer Consortium in collaboration with several major cancer groups that worked to make colorectal screenings more accessible to Kentuckians.

"What we've seen happen with colorectal cancer rates in Kentucky over the past two decades is truly a public health success story," Thomas Tucker, the Markey Cancer Center's senior director for cancer surveillance, told Chapin. "It goes to show that significant change can happen when we work together and coordinate our efforts."

Chapin reports that the KCC and its partners' efforts inspired an initiative to encourage primary care physicians to recommend and schedule colorectal cancer screenings. It also brought about two successful Kentucky bills: the first, approved in 2002, requires all health insurers in Kentucky to cover the cost of screening for age-eligible patients; the second, passed in 2008, established the Kentucky Colon Cancer Screening Program to screen uninsured age-eligible patients and educate the public about the importance of being screened.

These initiatives helped move the state's colorectal cancer screening rates from 49th in the nation to 20th.

"The results have saved thousands of lives," Tucker told Chapin. "To put it into perspective, today, 650 fewer Kentuckians are diagnosed and 270 fewer die from colorectal cancer each year than in 2001."

The Kentucky Cancer Program has also worked with KCC to increase screening rates by fostering community colon cancer screening programs, Chapin writes.

"The KCP's success in increasing colorectal cancer screening rates is attributed to working within communities at the local level," said KCP-East Director Mindy Rogers. "As residents of the areas they serve, our specialists have an understanding of their communities and the particular barriers they face when it comes to cancer screenings, treatment and care."

Despite Kentucky's progress, Chapin reports that roughly a third of eligible Kentuckians still do not seek colorectal cancer screenings due to health, socioeconomic and education disparities. 

She adds that the KCP team is collaborating with community partners to identify resources that can help overcome barriers such as transportation and family care.

Both the KCC and KCP model has led to a similar screening effort around lung cancer, including legislation to create the lung cancer screening program in the Kentucky Department for Public Health

"There’s more work to do because the goal is to be ranked number one in the nation for screening rates,” Tucker told Chapin.  “But Kentucky has a number of barriers not faced by many other states and together, we’ve made some remarkable change in the face of these incredible challenges.”

Tuesday, March 21, 2023

Seats available at Mar. 28 Recovery in the Workplace Conference

Author Sam Quiñones at an earlier Chamber conference
The Kentucky Chamber of Commerce is hosting its fifth annual Recovery in the Workplace Conference March 28 at the Marriot Griffin Gate Resort in Lexington and still has seats available.
 
The conference will feature best-selling author and journalist Sam Quiñones, who will share his experiences as a reporter covering the evolution of gangs, immigration, the southern border, drug trafficking, addiction and related issues over 35 years.

"I think that when you attend these kinds of things, you're able to share and you’re able to learn, you take that back to your own community, and that is a huge benefit," Quiñones said about the conference on Twitter. His latest book, The Least of Us, focuses on the rise of synthetic drugs in the opioid epidemic.

Members of the Kentucky Chamber Foundation team will speak about various initiatives in which employers can get involved to most effectively recruit and retain individuals in recovery. Topics will include an update on the status of substance use in the Kentucky workplace, programs that have led to long-term success for people in recovery, entrepreneurial opportunities that have led to improved recovery outcomes in Kentucky, issues of reentry specific to employment, and more. 

The Recovery Consortium of Kentucky will hold its 2023 Recovery Hall of Fame ceremony to recognize people in long-term recovery and those who have taken a leading role in addressing Kentucky’s addiction crisis through efforts for prevention, treatment, education, and advocacy.

The awards and recipients include: the Congressman Hal Rogers Award, going to Van Ingram, executive director of the state Office of Drug Control Policy; the Jay Davidson Award, to Charlotte Wethington (mother of the namesake of Casey’s Law); the Employer of the Year Award, to Toyotomi America Corp.; and a special award to Jeff Whitehead, executive director of the Eastern Kentucky Concentrated Employment Program (EKCEP)

Isaiah House Treatment Center presents the event. Click here to register.

Monday, March 20, 2023

New coronavirus cases dropped again last week in Kentucky, but state-recorded deaths from Covid-19 had another weekly increase

N.Y. Times map of new-case rates has Menifee County as a hot spot.
By Melissa Patrick
Ky. Health News

Last week, new coronavirus cases in Kentucky dropped 20 percent from the week before, but deaths from Covid-19 increased again. 

The state Department for Public Health attributed 66 more deaths to Covid-19 last week, up from 47 the week before and 13 the week before that. The state's pandemic death toll is now 18,243. 

The state reports there were 2,044 new cases of the coronavirus last week, or 292 cases per day. That's a drop from 2,572 the week before. 

The weekly new case rate was 6.17 cases per 100,000 people, down a bit from 6.39 the week before. The top 10 counties were Bath, 18.29 cases per 100,000; Rockcastle, 16.26; Lyon, 13.92; Powell, 13.87; Hopkins, 11.83; Webster, 11.04; Mason, 10.04; Wolfe, 9.98; Hardin, 9.91; and Fleming, 9.8.

The New York Times ranks Kentucky's case rate 12th among the states, with a 41% drop in cases in the last two weeks.

Get prepared now for Medicaid renewals, Kentucky

By Kennan Wethington
President, Anthem Blue Cross and Blue Shield in Kentucky

When Covid-19 hit three years ago, the federal government responded with a series of actions made possible by declaring a public health emergency. One of these actions was to freeze a process called Medicaid renewal, allowing Medicaid members to remain in their plans regardless of status or eligibility changes. That will all change in the coming weeks.

Screenshot of Anthem video explaining the renewal process
260,000 Kentuckians Could Lose Coverage:
Recent federal legislation ended continuous enrollment in Medicaid, allowing renewals to begin on April 1. As a result, the extended health coverage for some on Medicaid will end, with disenrollments expected as soon as June 1. Here in the commonwealth, up to 260,000 people and as many as 18 million across the country could be affected.

The good news for those losing Medicaid coverage is that new subsidies may make Marketplace health plans more affordable than ever. In addition, many helpful resources are available to guide people to the coverage and support they need. With Medicaid renewal resuming, now is the time to begin preparing.

Start planning now: Here’s a checklist for all Medicaid beneficiaries to get ready for Medicaid renewal:

1) Make sure Kentucky’s Department for Medicaid Services has your current contact information by visiting kynect.ky.gov or call kynect at 855-4KYNECT (855-459-6328).

2) Watch closely for letters and information from Kentucky Medicaid and respond to them quickly.

3) Visit the Kentucky Health Benefit Exchange for help understanding Medicaid eligibility changes: khbe.ky.gov/Enrollment/Pages/PHEUnwinding.aspx 

4) Even if you still qualify for coverage, you may receive renewal instructions from Kentucky Medicaid. Make sure to follow instructions carefully.

5) If you don’t qualify, start making plans now to find affordable health plans through your employer or the Marketplace. Don’t let your coverage lapse.

A change of employment will be a common reason many Kentuckians will no longer qualify for Medicaid plans. The next step for people in this situation is to talk to their employer to determine if they are eligible for employer-sponsored health benefits. If employer-based health plans are not an option, an Affordable Care Act health plan through the Kentucky Health Benefit Exchange is likely the best choice for health coverage.

There are options if you lose Medicaid: If you no longer qualify for Medicaid coverage and employer-sponsored plans are not an option, understanding health coverage choices available through the Health Insurance Marketplace and how to enroll can take some time to sort out. That’s where we come in – those of us in the community dedicated to connecting people to quality, affordable health care. Two helpful sources are:
  • The Kentucky Health Benefit Exchange, at khbe.ky.gov, is full of information, resources, agents, and health coverage guides called kynectors who can answer questions and help you understand your coverage options.
  • HealthCare.gov is another warehouse of information, quick start guides as well as connections to healthcare navigators and brokers in each community.
All these information tools, agencies, and surprisingly affordable health plan options work together, making sure no one falls through the gaps.

Health care can still be affordable and equitable: The Affordable Care Act led to the creation of health plans that go beyond basic coverage, yet remain affordable even for those who don’t qualify for Medicaid and lack access to employer-sponsored coverage. Marketplace plans cover essential health benefits, including emergency services, prescription drugs and pediatric services, and they offer no cost preventive care. This means consumers pay nothing for important services such as regular wellness visits, immunizations and screenings. These services are key to avoiding and managing serious health conditions.

Marketplace plans are often more affordable than ever because federal subsidies have been expanded through 2025 to help keep costs down for consumers. Most people covered by these plans receive a federal subsidy, and in fact, some families that qualify for subsidies will pay nothing for coverage. If you did not previously qualify for subsidies, you may now be eligible.

Let’s stick together, Kentucky: More than ever, the last three years taught us that health is a group effort, and that equitable, affordable access to healthcare is vital to our physical, mental, and financial well-being. We learned that our health is interconnected not just to each other as Kentuckians, but also to our commonwealth’s entire economy. We’re at a pivotal moment, let’s not lose the momentum we’ve gained. If you’re impacted by Medicaid renewals, please start preparing now to keep you and your family protected with health coverage that works for you.

How to create a successful fitness plan this spring

Photo from PeopleImages | iStock / Getty Images Plus
By Dr. Robert G. Hosey
University of Kentucky

Scientists have found that regular participation in aerobic exercise has been shown to decrease levels of stress, stabilize mood, improve sleep and improve self-esteem. Just five minutes of aerobic exercise can help alleviate and stimulate anti-anxiety effects. Here are some tips to create a successful fitness plan this year.

Preliminary checks: Before you start working up a sweat, schedule a visit to your doctor to gauge on your overall health. Discuss any aches, pains or limitations that might impact your plans to get active. Your doctor can also assess your cardiovascular health and help you understand how and when to increase your exercise intensity.

Make a plan: Exercise should be planned for a time in the day when you feel rested and have the most energy. If you are planning to exercise outside, avoid extreme temperatures (warmer than 85 degrees F or colder than 32 degrees F). Remember to dress appropriately for the weather and wear comfortable, supportive footwear. An indoor contingency plan for exercise can help you stay active even during spring showers.

Don’t forget to warm up and cool down: Aerobic exercise, such as walking or biking, is recommended for those getting started with a new routine. Your exercise session should start with a warm-up period of slow walking or low-resistance bicycling and end with a cool-down segment at similar intensity.

At the end of exercise, stretch the major muscle groups used by holding each stretch for 20-30 seconds. This can minimize injury and fatigue and increase flexibility.

Make it manageable: Begin your exercise routine with an amount of time that is manageable, something as short as a five-minute walk around the neighborhood. Once you’re comfortable exercising for that long, slowly increase the duration of your sessions.

Don’t push yourself too hard, either. You should be able to maintain a conversation at all times of exercise without experiencing breathlessness.

Hydrate, hydrate, hydrate: Drinking water is important, especially when you’re exercising more. Staying hydrated helps your muscles work more efficiently and helps your heart pump blood more easily. Make sure to drink plenty of water before you exercise — it’ll help your body perform at its best.

Buy a durable water bottle and carry it with you at work and when you run errands. Having a water bottle by your side will remind you to drink throughout the day.

Have fun: Exercise shouldn’t be a slog, so make sure you’re doing something that you enjoy and makes you feel good. A successful start of a new routine will keep you motivated to continue and progress.

Fitness trackers and fitness apps are additional options to stay engaged and monitor progress. Enlisting a companion for exercise will add an element of support and keep the activity enjoyable.

Robert Hursey, M.D., is physician with UK HealthCare Orthopaedic Surgery and Sports Medicine and professor of family and community medicine in the UK College of Medicine.

Saturday, March 18, 2023

Bill would address health-care workforce shortage with public-private fund to help Kentuckians enter health-related professions

By Melissa Patrick
Kentucky Health News

In response to Kentucky's health-care workforce shortages, the legislature has sent Gov. Andy Beshear a bill to create a fund with private and public money to help more Kentuckians pursue health-related careers.

Rep. Ken Fleming
"This is a growing crisis that threatens not only to burden families and providers, but may jeopardize the very availability of critical health care services across the country," Rep. Ken Fleming, R-Louisville, said in presenting the bill to the House March 8. 

The need for health-care workers in Kentucky is well-documented. 

The Kentucky Hospital Association's 2022 Workforce Survey Report cited 13,423 total vacancies in Kentucky hospitals, including 5,391 for RNs and LPNs combined, or more than one in five nursing positions. Other top vacancies included respiratory therapists (17.7%), laboratory staff (14.2%), environmental services (13.7%) and social workers (13.7%).

The report says urban hospitals had larger vacancy rates than rural hospitals, at 18.3% and 13.8% respectively, but both rates are "unsustainable."

The Eastern Kentucky Healthcare Action Plan by Shaping Our Appalachian Region says the region’s turnover rates in vital health-care roles are statistically at or above the national turnover rate of 19.5%. In 2021 it was 24.6%. Further, it says healthcare jobs are responsible for 17.6% of Eastern Kentucky's economy, more than any other industry in the region, and that thousands of jobs remain unfilled.

Fleming's House Bill 200 aims to address this shortage by creating the Kentucky Health Care Workforce Investment Fund. It would use public and private money to increase scholarship opportunities.

Fleming told the House that this "innovative and creative" approach "puts a jetpack on the health-care training pipeline." 

The fund will be administered by the Council on Postsecondary Education, with 65% of it to be used for educational scholarships and 35% to be used to incentivize universities and training programs. 

Money from the fund can be used for a wide range of certified and licensed health-care professions, including nurses, mental-health professionals and emergency medical professionals, to name a few. 

The bill says the money can be used to "improve racial and ethnic diversity within a specific designated healthcare credential."

Legislature passes bill aimed at preventing doctors' burnout by saying they don't have to report seeking mental-health treatment

Photo from Getty Images via Kentucky Lantern
By Sarah Ladd
Kentucky Lantern

A bill aimed at preventing burnout among physicians has cleared both chambers of the General Assembly. Senate Bill 12 unanimously cleared the Senate in late February and the House on Monday.

The legislation would protect Kentucky doctors who seek mental-health help from wellness programs by stating they do not need to report their participation in such a program and can't be dismissed for not reporting it. It does not mean that physicians don’t need to report conditions that have the potential to hinder their judgment, the Lantern previously reported.

Doctors who testified in committee in favor of the bill said burnout among doctors can lead to lower patient satisfaction, low morale, high turnover, increased rates of substance abuse and even suicide.

The bill's primary sponsor, Sen. Donald Douglas, R-Nicholasville, is a physician. He has testified that being able to access private help for stress “without fear of retaliation” is “imperative” for Kentucky’s doctors.

Rep. Killian Timoney, R-Nicholasville, in presentoing the bill to the House, sid it would “have a significant impact for Kentucky physicians.”

“Like many professions over the last few years,” Timoney said, “physicians have seen significant increases in work-related stress both due to the Covid-19 pandemic and the overall demanding nature of their work.”

He said SB 12 will help address this by encouraging doctors to get mental health help when they need it — and promising them confidentiality when they do so.

There was no discussion before a unanimous and bipartisan House vote. The bill now heads to Gov. Andy Beshear’s desk for a signature or veto.

Beshear gets bill to regulate Delta-8 tetrahydrocannabinol

UPDATE, March 23: Gov. Andy Beshear has signed the bill into law.

Centers for Disease Control and Prevention photo
By Melissa Patrick
Kentucky Health News

In response to a court decision that deemed products containing Delta-8 tetrahydrocannabinol to be legal, a bill to regulate products with the substance has passed both houses of the General Assembly without dissent and has gone to Gov. Andy Beshear for final action. 

“The Kentucky hemp program is a staple for our agricultural community, but the selling and usage of unregulated THC is a danger to every Kentuckian who may use it,” Rep. Rebecca Raymer, R-Morgantown, the bill's sponsor, said in a news release. “These products have no standards for production. If someone were to purchase Delta-8, they have no way of determining if it is safe. This measure will both protect our consumers and enhance the industry.”

According to WebMD, Delta-8 THC is a naturally occurring chemical compound called a cannabinoid that's found in small traces in hemp and marijuana plants. Its chemical structure is similar to that of Delta-9 THC, the main psychoactive compound found in marijuana. Delta-8 causes a milder high than Delta-9. It can generally be purchased anywhere that sells CDB products, including gas stations, convenience stores and vape shops. 

House Bill 544, sponsored by Raymer, directs the Cabinet for Health and Family Services to begin the process of regulating Delta-8 THC and any other hemp-derived substances by Aug. 1. 

The bill also makes it illegal for people under 21 to purchase Delta-8 THC products, requires retailers to keep the products behind a counter, and sets guidelines for labeling. It establishes a testing and approval process that products must clear before they can be sold or distributed in the state.

"These are just our recommendations of what we think should be included in it, and I think the hemp industry would like to be at the table to come up with the final recommendations of maybe what the testing and the thresholds would look like," Raymer told a House committee March 9.

Kentucky Hemp Association President Katie Moyer and Commonwealth Extracts CEO John Taylor endorsed the bill at the same committee meeting.

Taylor said, "Every valid actor wants these types of regulations. It gets rid of the bad actors that make it hard to compete. It costs a lot of money to do the right thing, and when we have people making things in bathrooms and basements and barns it really makes it very hard to compete on a legitimate level." 

The Senate changed the bill to say that if a Kentucky producer is shipping a Delta-8 THC product to a state with testing requirements, the producer can defer to that state's requirements, but if shipping to a state with no testing requirements, they should abide by Kentucky's regulations. The House agreed.

Gov. Andy Beshear is expected to sign the bill. He issued an executive order in November 2022 directing the health cabinet to regulate Delta-8 THC following the court ruling in Boone County last year. His order was coupled with one using his pardon power to allow people with certain medical conditions and a doctor's certificate to possess up to 8 ounces of cannabis bought legally in another state.

George Rawlings, who founded industry that recovers health-care costs from patients who get settlements or judgments, dies at 77

George Rawlings
George Rawlings, who made a fortune by starting an industry that recovers health-care providers' costs of caring for patients who later get settlements or verdicts for injuries from accidents and defective products, died Thursday of the blood cancer multiple myeloma. He was 77.

"His foundation’s tax records show he and his company gave away millions to both sectarian charities and evangelical causes, including youth camps in 13 underdeveloped countries and to the late Rev. Jerry Falwell’s Liberty University, where the divinity school is named for the Rawlings family," reports Andrew Wolfson of the Courier Journal. "He also gave generously to local causes, including $1 million to Baptist Hospital in La Grange and $100,000 apiece to the city of La Grange and Oldham County, when both were experiencing budget troubles."

In a 2018 profile, Wolfson described Rawlings as “probably the richest Kentuckian you never heard of.” His company, the Rawlings Group, is based in LaGrange and employs 1,600 people. Its customers pay it 20 percent of the amount recovered in a process known as subrogation. "Critics have called the subrogation practice cruel because severely injured people can lose most or even all of a settlement — money they counted on to defray lost wages or to compensate for pain and suffering," Wolfson writes. "Rawlings has said the recoveries his firm made reduced health-insurance costs."

UPDATE, March 24: Celebrations of Rawlings' life were held March 23 and 24 in La Grange. Memorial gifts may be made to the Rawlings Foundation, PO Box 794, La Grange KY 40031.

Vast majority of Kentucky continues to have low risk of Covid-19

Centers for Disease Control and Prevention maps, adapted by Kentucky Health News
By Melissa Patrick
Kentucky Health News

All but 10 of Kentucky's 120 counties have a low risk of Covid-19 infection on the latest federal risk map, and Menifee County is the only one considered to have a high risk.

The Centers for Disease Control and Prevention risk map, which considers both new cases and Covid-19 hospital numbers, shows Menifee as the only high-risk county, in orange. Counties with a medium risk of transmission are in yellow, and those with a low risk are in green.

Counties with medium risk are Harrison and Robertson; Elliott, Morgan and Rowan (the latter two border Menifee); and Clay, Knox, Laurel and Whitley.

In high-risk counties, the CDC continues to recommend that you wear a well-fitting, high-quality mask in public indoor spaces, and if you are at high risk of getting very sick, consider avoiding non-essential indoor activities in public where you could be exposed.

If you live in a medium or high-risk county, the CDC advises those who are at high risk of getting very sick to wear a well-fitting mask when indoors and in public and to consider getting tested before having social contact with someone at high risk for getting very sick and consider wearing a mask when indoors when you are with them.

In the last seven days, The New York Times ranks Kentucky's new-case rate 13th among the states, with a 41% drop in cases in the last two weeks. The Times has Menifee County's rate at 6.6 per 10,000 residents and the state's rate at 0.9 per 10,000 (or 9 per 100,000).

To enlarge any image, click on it; to download, right-click.

The CDC also provides a community transmission level map, largely used by researchers and health-care facilities, that shows the level of virus in each county, at one of four levels. The map shows six counties with low levels of transmission and 62 with a medium level; the rest have either substantial or high risk.

Stephanie Mayfield Gibson, who was health commissioner for Steve Beshear, is new board chair of Trust for America's Health

Dr. Stephanie Mayfield Gibson
Dr. Stephanie Mayfield Gibson, who was state health commissioner in 2012-15, is the new board chair of the Trust for America's Health, which defines itself as "a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority."

Mayfield Gibson, who lives in Memphis, is a board-certified anatomic and clinical pathologist. In 2012, Democratic Gov. Steve Beshear named her the first African American and first woman public-health commissioner in Kentucky. She had been director of laboratory services in the Cabinet for Health and Family Services

When Republican Gov. Matt Bevin took office, Mayfield Gibson became senior vice president and chief medical officer for population health at KentuckyOne Health, which operated several Catholic hospitals and Louisville's Jewish Hospital. She was associate chief of staff and staff pathologist at the Department of Veterans Affairs Medical Center in Louisville.

In 2020-22, Mayfield Gibson was director of Covid-19 response for Resolve to Save Lives, founded by Dr. Thomas Frieden, former director of the Centers for Disease Control and Prevention. It provided guidance and technical support to local and state health departments, other partners and federal agencies.