2011 GENERAL ASSEMBLY

Beshear backs elderly-protection bills, not minimum staffing for nursing homes

Gov. Steve Beshear has 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."

Beshear undecided on meds-for-meth bill, says state not ready for statewide smoking ban

By Al Cross
Institute for Rural Journalism and Community Issues

Gov. Steve Beshear says he hasn't made up his mind about the bill that would require prescriptions for decongestants used to make methamphetamine, but he sounds skeptical. And he doesn't think Kentucky is ready for a statewide smoking ban, but he might endorse legislation to better protect residents of nursing homes.

Beshear addressed the three health issues under questioning from Bill Bryant of Lexington's WKYT-TV on the latest "Kentucky Newsmakers," broadcast Feb. 5. To watch the broadcast, click here.

"I'm personally conflicted" about the meds-for-meth bill, Beshear said, but his more specific remarks indicated skepticism. He said people in law enforcement are "pushing very hard" for the bill, and noted that such a law greatly reduced the number of meth labs in Oregon, and might do the same in Mississippi, but he suggested the numbers might go back up.

"They’ll just go across the state line and get it across the counter," he said of meth makers, adding that the problem needs a national solution, perhaps like Kentucky's registration-and-reporting system for sales of pseudoephedrine and other decongestants. "You're going to have to have a system that applies in every state," he said. "I'm concerned about the millions of people who need to go buy cold medicine."

Bryant noted that law-enforcement officials say most pseudoephedrine sold in Kentucky goes to make meth, and asked Beshear if those officials had convinced him of the need for a prescription law. "I haven’t heard that statistic," Beshear said, reiterating his indecision. "It’s tough one because there isn’t any easy answer to it."

The meds-for-meth bill is one of the legislature's major issues, with drug manufacturers finacing heavy advertising campaigns against it but major political figures in Appalachian Kentucky weighing in for it. On Thursday, the bill pased a Senate committee on a bipartsan 6-4 vote after competing testimony from 5th District U.S. Rep. Hal Rogers and Pat Davis, the wife of 4th District Rep. Geoff Davis, all Republicans.

The bill's supporters also include House Speaker Greg Stumbo, the legislature's top Democrat, and Senate President David Williams, the top Republican, who is seeking his party's nomination for governor in the May 17 primary election.

Williams also favors a statewide smoking ban. Beshear, who is unopposed for the Democratic nomination, said Kentucky isn't ready for such a law, but will be once local bans become more prevalent: "Once you start getting experience with it, I think your business community becomes more comfortable with it … and people enjoy it."

The governor said momentum for a statewide ban "is building, but I don’t think we're at the point where everybody in the state is ready to go in that direction." He said his administration took a step against smoking by making cessation programs eligible for Medicaid.

Asked about a Stumbo proposal to ban smoking in cars with children, Beshear called it "an interesting concept" that deserves discussion but said the idea is "probably in the same situation" as a general ban, which has been offered as a bill by Rep. Susan Westrom, D-Lexington.

Williams' opponents in the Republican primary, Jefferson County Clerk Bobbie Holsclaw and Louisville businessman Phil Moffett, oppose a statewide smoking ban. Holsclaw favors local bans, but Moffett said at a recent Kentucky Press Association forum that the dangers of secondhand smoke have been "overblown."

Bryant asked Beshear if he plans to endorse a package of nursing-home legislation. "I’m talking to legislators who have some good ideas on how we can increase the protections to our elderly," the governor said. "We’ve got to do even better. The restrictive part is, we have no money … but that shouldn’t stop us and should not be an excuse for not doing some of the non-monetary things we can do to protect our elderly."

Beshear was not asked about specifics of the package, but for years Kentuckians for Nursing Home Reform and other advocates have lobbied for minimum staffing requirements at nursing homes. The long-term care industry, one of the more influential in Frankfort, has beaten back those efforts, arguing that homes need more flexibility and state inspections ensure proper care.

Bill filed to keep guns from those judged to be mentally ill

Keeping guns out of the hands of the mentally ill is the aim of House Bill 308, filed by Rep. Bob Damron, D-Nicholasville.

"We want only the right folks to be able to buy a firearm," said Damron, right. "That does not include the mentally ill. I think most gun owners would stand behind that." Damron is an ally of the National Rifle Association.

The bill covers a loophole in state law. Though the federal Brady Handgun Violence Prevention Act of 1993 requires background checks when someone buys a gun and prohibits the sale of guns to people "adjudicated as a mental defective or who has been committed to a mental institution," Kentucky does not require courts to give their mental health records to the FBI, The Lexington Herald-Leader's John Cheves reports. Since 1998, Kentucky has only submitted four records.

Damron's proposal would require state courts to inform the Kentucky State Police when someone is adjudged mentally incompetent or sent to a mental institution. The KSP would then notify the FBI, which in turn would add the names to the National Instant Criminal Background Check System. The names would only be those of mentally ill people who have been documented by the courts. Those who voluntarily commit themselves to a mental institution or who are treated for mental health issues would be protected by privacy laws.

The gap in the law, which exists in many states, went under a national microscope when Seung-Hui Cho killed 32 people and himself on the Virginia Tech campus in 2007. More than a year before the shooting, a judge had deemed Cho dangerously mentally ill following a stalking incident. When Jared Loughner killed six people and injured many others, including U.S. Rep. Gabrielle Giffords, in Tucson, Ariz., the gap again gained national attention. However, Loughner is not known to have been a patient in an institution, so it is not clear if his mental health issues were documented. (Read more)

Advocates of statewide smoking ban see clear public support, believe local ordinances have set the stage for it

By Tara Kaprowy and Al Cross

Though advocates of anti-smoking laws don't believe a statewide smoking ban will pass in the General Assembly this year, they see public support for it and have come to the conclusion that it's time to get the discussion started.

"This will get the ball rolling at the state level," said Dr. Ellen Hahn, left, a nursing professor at the University of Kentucky and director of the Kentucky Tobacco Policy Research Program. "We know the best comprehensive laws won't happen overnight. We really need to start somewhere."

On Wednesday, state Rep. Susan Westrom, D-Lexington, filed House Bill 193, which would prohibit cigarette use in all enclosed public places and enclosed places of employment, including restaurants and bars. It also bans smoking within a "reasonable" distance outside of public places and work places.

Hahn, who has been reluctant to support a statewide ban, said Westrom's move is timely. Dozens of organizations now publicly support "smoke-free" laws, and 29 communities have enacted local smoke-free ordinances. "We're getting more ready every day because local leadership has shown the way," Hahn said. For a list of the communities and more details, click here.

As of now, 32 percent of Kentuckians are covered by smoke-free laws, and those numbers are growing, thanks, in part, to Campbell County's recent ordinance (though a new Fiscal Court is moving to repeal it before it takes effect). "I think the movement in Northern Kentucky has helped," Hahn said. "That's kind of the last urban area anywhere. Bans have also gone into effect in Bardstown and Glasgow. We've had some key places in the state if you look at the map. We're starting to fill in some areas."'

Hahn is the leading advocate for smoke-free ordinances in the state, but has long been reluctant to push for a statewide ban. "My hesitation was that we would end up with something bad, a law that would tie the hands of local government," she said. "And we didn't want something that was carved up with loopholes."

But the tide has turned, Hahn said. "I've said all along everyone deserves protection, everywhere. I don't think we'll ever see local ordinances in every locale in the state. In some ways, it's got to start some time and we're on first base. It's a process."

Jim Waters of the Bluegrass Institute for Public Policy Solutions, a free-market think tank in Bowling Green, replied to the developments this way: "Ironically, state politicians who loathe interference from Washington seem want to impose Frankfort's will on local communities. Some local communities like Bowling Green have had their own hard-fought, emotional battles over the smoking-ban issue. It would be outrageous for Frankfort now to come swooping in and possibly override their decisions."

Waters has branded Hahn "the smoking nanny" and debated her in a series of "Sorting Through the Smoke" seminars for journalists held by Kentucky Youth Advocates and the Institute for Rural Journalism and Community Issues, another UK-based center that publishes Kentucky Health News. For video of one encounter they had, in Danville, click here.

Hahn said it takes an average of two and a half to five years for Kentucky communities to pass smoke-free ordinances. As for enacting statewide bans, "It really varies across the country," she said, adding that she's willing to wait. "We don't want them to do something until they're ready," she said. "It's going to take a while for state legislators to study the science. They haven't done it before. We haven't asked them to do it."

What's important, Hahn said, is to wait until legislators are ready to pass a comprehensive law, not one subject to exemptions such as private clubs or nightclubs. Amy Barkley, a director for the Campaign for Tobacco-Free Kids, agreed. "Here's what's important: We don't want to settle for a half-baked law," Barkley said. "This is not an area that can be compromised."

Exemptions to the law lead to complications, Barkley said. "First, they mean that certain employees are not protected," she said. "If the intent of the bill is to protect people, why are some people more important than others?" Second, laws with exceptions are more difficult to enforce. "With a comprehensive law, everyone knows if you're indoors you can't smoke," Barkley said. "These things are very self-enforcing the more clear, concise and comprehensive they are."

Thirdly, exemptions can result in legal challenges," Barkley said, citing an example in Louisville when its smoking ordinance exempted Churchill Downs from being subject to it. "There was a lawsuit over that and the ordinance could not be put into effect while it was pending," she said.

Ultimately, both Hahn and Barkley are willing to bide their time. They both stressed the importance for local governments to continue their smoke-free efforts in the meantime. "These local officials shouldn't wait," Hahn said.

Poll shows clear support for statewide ban

A poll released Thursday by supporters of a statewide ban shows that a majority of Kentucky adults favor it, that opinions on both sides are strong, and that local communities should have the option of passing additional restrictions on smoking in public places and workplaces.

The telephone survey was taken Dec. 12-14 by Public Opinion Strategies, a well-regarded national firm that gave Kentucky Health News its questionnaire and the number of adults it called in each county. The poll asked, "Would you favor or oppose a state law in Kentucky that would prohibit smoking in most public places, including workplaces, public buildings, offices, restaurants and bars?" Then they were asked if they felt strongly about their opinion or were "just somewhat" in favor or opposed.

The results: 44 percent said they strongly favored such a law, while 15 percent said they were somewhat in favor of it, for a total of 59 percent. The opposition totaled 39 percent: 14 percent said they were somewhat opposed to the law, and the strongly opposed were 25 percent, the same percentage of adult Kentuckians who said they smoke. The strong opinions on both sides totaled 69 percent, a very high figure. The margin of error for the poll of 500 adults was plus or minus 4.38 percentage points for each figure, so a clear majority favors a statewide smoking ban.

Among smokers, 31 percent said they favored the law and 68 percent opposed it. Among the three-fourths of Kentuckians who don't smoke, the figures were virtually a mirror image: 69 percent in favor, 29 percent opposed. (The figures for smokers come from an interview by Kentucky Health News with Glen Bolger, a partner in the Arlington, Va.-based polling firm.)

Statistically, the poll found no difference among Democrats, Republicans, independents and tea-party supporters, with 55 to 60 percent identifying with each label saying they support a statewide ban.

While both leading candidates for governor, Democratic Gov. Steve Beshear and Republican state Senate President David Williams, have said they favor a statewide ban, neither has emphasized it, and there is skepticism among state legislators that it would be a deciding issue for voters. However, the poll found that 34 percent of voters said they would be "much more likely" to vote for a candidate for state office who supports the law, and 21 percent said they would be "somewhat more likely" to do so, for a total of 55 percent. On the other side, a total of 36 percent said they would be less likely to vote for a supporter of the law (20 percent much more likely and 16 percent somewhat). Only 6 percent said the candidate's position would make no difference.

The question initially described two alternative, unnamed candidates in terms of positions on the issue and asked, "For which of these candidates would you vote?" Even 31 percent of smokers said they would be more likely to vote for a candidate who supports a statewide ban.

Then the survey asked which is more important, the rights of smokers and of restaurant and bar owners, or the rights of employees and customers to breathe clean air in such establishments. (The alternatives were rotated, as were those on other questions.) A majority said employees' and customers' rights were more important, 53 percent much more so and 15 percent only somewhat. The poll did not differentiate between the rights of smokers and business owners or those of employees and customers.

Waters said, "Just because a majority of people in some poll say they want more government nanny-ism doesn't make it the right, or constitutional, action to take. The last time I checked, restaurant and bar owners' constitutionally protected private property rights are not subject to polling. In fact, the constitution exists for the express purpose of protecting those rights from some popular movement such as that being pushed by Kentucky's health nannies who want to deny Kentuckians their individual liberty to make their own decisions regarding smoking, eating and other lifestyle choices."

The main medical reason for smoking bans is research showing that second-hand smoke causes cancer and other diseases, and Kentuckians seem to accept those findings. Almost half, 48 percent, said exposure to second-hand smoke is a serious health hazard, while 28 percent said the hazard is moderate, 17 percent said it is minor, 5 percent said it is not a health hazard at all and 2 percent declined to say.

Many smokers acknowledged their risky behavior; 24 percent said second-hand smoke is a serious health hazard, while 35 percent said the hazard is moderate and 28 percent said it is minor. Only 10 percent said it is not a health hazard.

The poll found that regardless of what happens at the state level, 76 percent of Kentucky adults think local communities "should continue to have the option of passing additional restrictions on smoking in public places and workplaces." Fifty percent strongly agreed with the statement, and 26 percent agreed somewhat. Most of the 22 percent who disagreed did so strongly, again revealing the depth of feeling about the issue.

Waters said the Bluegrass Institute favors local control. "Even though we vehemently disagreed with the smoking bans implemented by Louisville, Lexington and other communities," he said, "we would be absolutely opposed to Frankfort overriding those local communities' decisions."

The poll also illustrated the precipitous decline of tobacco as a political force in Kentucky since repeal of the federal quota and price-support program in 2004. Only 6 percent of respondents said they grow tobacco or own land on which it is grown. For the poll questionnaire and results, click here.

Republican lawmaker, a nurse and former hospital boss, offers bills to help children's health, gets criticism

By Tara Kaprowy
Kentucky Health News

A Republican legislator from Northern Kentucky is proposing several bills that she says would improve children's health, defending herself from criticism by conservative bloggers who say she would extend government's boundaries too far, and picking up support from a conservative newspaper columnist.

Rep. Addia Wuchner of Florence, left, a registered nurse and former hospital administrator, wants to require 30 minutes of exercise a day in elementary schools by 2013 and have entrance forms for kindergarten and sixth-grade students include the students' body mass index, roughly a measurement of weight-to-height ratio.

Other proposals in what Wuchner calls her Kentucky Kids First package would form a childhood obesity task force; and requiring the Cabinet for Health and Family Services to create nutritional and physical activity guidelines for licensed child care centers.

“This is about our workforce, this is about (our children’s) future,” she said. “We want our children to be healthy. We want parents to have that choice.”

But Wuchner has caught flak from some Republicans, including lawyer-blogger Marcus Carey, who asked on his blog, The Bluegrass Bulletin: “Does Rep. Wuchner realize that she is violating about 15 fundamental Republican precepts against helping public schools or children in poverty, citing scientific facts, interfering with parental rights and promoting socialistic notions of healthy behavior?”

Tom Wurtz was likewise critical in a post on the Northern Kentucky Tea Party website, titled “Rep. Wuchner: Leave Our Kids’ Big Macs Alone!”

“Most legislation starts out innocently enough, but it always leads to the destruction of our freedoms,” he wrote. “The Dudley-Do-Rights always start off by just collecting data. Then they are so ‘shocked’ by the data that they feel compelled to take action to control our children. They will say they don’t want to, but they must, because they love the kids so much and they like the power and control too.”

In an interview with Kentucky Health News, Wuchner said her critics are off base.

“I don’t believe in a nanny state or a fat police and that’s not what this bill is about,” she said. “Just like we want 100 percent of our children reading by the third grade, we’re saying, by 2013, we want our children to receive moderate to vigorous movement activity or physical activity 30 minutes a day.”

As for adding the BMI measurement, Wuchner said the school forms already list height and weight, and the BMIs would provide data that could easily be compared over time and among schools. “They could pull it by district or by county and know statistically are we improving or are we getting worse,” she said. That would allow creation of child-obesity maps, like the one below for adult obesity, from http://www.kyhealthfacts.org/.

Wuchner said she has sponsored similar proposals since 2006, a year after she supported Senate Bill 172, which limited sales of soft drinks and sugary snacks in schools.

“Now there is a heightened concern about the height and breadth of government,” she said. “But public school is an institution that exists already. We’re not reaching into their homes or in their bedrooms or under their kitchen tables and telling them they have to do jumping jacks. This is taking place in the school environment.”

Wuchner's proposals are actually conservative, Louisville lawyer and Mitch McConnell biographer John David Dyche wrote in his column in The Courier-Journal on Jan. 4, the day the legislative session began.

“These measures would save the state money in the long run,” he wrote. “Yet some Northern Kentuckians who should be Wuchner’s allies are reacting with short-sighted ideological horror ... These critics evidently prefer that Kentucky continue suffering childhood obesity’s enormous economic and human consequences, rather than having state government take sensible action on an issue so squarely within its 10th Amendment sphere.”

The 10th Amendment, often cited by advocates of limited government, says that "The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people."

Wuchner cited a November 2009 Emory University study concluding that by 2018 more than half of Kentuckians will be obese. The study also indicated that, in the next 10 years, the United States is expected to spend $343 billion on health-care costs attributable to obesity if rates continue to increase at their current levels.

“For me, this is an economic thing,” she told The Kentucky Enquirer, an edition of The Cincinnati Enquirer. “It impedes the future of the state because no one is going to look at Kentucky when we have a population that is not
healthy, that is not literate and able to work.” (Read more)

Here are Wuchner's bills, as links:
BR 159, to enact 30 minutes of physical education for school children a day
BR 160, to enact inclusion of body mass indices on school physical examination forms
BR 197, relating to early education assessment and intervention
BR 310, to establish a Legislative Task Force on Childhood Obesity
BR 312, to educate parents and caregivers about pediatric abusive head trauma

Legislator wants to ban caffeinated energy drinks

Kentucky teenagers will have to be 18 in order to buy high-caffeine energy drinks if state Rep. Danny Ford, R-Mount Vernon, has his way.

The lawmaker, left, told The Associated Press he plans to have the General Assembly consider banning the sales of the drinks to anyone under 18 when it convenes today, Jan 4.

Ford's move comes after the U.S. Food and Drug Administration deemed alcoholic energy drinks an "unsafe food additive." The worry is the caffeine diminishes feelings of intoxication, increasing risks of alcohol poisoning. Ford said he feels nonalcoholic energy drinks can also be potentially risky to children's health.

Kentucky legislators have considered, but have not passed, a ban on caffeinated energy drinks. "I think if we had some of the information then that we have now that it would have passed," Ford said. The ban targets carbonated drinks with 71 milligrams of caffeine per 12-ounce serving containing taurine and glucuronolactone. (Read more)

Bill would require background checks for all nursing home staff

A bill filed Tuesday would require that all nursing home staff, not just employees in direct contact with residents, be subject to background checks.

State Sen. Tom Buford, R-Nicholasville, right, sponsored the legislation, saying the move would not cost the state any money, the Lexington Herald-Leader's Valarie Honeycutt Spears reports.

The bill would affect staff such as custodians, maintenance employees and food- service workers. Workers who has been convicted of a misdemeanor, if it is not related to abuse, neglect or exploitation of an adult, would still be eligible for hire. (Read more)